Skip to main content
SpringerLink
Log in

Adipositaschirurgie: Indikation, Therapieverfahren und Nachsorge

Surgery for obesity: indications, therapy procedure and aftercare

  • Schwerpunkt
  • Published:
Der Gastroenterologe Aims and scope

Zusammenfassung

Unter „Adipositaschirurgie“ versteht man operative Maßnahmen, die darauf gerichtet sind, die Erkrankungsursache oder die Folgen der krankhaften Fettleibigkeit zu behandeln. Die Adipositaschirurgie ist symptomorientiert und kann eine Hilfestellung für die Lebensführung bieten. Oft bedarf es der operativen Einschränkung der resorptiven Kapazitäten des Gastrointestinaltraktes, um eine Gewichtsreduktion überhaupt erst einleiten zu können. Die mit der veränderten Nahrungsresorption und der daraus resultierenden Gewichtsreduktion verbundenen Veränderungen können zu lang anhaltender Gewichtsstabilisierung führen und zu einer Verbesserung (ggf. sogar Beseitigung) adipositasassoziierter Erkrankungserscheinungen. Neben den intestinalen Eingriffen zur Veränderung der Resorptionskapazitäten haben sich plastisch-chirurgische Methoden zur Körperkonturierung („body contouring“) etabliert. Gerade diese Methoden der postbariatrischen Verbesserung der Körperform tragen zu weiterer Stabilisierung der Gewichtsreduktion bei, indem die Patienten nach plastisch-ästhetischen Eingriffen ein neues und verbessertes Körperbild bei sich wahrzunehmen, für das es sich lohnt, den beschrittenen Weg beizubehalten.

Abstract

The term obesity surgery covers operative measures, which are aimed at treating the origin of the disease or the sequelae of morbid obesity. Obesity surgery is symptom-oriented and can offer help for the lifestyle. It is often necessary to surgically limit the resorptive capacity of the gastro-intestinal tract in order to even start to initiate weight reduction. The changes connected with the altered nutritional intake and the resulting weight loss can lead to a persistent weight stabilization and to an improvement (sometimes even removal) of obesity-associated symptoms. In addition to intestinal surgery to alter the resorption capacity, plastic surgery for body contouring has also become established. It is exactly these methods of postbariatric improvement of body shape which assist the further stabilization of weight reduction in that as a result of cosmetic surgery patients become aware of a new and improved body which encourages and motivates them to continue on this route.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2
Abb. 3
Abb. 4
Abb. 5

Literatur

  1. Acarturk TD, Wachtman G, Heil D et al. (2004) Panniculectomy as an adjuvant to bariatric surgery. Ann Plast Surg 53: 360–366

    Article  PubMed  Google Scholar 

  2. Arcila D, Velázquez D, Gamino R et al. (2002) Quality of life in bariatric surgery. Obes Surg 12: 661–665

    Article  PubMed  Google Scholar 

  3. Andersen T, Backer OG, Stokholm KH, Quaade F (1984) Randomized trial of diet and gastroplasty compared with diet alone in morbid obesity. N Engl J Med 310: 352–356

    PubMed  CAS  Google Scholar 

  4. Belachew M, Belva PH, Desaive C (2002) Long-term results of laparoscopic adjustable gastric banding fort he treatment of morbid obesity. Obes Surg 12: 564–568

    Article  PubMed  CAS  Google Scholar 

  5. Buchwald H, Avidor Y, Braunwald E et al. (2004) Bariatric surgery: a systematic review and meta-analysis. JAMA 292: 1724–1737

    Article  PubMed  CAS  Google Scholar 

  6. DeMaria EJ, Schauer P, Patterson E et al. (2005) The optimal surgical management of the super-obese patient: the debate. Presented at the annual meeting of the society of American gastrointestinal and endoscopic surgeons hollywood Florida/USA, April 13-16. Surg Innov 12(2): 107–121

    Article  PubMed  Google Scholar 

  7. Fobi MA, Lee H, Holness R, Cabinda D (1998) Gastric bypass operation for obesity. World J Surg 22: 925–935

    Article  PubMed  CAS  Google Scholar 

  8. Freeman JB, Kotlarewsky M, Phoenix C (1997) Weight loss after extended gastric bypass. Obes Surg 7: 337–344

    Article  PubMed  CAS  Google Scholar 

  9. Heitmann C, Germann G (2007) Body contouring surgery after massive weight loss. Part I: abdomen and extremities Chirurg 78(3): 273–284

    Google Scholar 

  10. Hess DS, Hess DW (1998) Biliopancreatic diversion with a duodenal switch. Obes Surg 8: 267–282

    Article  PubMed  CAS  Google Scholar 

  11. Hess DS (2005) Biliopancreatic diversion with duodenal switch,Surg Obes Relat Dis 1(3): 329–333

    Google Scholar 

  12. Kremen JA, Linner LH, Nelson CH (1954) An experimental evaluation of the nutritional importance of proximal and distal small intestine. Ann Surg 140,439

    Google Scholar 

  13. Kuzmak LI, Yap IS, McGuire L et al. (1990) Surgery for morbid obesity. Using an inflatable gastric band. AORN 51: 1307–1324

    Article  CAS  Google Scholar 

  14. Lockwood TES (1991) Superficial fascial system (SFS) of the trunk and extremities: A new concept. Plast Reconstr Surg 87: 1009–1014

