Welcome to OBESITY SURGERY PARIS (OBESITE CHIRURGIE PARIS) site of Dr. Jean-Pierre Anfroy and Dr. Bruto Randone, Bariatric Surgeons in Paris.
Dr. Jean-Pierre Anfroy, Bariatric surgeon, is a former Chief of the Surgical Intensive Care Unit and Emergency Department of the University Hospital BICHAT in Paris. Since 20 years, he performs bariatric surgery at the Clinique Internationale du Parc Monceau* in Paris, a modern clinic perfectly equipped for surgery of obesity, located in the centre of Paris. His licence N° is 93/ 03842 at the Medical Council in France.
Dr. Bruto Randone, Bariatric Surgeon, Former Head of Hospitals in Paris, also practices bariatric surgery at the Clinique Internationale du Parc Monceau in association with Dr. Anfroy. His licence N° is 10004078225 at the Medical Council in France. He sees patients every Friday afternoon at the Clinique Internationale du Parc Monceau in Paris.
Only treatment of real obesity (BMI superior to 35) bariatric surgery, commonly practiced for more than 20 years, covers a period of maturity due to its experience. Indeed, it takes several years to analyze advantages and disadvantages, as well as the technical modifications, of the 3 main interventions practised: sleeve gastrectomy, bypass and gastric band: 50.000 operations in 2015 in France.
Obesity surgery may be considered in patients who meet specific conditions. Calculate your BMI (Body Mass Index), very important to know if you can benefit from obesity surgery, then read the paragraph INDICATION (below) and the Preoperative check-up page.
Let’s emphasize once again that, whatever the chosen intervention, a life long change of eating habits and lifestyle is essential.
1. SLEEVE Gastrectomy is the most practiced intervention in France in recent years.
Intermediate technical difficulty between gastric band and by-pass, it can be said that the Sleeve has only one disadvantage: the risk of fistula at the level of the stomach operated. The intervention consists in removing 3/4 of the stomach, a tube through the mouth during the intervention in the stomach is used to calibrate the size of the new stomach. We cut it along the probe and at the same time the automatic clip sutures the section of the stomach. It thus poses a triple row of staples, but despite this there is still a risk of bad, or lack, of healing on the instalment of the section. There may thus appear a fistula with leakage of gastric contents in the ‘belly’, dreaded complication resulting re-intervention, drainage, put in place of prosthesis.
- Advantages: No deficiency because the intestinal system is retained (easy to treat hairloss can occur), no food blockages, no remote surgical complications, simple medical follow-up, quick weight loss of 30 Kg in most cases in the first year.
- INDICATION: BMI ≥ 40 and/or patients with a BMI ≥ 35 associated at comorbid conditions likely to be improved after the surgery (including cardiovascular disease, sleep apnea, severe respiratory disorders, severe metabolic disorders, especially type 2 diabetes, osteo-articular diseases).
- In second intention after failure of medical treatment, nutritional, dietary and psycho-therapeutic, well conducted during 6 to 12 months.
- In absence of sufficient weight loss or in absence of weight loss maintenance, after diets supervised by a specialist (nutritionnist, dietician, endocrinologist) with written proof (prescriptions etc.), very important for your medical insurance company !
- Patient well-informed in advance.
- Assessment and multidisciplinary preoperative support for several months.
- Procedure and need understood and accepted by the patient for life during medical and surgical follow-up.
- Acceptable operative risk.
2. The By-Pass is certainly the most effective intervention resulting in the most rapid, important and probably the most sustainable weight loss.
It is the most difficult intervention, technically spoken, with a risk of complications in short and long-term. The most important complications occur even in the simplified version of Mini By-Pass.
The absence of food absorption at the level of the proximal part of the intestine causes deficiency of certain essential vitamins, obliging lifelong therapy of vitamin replacement and some deficiencies can be very difficult to treat in the long-term.
Indication: BMI ≥ 40, failure of another bariatric surgery (gastric band for example), compulsive eater, diabetic.
- Aftercare is very important, abdominal pain is difficult to label and not exceptional.
3. The Gastric Band (several hundred thousands have been placed on all continents) is in sharp decline due to its lack of long-term efficiency and constraints it imposes: strict diet, multiple fills and unfills, well-ordered life. Vomiting, or even total inability to drink or eat, requiring surgical removal of the band by emergency.
This reputation isn’t totally justified and if its failures, some years after the operation, are numerous we currently know the reasons: bad choice of a too young patient, wrong adjusted lifestyle, or changing lifestyle, making it difficult to adapt to a regular and strict diet and psychological fragility.
- The indication for patients with a BMI ≥ 35 – 40 still remains: older patients and / or those having a stable lifestyle, wishing transitional aid.
* In January 2013 the operating block of the Clinique Internationale du Parc Monceau has obtained the highest rank by the French National Authority for Health (HAS) and has been rated “A category”, without any reserve or restriction. Check here.
** On 7 June 2015 the Clinique Internationale du Parc Monceau received the label « CENTRE of EXCELLENCE » of the French Society for Obesity Surgery and Metabolic Diseases (SOFFCOMM) on the basis and consideration of criteria of quality of the technical plateau, organization, security support for patients, skills of practitioners and staff dedicated to obesity surgery. Only two institutions are labeled in Paris.
It is mandatory to have regular follow-up after surgery: a consultation with a nutritionist every three months, and at least every six months. Then, consultations can be done with annual frequency.
This site is exclusively devoted to obesity surgery. Dr. Jean-Pierre Anfroy is the author, he receives no support for its financing and refuses any form of advertising. Last update: 01/09/17