Bel Medic General Hospital is the only hospital in Serbia that has
complete center for minimally invasive surgery. The goal of the
center is to eliminate the need for conventional surgery through
the development, testing and implementation of less invasive
procedures. Bel Medic provides surgeries in all medical fields: VATS,
laparoscopic surgery, arthroscopy and endoscopic spine surgery
Dr ĐORĐE BAJEC, General surgeon in the General Hospital “Bel Medic” and president of the Serbian National Bariatric Surgeons Association
About advantages and opportunities of minimally invasive access in abdominal surgery, we talked with the professor Dr Đorđe Bajec, general surgeon in the General Hospital “Bel Medic” and president of the Serbian National Bariatric Surgeons Association.
What is the difference between open abdominal surgery and laparoscopic surgery?
— Laparoscopic surgery or keyhole surgery is minimally invasive surgery that is associated with several advantages over traditional open surgery. In an open procedure, one large abdominal incision is made to expose the tissues and structures inside for examination and surgery. In a laparoscopic procedure on the other hand, only a small incision of up to 1.5 cm in length is made in the abdomen, usually around the belly button area. Scars from open surgeries are not only an aesthetic problem, but also a health problem, because they significantly distort the structure of the anterior abdominal wall. Since the overall trauma to the skin and muscles is reduced, less post-operative pain and disability, a shorter hospital stay, and a quicker recovery period are major advantages that laparoscopic surgery offers when compared to traditional operations.
What kind of operations can be performed using laparoscopic surgery?
— Twenty years ago indications for laparoscopic surgery were related exclusively to gallbladder operations. Technology and the experience of surgical teams today have reached such a level that the majority of procedures in the abdominal surgery can be done laparoscopically. This includes all urgent conditions, such as gall bladder inflammation, ulcer perforation, appendicitis and so on.
How is it possible to remove organs, such as spleen, or a gallstone through few millimetres incision?
— There are special instruments that are mulching tissue of the different organs or mulching gallstones. Small tissue parts are than easily removed through less than 12mm incision.
You are one of the leading experts in bariatric surgery in this part of Europe. What are results of laparoscopic bariatric surgery?
— The World Health Organisation has recognised extreme obesity as a disease, because it seriously threatens health, primarily as a risk factor for the development of cardiovascular and heart disease, type two diabetes and other diseases. In recent years extreme obesity has reached epidemic proportions, as confirmed by the fact that bariatric surgery is ranked in second place in the U.S. among all operations in the abdominal cavity. Extreme obesity is the result of a complex interactions between genetic and environment. Usually, it is very difficult that extreme obese patient lose weight with conventional methods, such as diet, physical activity and medications. Bariatric surgery has proved to be very effective in this case. Reducing stomach volume and consequently food intake weight can be permanently reduced and risk for comorbidities is significantly decreased.
How much weight can be lost after bariatric surgery?
— Patients who have BMI (body mass index) more than 60 can reach an ideal weight within a year or two, while those with a lower BMI can do it even faster. Most people are aware of gastric bypass surgery and gastric banding as popular options for bariatric surgery. However gastric sleeve resections have grown in popularity over the last five years.