For an interdisciplinary treatment of our patients before, during and after surgery, we founded the "Center for Obesity and Metabolic Surgery".
The center is a certified competence center for bariatric surgery and works in an interdisciplinary manner with the Department of Endocrinology and the Department of Psychosomatic Medicine. All therapeutic decisions are made in a team. The required follow-up after obesity surgery is also provided through the interdisciplinary cooperation of all participating clinics.
At our center we perform the following interventions:
These websites are aimed at all those who want to do something about their overweight and are interested in a conservative therapy or surgery. We want to inform about the disease obesity and possible therapies. We hope that we can answer you a few questions, and if you have further questions, the staff of our team from the Surgical Clinic, the Medical Clinic for Endocrinology and the Medical Clinic with a focus on Psychosomatics are of course glad to help you disposal.
The Charité has set itself the task of offering the best possible treatment to the increasing number of obese patients. This therapy offer includes the knowledge and the treatment options of different departments. Doctors of endocrinology, psychosomatics and the "Center for Obesity and Metabolic Surgery" would like to offer you the currently best possible therapy.
In addition to behavioral therapy, drug therapy, nutritional and exercise therapy, bariatric surgery (bariatric therapy) is another way to reduce weight permanently.
The weight reduction caused by the operations and also the improved metabolic situation and improved quality of life require intensive aftercare. This aftercare of operated patients is the best prevention in the fight against a new weight gain.
Obesity may be caused by increased food intake due to inadequate physical activity (primary obesity), but may also be due to physical illnesses (secondary obesity). The primary form often also has a hereditary component. Being overweight increases the risk of certain diseases, including high blood pressure, heart attack and other heart problems, as well as diabetes mellitus, thus reducing the person's life expectancy. In addition, gallstones, impairments of the musculoskeletal system (such as the joints) and, not least, mental health problems can result.
Depending on their severity, overweight people have problems with their physical performance, because circulation and respiration are quickly overloaded. Furthermore, it comes to complaints, especially in the joints and skin problems due to strong wrinkling.
The diagnosis is usually already done by the sight of man. A weight measurement is performed and the body mass index (BMI) is determined. Furthermore, an examination for secondary diseases of the overweight can be carried out.
Obesity caused by underlying diseases such as Cushing's syndrome (increased cortisol in the body) or under-functioning of the thyroid gland must be distinguished from the more common form of civilization caused by lack of exercise and excessive energy intake.
First of all, measures such as dieting and exercise must be tried to lower body weight. Psychological support can also be useful.
For gastric banding surgery to be performed, there must be medical reasons and failure of conventional therapy. The procedure is to separate a so-called pre-stomach (pouch) from the rest of the stomach with only a close connection. The food gets slowly into the main part of the stomach. This greatly reduces the amount of food that can be eaten at any given time. The patient feels less hungry. For the procedure a general anesthetic is made.
In addition to the traditional abdominal incision (laparotomy) is now more often a laparoscopy performed. In this case, an optical device (laparoscope) with a small video camera is inserted via a short incision on the belly button. To expand the abdominal arch and improve visibility, CO2 gas is injected. Required instruments are introduced via further incisions in the abdomen. On a monitor, the surgeon sees the operating area in real time.
There are several ways to perform a stomach operation for the purpose of weight loss.
Often, an adjustable gastric band is wrapped around the upper area of the stomach to functionally separate a small forestomach leaving a tight one to two centimeter diameter connection. The band is about an inch wide and made of silicone. It can be filled with water via a reservoir (port) to increase the effectiveness of losing weight. The port, which is connected by a tube with the gastric band, is usually placed under the abdominal skin, so that it can be filled by simple injection. This usually happens under X-ray control.
Another option is the vertical gastroplasty of Mason. Here, a forestomach is separated from the rest of the stomach with brackets, leaving a tight connection. This is stabilized by introducing a plastic net or a silicone ring. The change is permanent. A reservoir can then also be used to adjust the diameter of the connection. To measure the volume of the forestomach, a special measuring device is pushed over the esophagus into the upper part of the stomach.
In case of complications or certain circumstances, it is sometimes necessary to change the method of operation, for example, from a laparoscopy to an abdominal incision.
If necessary, medications that inhibit blood clotting must be discontinued in consultation with the doctor. These include Aspirin® and Marcumar®.
It is important to adhere to the necessary diet as otherwise dangerous conditions may occur. A care by diet advice may be useful, even a psychological support can positively influence the course. The food should be chewed well and only small amounts should be consumed. It should only be drunk between meals. Certain medicines may only be taken in consultation with the doctor so that there is no additional burden on the stomach. For the first six weeks, heavy objects should not be lifted or carried to prevent the scar from being strained. The regular follow-up checks must be carried out.