Experience and outcomes

1. Pioneers in Spain in the implementation of multidisciplinary teams of specialists to support obese patients.

What´s its function?:

Thoroughly evaluate the patient before being operated, in order to know as accurately as possible, which is the most appropriate operation for him (restrictive pure or restrictive more malabsorptive).

Provide essential support to patients who have already undergone surgery, in order to facilitate changes in dietary habits and lifestyle.

What´s their justification?

• Patients with morbid obesity cannot change their habits overnight after an obesity operation.
• The support of Dietitians-Nutritionists, Clinical Psychologists, Bariatric Surgeons and a physical training program is fundamental to achieve good results after an obesity operation.
• We implemented the Multidisciplinary Obesity Team in 2003, applying a methodology learned from European and American teams, which we have also been improving and adapting to our environment.
• Today, we carry out a complete training programme for our patients, which includes individual consultations with the aforementioned specialists, as well as practical psychological and dietetic workshops, physical training programmes, and a library with recommended bibliography on the three basic aspects: dietetic, psychological and physical training.
• We participate in Courses and Scientific Congresses of Obesity, exposing our experience and results in Multidisciplinary Team of support to Obesity.

2. Our experience with the Intragastric Balloon:

The Intragastric Balloon is not a definitive treatment and therefore the patient can recover the lost weight, at the same time of the withdrawal of the same one.

We have largely solved this problem. We know that the patient does not regain weight or does so late (checks up to 2 years), when:

• During the treatment with Intragastric Balloon, is able to make a real change of mentality, in its “relationship with food.
• It changes their dietary habits and lifestyle, according to the recommendations of the team.
• The patient is able to achieve a satisfactory final weight that meets his expectations when the Intragastric Balloon is removed.
• When these three points are met, the patient is able to “take the reins of weight”, with enthusiasm and conviction, maintaining long-term results.

We have incorporated the latest advances in the treatment of the intragastric balloon:

• Ingestible and excretable balloon or also called Balloon Capsule: Allows a simple implantation, without the need for endoscopies or sedation. The patient swallows the capsule, with radiological control, and once it is verified that it is in the stomach, it is filled with physiological serum through a tube that remains in the hand of the implanting physician, and that is then removed by simple traction. The balloon is spontaneously excreted in faeces at 16-17 weeks. Specific training is necessary for the physician to implant it.
• Endoscopic balloon of 1 year: It is the same balloon of 6 months, but it has been designed with a more resistant silicone that allows to guarantee a durability of one year in the stomach. Even so, we warn patients that the stomach is not always able to “endure” a year the over exertion of a gastric balloon. In those cases, it must be removed before 12 months of age.
• Adjustable balloon of 1 year: Same as the previous one, but it can be adjusted to the months of its implantation, because the patient has no longer a sense of satiety, and fill it with more physiological serum, up to 700cc in total.

We have an experience of more than 16 years and 500 balloons with our patients, with excellent results, and without relevant complications. All this thanks to a good control during all the time that the patient wears the implanted balloon, and to a good multidisciplinary work with the patient.

3. Our experience in Laparascopic Surgery

• Dr.Jose Vte. Ferrer, chief surgeon and coordinator of the Clinica Obesitas team, has an accumulated experience of more than 500 interventions by laparoscopic surgery, of the more than 150 have been in morbidly obese patients.
• He was the founder and coordinator of the School of Laparoscopic Surgery of the Biomedical Research Unit, Hospital de Navarra, between 1995 and 1998.
• He has attended multiple national and international courses on laparoscopic surgery, and has learned Laparoscopic Surgery of Obesity with the best specialists in Spain and Europe: Dr. Chevalier, Dr. Chiche, Dr. Weinner, Dr. Hernández and Dr. Baltasar, each specializing in a different type of obesity operation.

