When to resort to surgery?

WHEN TO RESORT TO SURGERY?

General case

YOU ARE OBESE WITH A BMI OF 35 TO 50

The Le Goff Technique (GPSP) is aimed at all types of patients whatever their weight, or BMI, including for the morbidly obese (BMI > 50).

These patients benefit from a non-invasive surgical technique that gives the best currently known results, according to world scientific publications.

Of all the bariatric surgery techniques (band, sleeve, bypass), it is the one with the fewest pre- and (above all) post-operative complications.

Specific cases

The Le Goff Technique (GPSP) is aimed at everyone, but there are some contraindications.
Specific cases include:

  • Absolute contraindications against general anaesthesia for laparoscopic surgery
  • Very severe psychiatric disorders (unstable serious psychosis)
  • Very severe medical contraindications (extremely rare)

YOU ARE OBESE WITH A BMI OF 30 TO 35

In this case, we prefer to place an intra-gastric balloon, rather than use the Le Goff Technique (GPSP) .

Intragastric balloons are used for overweight patients with a BMI < 35 with only 10 to 20 kg to lose. The aim of the balloon is to replace stomach volume in order to reduce the sensation of hunger, for 6 months. This will lead to a considerable reduction in food intake.

Aims of the intragastric balloon

Feeling of fullness

Considerable reduction in hunger

Maximum weight loss of 10 to 20 kg over the 6 months the patients keep the balloon

Inserting the balloon

Out-patient operation under endoscopic control with anaesthesia

Balloon inflated with blue saline up to 700 cm3

Additional measures

Antacids prescribed for 6 months post-operative to treat reflux

Multidisciplinary treatment (psychological, nutritional and sports) as provided in the Le Goff Technique treatment contract

Removal of the balloon

Removal of the balloon after 6 months endoscopically under anaesthetic

Multidisciplinary treatment enables the patient to conserve the weight loss after the balloon is removed

YOU ARE OBESE WITH A BMI OF 30 TO 35

YOU ARE SUPER-OBESE WITH A BMI GREATER THAN 50

The Le Goff Technique (GPSP) is aimed at the super-obese with post-operative results on weight loss equivalent to BMI < 50.

The results are equivalent both in terms of percentage of excess weight loss and in terms of the low rate of complications.

The Le Goff Technique (GPSP) is well indicated as it can be performed whatever the BMI. The results are just as good as when the BMI < 50 as this score just means that:

  • Their history of morbid obesity is longer in time
  • The surgical treatment was later
  • Their personal history is more complicated

GASTRO-OESOPHAGEAL REFLUX

Clinical, endoscopic or radiological reflux with hiatus hernia (search for oesophagitis, search for hiatus hernia) poses no contraindication for the Le Goff Technique (GPSP) .

The reflux is cured at the same time as the Le Goff Technique (GPSP) .

Anti-reflux surgery:

  • Dissection of the hiatal orifice + closing of the diaphragm pillars with 1 to 3 individual stitches
  • Lengthening of the abdominal oesophagus
  • Band attachment gastro-oesophageal anti-reflux valve

The reflux is corrected by the cure and this correction is enhanced by weight loss.

FERTILITY AND PREGNANCY

The weight loss generated by the Le Goff Technique (GPSP) enhances fertility and thus secondary pregnancies.
There are numerous “band babies” (pregnancies due to the Le Goff Technique (GPSP)).
There are fewer complications in pregnancy due to the weight loss generated by the Le Goff Technique (GPSP).
Deficiencies are almost inexistent in the Le Goff Technique (GPSP).
In the event of 1st trimester syndrome with significant vomiting, the band can be adjusted by deflating it.