Director of Department Dr. Pietro Pizzi

The C.S.R.T.O. (Centre for Obesity Research) at Policlinico di Monza  has been providing solutions to obesity-related problems for the last 15 years. Its main goal is to help super-obese patients reacquire normal life conditions. 3000 patients have been treated with a success rate of 70%.

Our priority is to offer guidance in terms of nutrition. Delivering nutrition education lies at the basis of every surgical method chosen.

Major bariatric surgery techniques

Procedures to limit food intake

a) with a mainly mechanical activity (restrictive procedures):
  • gastric balloon
  • adjustable gastric banding
  • vertical banded gastroplasty
  • sleeve gastrectomy

b) with a mainly functional activity:
  • gastric bypass and similar surgeries

Patient cooperation is essential. Without the patient's commitment to follow nutrition guidelines, surgical success can't be achieved. As every procedure stimulates the sense of satiety and reduces the gastric volume, patients need to change their eating habits, control hunger and eat reasonable amounts of food.
banded gastroplasty

banded gastroplasty

Procedures to limit energy absorption:  

  • Biliopancreatic diversion-Scopinaro procedure and variants
  • sleeve gastrectomy with duodenal switch

Methods and devices for the surgical creation of satiety

  • HELIOSPHERE BAG : is an intragastric balloon  that stimulates the sense of satiety
  • GASTRIC BANDING: an inflatable band is placed around the upper part of the stomach. This slows and reduces the amount of food that can be consumed each time.
  • GASTRIC BYPASS: is a partially restrictive, moderately malabsorptive procedure
  • BILIOPANCREATIC DIVERSION: is a predominantly malabsorptive procedure

Super-obese people generally eat excessive amounts of food. Some of them, though, suffer from eating disorders with no psychiatric consequences. Helping these acquire nutritional through dietary guidance is our  priority.
In both the afore-mentioned cases, it is of utmost importance that the patients cooperate with physicians. Physical and psychological well-being, as well as  self-esteem and social life can be achieved through strong motivation only. Personally contributing to this difficult process will boost the patients' self-esteem and awareness of their achievements.

We place particular emphasis on restrictive surgery as it helps patients control hunger. Managing appetite requires will power and commitment, which is key. Besides, restrictive surgery has lower rates of  severe post-operative complications.
Once major weight-loss and nutritional balance have been achieved, patients can have reconstructive plastic surgery to improve the shape and tone of the body. Following a substantial amount of weight-loss the skin often lacks elasticity and cannot conform to the reduced body size.

Post bariatric plastic surgery

Bariatric surgery can often result in substantial weight loss and therefore in a disproportionate body.
That's when plastic surgery can help.
Body contouring surgery can help reshape body features that cannot be improved by other measures. More procedures (sometimes 3 or 4) may be required not only for aesthetic purposes, but also for the overall improvement of the skin ( in the event of intrertrigo, rash, infections or skin folds fungal infections)  and of the psychological status (depression, sexual life, difficult relationships).
Post bariatric plastic surgery procedures include:
  • Abdominoplasty (tummy tuck)
  • Mastopexy (with or without mesh)
  • Breast reduction
  • Thigh lift
  • Lower body lift
  • Arm lift
  • Liposuction
  • Circumferencial body lifting

Reconstructive plastic surgery is not a miracle cure for obese patients. It aims at improving the patients' quality of life by minimising the damage caused by obesity and weight loss. 
Rigorous psychological assessment, together with morphofunctional and medical history evaluation allow physicians to deliver the best possible procedure to each patient.

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