Bariatric Surgery

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# Stomach reduction

# Finally lose weight

# Life 2.0

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Bariatric surgery & metabolic surgery (also known as bariatric surgery) include various surgical procedures such as sleeve surgery, in which around 2/3 of the stomach is surgically removed, as well as various gastric bypass operations. If you would like to submit an application for reimbursement of costs for an operation to your health insurance company, then you will need, among other things, proof of a nutritional consultation carried out over a period of 6 months with 1 meeting per month.

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Common surgical methods :

• Omega loop gastric bypass

• Sleeve

• Proximal Roux-Y gastric bypass

• Biliopancreatic Diversion

• Biliopancreatic Diversion with Duodenal Switch

• ReDoos - 2nd operation after a sleeve stomach, for example

I can do that for you:

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Nutritional advice

Medically prescribed (for 6 months, with 1 meeting per month), download your doctor's prescription & bring it with you to the first appointment: to the form

Consulting content:

• Conventional weight loss taking into account your individual situation & accompanying illnesses & advice on all areas - nutritional psychological advice

• Reduced energy diet

• Hypnosis enjoyment training  & virtual stomach reduction

• Nutritional preparation with a view to your planned operation:

• Nutrition plan 10-14 days before surgery

• Post-op nutrition (1st day to 5 weeks after surgery)

• including daily and weekly plans with recipes and preparation instructions

• healthy permanent nutrition according to Op

• suitable supplements (vitamins, minerals, proteins (protein))

• nutritional aspects

• Daily plans

• additional Information

• Nutritional follow-up care after the operation

on all content during the initial meeting and follow-up advice

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Evidence for your health insurance company

• Certificate for the nutritional therapy consultation carried out to apply for reimbursement of costs for an operation

• If you wish, I will create a 2-page report for you after the consultation about the content and the course of the consultation

To the course of a nutritional consultation

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The following clinics offer bariatric surgery in the Schorndorf area:

Extract from some clinics, not complete (as of 2021).

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1. Bad Cannstatt Hospital

2. Esslingen Clinic

3. Obesity Center Stuttgart - Karl-Olga Hospital

4. Marienhospital Stuttgart

5. Sana Klinik Bethesda Stuttgart

6. DIAK Clinic Schwäbisch Hall

Many clinics offer bariatric surgery. There is the possibility to be certified / recertified as a clinic & z. B. to be considered a competence center / reference center or even a center of excellence. In addition, there are of course many other clinics that are not certified, but still offer and perform bariatric surgery.

Overview of all certified clinics - obesity centers in Germany (DGAV)

88 certified centers, last updated on 02/05/2021

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Here you can find out more about the surgical interventions:

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Guidelines on Obesity & Metabolic Diseases Surgery

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The requirements for bariatric surgery

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There are 2 classifications of bariatric surgery:

Bariatric surgery aims at sustainable weight reduction in order to avoid secondary diseases and to improve the quality of life. Even with type 2 diabetes mellitus, weight reduction is the focus.

Metabolic surgery is primarily aimed at improving blood sugar levels in type 2 diabetes mellitus.

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Indications for obesity surgery

1. Body mass index (BMI)> 40 kg / m² without concomitant diseases, after conservative therapy has been exhausted

2. BMI > 35 kg / m² with one or more obesity-associated concomitant diseases such as diabetes mellitus, sleep apnea, arterial hypertension, joint problems, stressed psyche, fat metabolism diseases etc. after exhaustion of conservative therapy

3. in the sense of a primary indication without prior therapeutic attempt

• in patients with a BMI > 50 kg / m²

• in patients for whom the multidisciplinary team did not consider a conservative attempt at therapy to be promising or hopeless.

• in patients with particular severity of concomitant and secondary illnesses that do not allow the postponement of an operative intervention.

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Indications for metabolic intervention

With a BMI <40 kg / m² , a diabetologist should be included in the multidisciplinary treatment team and the procedure should only be carried out at a center with special expertise (certified obesity centers).

In patients with coexisting type 2 diabetes mellitus:

1. From a BMI > 40 kg / m², metabolic surgery should be recommended as a possible therapy option.

2 . to a BMI> 35 kg / m² and <40 kg / m² metabolic surgery be recommended as a possible treatment option if the diabetes-specific individual targets are in accordance not reached the National Disease Management Guideline.

3. should be at one  BMI > 30 & <35 kg / m², metabolic surgery should be considered if the diabetes-specific individual target values according to the National Health Care Guideline are not achieved.

4. with a BMI <30 kg / m² only in the context of scientific studies

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Contraindications

• Conservative methods not exhausted with the appropriate BMI, at least 6 months (nutritional advice, exercise training, behavioral therapy)

• Psychosis, depression (excluding reactive depression due to weight).

• Symptoms of addiction (because of the possible danger of shifting addiction; no alcohol, tablet or drug addiction).

• No existing or immediately planned pregnancy, the desire to have children is not a contraindication

• even older than 65 is not a contraindication.

• The presence of a chron. Inflammatory bowel disease is not a contraindication.

Source: S - 3 Guideline on Surgical Obesity, as of February 2021

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Classification of certified obesity clinics: Requirements for certification

Source: https://adipositas-kliniken.com/zertifikation/ (as of: 26.2.21)

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During the certification process, the DGAV assesses the personnel and material equipment, clinical experience, possible training authorizations and scientific activities. It distinguishes between three different levels of competence:

• Competence center

• Reference center

• Center of Excellence

If a clinic has the equipment and experience that, according to the certification requirements, ensures good quality treatment, it receives the status of a competence center.

For certification as a reference center, in addition to the conditions for the competence center on obesity, further training authorizations as well as scientific work must be proven.

Clinics that have been awarded the Center of Excellence certificate are leading institutions with the greatest clinical experience, the highest level of technical and human resources and scientific work in the specialist areas. In the form of certificates, it must be proven that at least two further training measures have already been successfully carried out during the last three years before the application for certification.

Additional requirements

For reference centers and centers of excellence, there is also the requirement to offer advanced training courses aimed at obesity in a certain number for third parties. These advanced training measures must also be certified by the Medical Association. In addition, you must also offer observation sessions, the participants of which are officially recorded and verified.

Certified institutions of all levels are required to take part in clinical studies on the subject of obesity treatment. However, an obligation only applies to the centers of excellence. They must take part in at least one registered study of a specified level within 24 months, with a minimum of 20 patients.

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Possible recipients of the certification

Certificates can be obtained from individual surgical departments, a network of different surgical departments or contractually bound cooperations. More details and requirements  for the individual areas are specified in the certification regulations.

Certification only takes place upon request. Institutions that want to obtain the certificate can - provided the basic requirements are met - submit an official application. Initial certification is always granted for a period of three years.

Certified clinics or facilities receive a certificate and a corresponding signet, which can be used in letterheads etc. to make the certification recognizable to third parties.

Continuation of the certification

In order to retain the certification after the first three years, the institutions must present comprehensive and concrete data that prove the results and the quality of their work during this time. If individual patients have not approved the recording of their data, these must also be listed.

Conclusion

This is only a superficial representation of the requirements of the certification. In all areas, the individual requirements in the certification regulations are set out in much greater detail. The specifications are extensive and are explicitly checked. For patients, this means that with a facility certified in this way, you can always assume a high and well-tested quality level.