    Article  PubMed  CAS  Google Scholar 

  15. Mason EE, Ito C (1967) Gastric bypass in obesity. Surg Clin North Am 47: 1345–1351

    PubMed  CAS  Google Scholar 

  16. Marceau P, Hould FS, Simard S et al. (1998) Biliopancreatic diversion with duodenal switch. World J Surg 22: 947–954

    Article  PubMed  CAS  Google Scholar 

  17. Matthews BD, Sing RF, Delegge MH et al. (2000) Initial results with a stapled gastrojejunostomy for the laparoscopic isolated roux-en-Y gastric bypass. Am J Surg 179: 467–481

    Article  Google Scholar 

  18. Nemerofsky RB, Oliak DA, Capella JF (2006) Body lift: An account of 200 consecutive cases in the massive weight loss patient. Plast Reconstr Surg 117: 414–430

    Article  PubMed  CAS  Google Scholar 

  19. Nguyen NT, Goldman C, Rosenquist CJ et al. (2001) Laparoscopic versus open gastric bypass: a randomized study of outcomes, quality of life and costs. Ann Surg 234: 279–289

    Article  PubMed  CAS  Google Scholar 

  20. O’Leary JP (1992) Gastrointestinal malabsorptive procedures. Am J Clin Nutr 55(Suppl 2): 567S–570S

    Google Scholar 

  21. Payne JH, DeWind LT (1969) Surgical treatment of obesity. Am J Surg 118,141

    Google Scholar 

  22. Reddy RM, Riker A, Marra D et al. (2002) Open Roux-en –Y gastric bypass for the morbidly obese in the era of laparoscopy. Am J Surg 184: 611–615

    Article  PubMed  Google Scholar 

  23. Rohrich R (2002) Marking and operative techniques. Plastt Reconstr Surg: 117, 1S 45–73 S

    Google Scholar 

  24. Rohrich R (2006) The physiological impact of bariatric surgery on the massive weight loss patient. Plast Reconstr Surg 117,1S 14–16 S

    Google Scholar 

  25. Sati S, Pandya S (2008) Should a panniculectomy/abdominoplasty after massive weight loss be covered by insurance. Ann Plast Surg 60(5): 502–504

    Article  PubMed  CAS  Google Scholar 

  26. Scheufler O, Erdmann D (2007) Current concepts and trends in post-bariatric plastic surgery. Chirurg 78: 316–325

    Article  PubMed  CAS  Google Scholar 

  27. Scopinaro N, Gianetta E, Adami GF et al. (1996) Biliopancreatic diversion for obesity at eighteen years. Surgery 119: 261–268

    Article  PubMed  CAS  Google Scholar 

  28. Sjöström L, Lindroos AK, Peltonen M et al http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Dahlgren%20S%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus

  29. Larsson B, Narbro K, Sjöström CD et al. (2004) Swedish obese subjects study scientific group Lifestyle, diabetes and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med 351: 2683–2693

    Article  PubMed  Google Scholar 

  30. Sozer SO, Agullo FJ, Wolf C (2005) Autoprosthesis buttock augmentation during lower body lift. Aesthetic Plast Surg 29: 133–137 discussion 138–140

    Article  PubMed  Google Scholar 

  31. Stroh C, Hohmann U, Schramm H, Manger T (2005) Long term results after gastric banding. Zbl Chir 130: 410–418

    Article  PubMed  CAS  Google Scholar 

  32. Suter M (2001) Laparoscopic band repositioning for pouch dilation / slippage after gastric banding:Disappointing results. Obes Surg 11: 507–512

    Article  PubMed  CAS  Google Scholar 

  33. Weber M, Müller MK, Bucher T et al. (2004) Laparoscopic gastric bypass is superior to laparoscopic gastric banding for treatment of morbid obesity. Ann Surg 240: 975–982

    Article  PubMed  Google Scholar 

  34. Weiner R, Wagner D, Blanco-Engert R, Bockhorn H (2000) Eine neue Technik zur laparoskopischen Plazierung des steuerbaren Magenbandes zur Vermeidung eines Slippage. Chirurg 71: 1243–1250

    Article  PubMed  CAS  Google Scholar 

  35. Weiner R, Blanco-Engert R, Weiner S et al. (2003) Outcome after laproscopic adjustable gastric banding – 8 years experience. Obes Surg 13: 427–434

    Article  PubMed  CAS  Google Scholar 

  36. Wittgrove AC, Clark GW, Tremblay LJ (1994) Laparoscopic gastric bypass, Roux-en-Y: preliminary report of five cases. Obes Surg 4: 353–357

    Article  PubMed  Google Scholar 

  37. Wittgrove AC, Clark GW (2000) Laparoscopic gastric bypass, Roux-en-Y. 500 patients: technique and results with 3-60 month follow-up. Obes Surg 10: 233–239

    Article  PubMed  CAS  Google Scholar 

Download references

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

Author information

Authors and Affiliations

  1. Klinik für Plastische-, Hand- und Wiederherstellungschirurgie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland

    P.M. Vogt

  2. Chirurgische Klinik, Allgemeines Krankenhaus, Celle, Deutschland

    K.J. Oldhafer

Authors
  1. P.M. Vogt
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. K.J. Oldhafer
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to P.M. Vogt.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Vogt, P., Oldhafer, K. Adipositaschirurgie: Indikation, Therapieverfahren und Nachsorge. Gastroenterologe 3, 399–407 (2008). https://doi.org/10.1007/s11377-008-0205-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11377-008-0205-y

Schlüsselwörter

Keywords

Search

Navigation