Obesity and Metabolism Surgery (Center of Excellence)

Obesity is considered morbid when the Body Mass Index (BMI) is 40 or higher, or 35 or higher in the presence of concomitant diseases resulting from obesity. Patients with a BMI over 50 need a more aggressive therapeutic approach.

Criteria for surgery also include, among others, repeated unsuccessful attempts to lose weight with diet for at least two years and an acceptable surgical risk.

Weight loss surgery includes restrictive, malabsorptive and mixed-type procedures, as well as procedures that modify gastric motility. The surgical team of Dr. Konstantinidis performs the full range of metabolic surgery with the da Vinci Xi robotic system at Athens Medical Center, Maroussi, such as:

• Gastric sleeve (sleeve gastrectomy): a restrictive operation in which part of the stomach is removed, after which the stomach looks like a sleeve. The removed part produces ghrelin, the hormone responsible for hunger.
• Gastric bypass: a small pouch is created in the upper part of the stomach and a small diversion of the intestine is made. The procedure takes 2 to 4 hours on average, with an average hospital stay of 4 to 5 days, and can lead to a loss of 65-85% of excess weight.

Metabolic surgery offers hope not only for significant and lasting weight loss but also for treating conditions that result from obesity, such as type 2 diabetes, hypertension and coronary heart disease. Gastric bypass can lead to improvement or complete remission of concomitant diseases such as hypertension, type 2 diabetes and sleep apnea syndrome.

Gastric band removal is indicated when weight loss is not adequate or when problems appear, such as band erosion, infection or slippage, symptoms of band intolerance, difficulty swallowing or gastroesophageal reflux. The band is removed laparoscopically or robotically, and patients may be discharged even on the same day.

Gastric plication is a laparoscopic procedure in which the stomach is folded and sutured. If weight loss is not as desired or there are complications, a gastric plication reversal can be performed, possibly with revision into another procedure to treat obesity.