4. Our experience in Gastric Band (BGA) By Laparocopy

• Dr. Jose Vte. Ferrer, performed the first intervention of BGA by laparoscopy in 2003 and to date has operated on more than 130 patients.
• A good surgical training, a meticulous method, a good technical equipment, and a well cohesive and well rolled surgical and anaesthetic team, has allowed us not to have any outstanding complication until now.
  We have implanted modifications in the surgical technique, learned from international experts, which has allowed us to reduce the frequency of slips and erosions (important complications of BGA) to 0.7%. Other groups publish a frequency between 5-15%). Our rate of minor complications is 2-3% and mortality is 0%.

This surgiccal technique discontinued in 2013, due to more developed and effective tecniques, who also don´t have the inconvenient of having to leave a foreign body in the organism.

Bad use of the Gastric Band

• The gastric band continues to be a safe treatment, and patients who wear a gastric band should be completely calm and confident with it. Simply check every 2 or 3 years with your specialist.
• The indication of the gastric band and its implantation without the necessary experience or knowledge can lead to different types of problems.
• Due to our long experience in gastric banding, we have specialized in evaluating and solving problems related to misuse of the gastric band.
• In this sense, the most frequent practice is to remove the gastric band by laparoscopy and in the same surgical procedure, perform another anti-obesity surgical technique, the most frequent, Gastric Tube or Sleeve.

5. Our experience in the Laparoscopic Gastric Tube or Sleeve

• Pioneers in Spain in the implantation of the tecnique of Gastric Tube(GT), as a definitive restrictive technique for morbid obesity.
• The GT is a new technique, which for 6 years has been used as the first surgical intervention in superobese patients, in order to produce a first weight loss and 1-2 years to perform a definitive intervention (usually Gastric By-Pass). The finding has been that many of the patients lost much more weight than expected and also did not regain it. Finally, many patients did not need a second operation.
• Since 2010, TG has been used as a definitive intervention for obesity worldwide, to the point that it has been the first surgical technique that has surpassed in number of cases the classic Gastric Bypass.
• Dr. Jose Vte. Ferrer, after learning the technical details with the best specialists, began to apply the GT in February 2007. It is proposed as a restrictive method, similar to BGA although without having to wear a prosthesis for life, and as an alternative method to By-Pass when the patient’s characteristics allow it.
• Weight loss results are excellent. Patients are only admitted 1 day, and can make normal life in 7 days.
• Currently it is one of the interventions that arouses more interest among our patients.
• With more than 600 patients, we are one of the most experienced teams in Spain in this surgical technique.

6. Our experience in the Gastric Bypass by Laparoscopy

• The intervention of Gastric Bypass, is the “gold of standard” of the obesity surgery. It has a history of 25 years and is the best known and proven tecnique.
• Although its a tecnique with more risk by anassymosis or joints that are performed between the stomach and small intestine, nevertheless its development by laparoscopic surgery has greatly reduced complications.
• After an important formative effort during the last 2 years, Dr. Jose Vte. Ferrer has implanted the Gastric By-Pass by laparoscopy in March 2007. In addition, as a support for this operation, we have incorporated to the surgical team a new specialist surgeon with excellent training in laparoscopic obesity surgery.
• The results are excellent, proper of this contrasted technique. Patients are only hospitalized 1 day, and can make normal life within 7 days. We have not had any major or minor complications.
• The weight loss is excellent, as we already expected with this intervention.

We have incorporated the latest advances in Gastric Bypass

SADIS type bypass: You can read more details in the treatment tab of this website, it is a pioneering technique and very effective. Due to its greater potential, it is recommended for patients with diabetes mellitus who require insulin, and for patients with BMI greater than 50 (double morbid obesity).

It is technically complex and should only be performed by really highly qualified teams.
We were trained in 2014 with Dr. Andres Sanchez-Pernaute, the driving force behind this technique in Spain, and Prof. Torres, from the Hospital Clínico in Madrid, with excellent results and no outstanding complications since then.

6. Other methods

We have incorporated other vanguardist procedures such as the Apollo Method and Laparoscopic Gastric Plication. Both techniques have been protocolized and implemented for our patients, after a thorough training with the best specialists and hospitals in the world.
You can read more details of these techniques in the treatment section.