I run a clinic in the United States

Chapter 51 Laparoscopic sleeve gastrectomy

With a sad face, Felipe asked the core question that he was most concerned about and had troubled him for many years.

Because Zhou Qiao also told him just now that diabetes is mostly caused by obesity. If obesity is not resolved for a day, it is estimated that diabetes will be difficult to completely control.

Old mother Taylor also looked over with burning eyes.

Diabetes was unplanned, weight loss was the purpose of their trip.

Zhou Qiao pondered for a while. In fact, he has been thinking about this question since he saw the patient yesterday. Considering the patient's weight, obesity history, and other weight loss methods are probably not very effective. Hope to lose weight.

What medicated diet, diet, and exercise are almost impossible!
Moreover, the other party's physical condition is very poor and he cannot do strenuous exercise. If he really wants to do those strenuous exercises, if he does not lose weight, he may die!
The other party's obesity is life-threatening!
It is possible to sleep, it is possible to walk, it is possible to fall and not get up, and it is a bit of luck to be able to survive till now.

Therefore, Zhou Qiao solemnly recommended this method.

After cutting the stomach, it should be feasible to supplement it with medicinal diet!
As for gastric resection surgery, although he has never done it, doesn’t he still have medical wisdom?
Although the poor medical mystical points are not many, they still have to be spent!
"Gastrotomy surgery?" Felipe and Taylor were both a little nervous. This was going to be an operation!
"Yes, this operation has many benefits, especially for Felipe's condition..."

Zhou Qiao began to explain the relevant knowledge, describe its advantages, and its application scope.

As early as 1966, Edward Manson of the United States carried out this kind of surgery for some obese patients, including sleeve gastrectomy, gastric bypass surgery, etc. The principle is to achieve weight loss by controlling the patient's gastric capacity.

Among them, a vertical sleeve gastrectomy is performed by removing most of the outside of the stomach, creating a narrow gastric sleeve.

Gastric bypass surgery divides the stomach into two parts, one of which is directly connected to the small intestine, bypassing the remaining stomach.

In particular, the following groups of people are particularly applicable:

One is severely obese individuals: BMI greater than 40 or BMI greater than 35 and associated with related diseases (such as diabetes, hypertension).

The second is individuals who have failed to control their weight through non-surgical methods: Gastric surgery is a very good option for those who have failed to control their weight after trying various non-surgical weight loss methods.

The third is the existence of obesity-related diseases: gastrectomy surgery can be an effective way to improve many obesity-related health problems, such as type II diabetes, hypertension, and sleep apnea.

Almost all of these, Felipe was said!

Zhou Qiao told them that there are many treatments for diabetes, including changes in eating habits, exercise, drugs, insulin therapy, metabolic surgery, etc., but gastric resection, especially "sleeve gastric surgery", is also one of them.

Moreover, this operation is currently known as one of the methods that can effectively cure type II diabetes, and it has been written into the guidelines for the treatment of diabetes.

For simple obesity patients with BMI ≥ 37.5, active surgery is recommended;
32.5≤BMI<37.5, surgery is recommended;
27.5≤BMI<32.5, difficult to control with lifestyle changes and medical treatment, and meeting at least 2 components of metabolic syndrome, or with comorbidities, surgery may be considered after comprehensive evaluation.

……

Zhou Qiao's talk lasted for a full two hours!

He made a comprehensive assessment of Felipe's condition through the physical examination report, using data to speak, and then introduced the specific process of the operation in detail, and analyzed the various pros and cons after the operation.

Since this surgery is going to be done, he gave the exchange order when he was speaking, and after spending 15 medical mystery points, he will exchange for the master-level gastrectomy surgery!

Then, it became more eloquent and eloquent.

Taylor listened, listened, and couldn't help showing a smile of relief and expectation.

She felt that Zhou Qiao's level was really good, although she couldn't understand most of them!

However, with her more than 70 years of life experience, she felt the utmost care and rigor from Zhou Qiao. It is reassuring that such a doctor performs surgery!
And Zhou Qiao's age disadvantage can be ignored with such a professional and meticulous expression.

Although Felipe is 42 years old, he is still a baby boy. His mother nodded, and he nodded accordingly.

In fact, another very important point that impressed Taylor was that among obese people, patients who did not undergo surgery had an 8-fold increased risk of death compared with patients who underwent bariatric surgery; while patients who underwent bariatric and metabolic surgery were less likely to die. For those who underwent surgery, the relative risk of death was significantly reduced by 89%.

The risk of this operation is relatively low.

Taylor felt that surgery was imminent, otherwise it would really be life-threatening!

What would she do if her son died?
After the patient and family agreed, Zhou Qiao asked Ava to call Community Medical and make an appointment with the other party's operating room and anesthesia team.

Because this operation is laparoscopic, general anesthesia is required.

Usually during laparoscopic surgery, carbon dioxide is injected into the patient's abdominal cavity to form pneumoperitoneum, which facilitates the operation of various medical devices.At the same time, when the abdomen bulges, it will affect the patient's breathing and require ventilator assistance; in addition, general anesthesia is safer for the patient and has a better experience. When "asleep", there will be no tension, fear, anxiety, etc. .

Elderly patients can better detect hemodynamics under general anesthesia, detect abnormalities and deal with them in time.

They were very lucky. The operation was scheduled for one o'clock in the afternoon the next day. Zhou Qiao suggested that Felipe should stay in the ward of the Iris Clinic tonight to improve some preoperative preparations and monitoring.

Taylor didn't go home either, she lived in another bed in the same ward.

At night, when the mother and son fell asleep, they were inevitably uneasy, but at the same time they were also endlessly longing for it.

Since there were patients in the clinic, Zhou Qiao and Elena restrained themselves a little.

After 15 points were deducted from his Yixuan point account, and the account has been credited again in the past few days, the account balance now has 154 points.

He felt that if he was free, he should go find Roya, because if he exchanged the Qiang Kidney Capsule, Elena would definitely not be able to resist his attack.

If you give it to Elena too...

It's not that he didn't think about it, but it would be equivalent to strengthening both sides at the same time, and it wouldn't help to create medical mysteries.

The reason why I redeemed it for the master-level one was because I wanted to use it sparingly.

The other thing is, for this kind of surgery, a master-level one is enough!

It would be too wasteful to use perfect.

The master level is not weaker than that of senior experts such as Mayo Clinic and University of California Medical Center.

Naturally, they are by no means inferior to experts from domestic Union Medical College, West China, Zhongshan, Ruijin, Tongji, Xiangya and other hospitals!

Even better than that!
After recuperating all night, Zhou Qiao asked Ava to call one by one the next morning and change the time of the clients who had originally made appointments between [-] and [-] pm, explaining to them that it was because of emergency surgery.

Fortunately, most customers understand and say they will come later or make an appointment at another time.

After lunch, Zhou Qiao hung a sign outside the clinic: "Dr. Zhou is performing surgery in a community hospital and is temporarily closed."

Then, they took Elena, Ava, and Taylor, Felipe, mother and son to the community hospital.

Since the distance was relatively close, Felipe insisted on walking over.However, when he comes back, he will probably have to call an ambulance or just be pushed back on a hospital bed.

When they arrived at the community hospital and entered the operating room, they were caught by a short, fat, bald old man.

The other person has gray hair on his temples, a hooked nose, and deep eyes. He is Kainz, the owner of the Red-billed Gull Clinic.

Kainz was talking with a staff member of the community hospital, and he couldn't help but be taken aback when he saw this scene: "What the hell? The Iris Clinic actually came to perform surgery? A young doctor who just graduated, has this level?"

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(End of this chapter)