Sleeve Gastrectomy against obesity
More than half of all Germans are affected by obesity. Some of them are so strong that only an operative stomach reduction is possible. Due to numerous sequelae, the World Health Organization now classifies obesity as an illness. Last chance: a sleeve gastrectomy operation.
Christian Kröber has a full life. The 45-year-old loves his garden, is up and running and his two dogs keep him busy. As a caregiver for disabled children, he often goes for walks in the woods or in the swimming pool. But Christian Kröger does not feel well in his skin. With a BMI (Body Mass Index) of over 40 and 140 kilograms of body weight, he is severely limited in his activities. Because of the strong overweight, he also suffers from hypertension and has a disc disease. His biggest wish is to be able to go by bike or to tie up his shoes. As a child and a young man, the trained baker was very thin, but since he was 30 years old, he grew fatter. Neither diets nor nutritional advice helped. He lost five kilos, he had twice as much on his hips a little later. In 2017, Christian Kröber then applied for the reimbursement for a gastric reduction with a sleeve gastrectomy operation at his health insurance and a small fight for approval began. Despite psychological report, the motivation to sports and a change in diet, he received several rejections. At the end of 2018 he got the hoped-for approval and was able to undergo surgery in February of this year by Professor Frank Benedix at the University Hospital in Magdeburg.
An operation for gastric reduction is only possible if the applicant reveals his absolute willingness for a positive change in his habits and has at least two failed diets or cures behind him. According to the Federal Social Court, the cost assumption of an obesity operation by the statutory health insurance funds is only as an "ultima ratio", so if nothing else helps. Mainly because of the high follow-up costs, the health insurance companies hesitate in granting the costs. In addition, BMI must be above 40 (Grade 3 obesity) or between 35 and 40 (Grade 2 obesity) with additional conditions such as diabetes, heart disease or sleep apnea. A pregnancy or a metabolic disease must not be present. The application for reimbursement by the statutory health insurance funds must be accompanied by a medical certificate and various documents. Including certificates of participation in weight loss programs and sports courses as well as a food diary. To show serious readiness, a letter of motivation must not be missing. An operation should always be the last step!
If the criteria for obesity surgery are met, various surgical procedures are available. The gastric band, the stomach and the gastric bypass are most commonly used. In the peritoneal surgery, about three-fourths of the stomach are surgically separated, reducing the capacity of 1.5 liters to 50 to 150 milliliters. The shape of the stomach now reminds of a tube. In addition, hormone-producing cells in the stomach are removed. The hormonal changes curb the appetite and have a favorable effect on diabetes. The average weight reduction of the overweight is 50 to 60 percent. Disadvantages can be complications with leaky surgical sutures, the formation of gallstones due to too rapid weight loss and a renewed weight gain. A stomach can not be undone!
When deciding for or against sleeve gastrectomy, it is important to carefully weigh the pros and cons of surgery. It was the same with Yvonne Stadtmüller. 1.5 years ago, Professor Benedix performed a perineum surgery on the today 34-year-old. Before the procedure, she weighed 160 kilograms at a BMI of 60. She had high blood pressure, poor blood levels, and symptoms of a heart attack. So her last chance was seen in the operation. Although she survived this well, she had to be revived after the procedure. At her high body weight, the anesthesia could not be properly dosed. Yvonne Stadtmüller says: "I died for my new life." She was not allowed to eat for the first few days after the procedure. She swallowed too much air while drinking, that stretched her stomach and she was in pain. A two-week soup phase followed. For this purpose, the soup was frozen in preparation for ice cubes. Per meal Yvonne Stadtmüller managed only three thawed cubes. Then came a two-week porridge phase before finally eating half a slice of toast.
But the pounds tumbled and that was a positive vote. Yvonne Stadtmüller had to learn what she can tolerate and how much she can eat. Above all, protein is on the menu. Today, the trained automotive mechatronics technician weighs 97 kilograms and is again up and running and active. She wants to lose another 20 kilograms later this year.