Frequently Asked Questions

ADVANCED LAPAROSCOPIC AND BARIATRIC

1. What is Bariatric Surgery?

Procedures through which the stomach or intestine is reshaped to achieve a satisfactory weight loss.

2. What is laparoscopy?

A way to perform abdominal surgery using cameras, long and thin instruments permitting the manipulation of the structures through the skin, with the following advantages over conventional surgery: the suffering of less pain after surgery, faster recovery as well as fewer complications associated with wounds and finally additional aesthetic benefits. Eventually, any kind of surgery can be done in intra-abdominal organs.

3. Am I a candidate for obesity surgery?

According to the established criteria, people in general who are candidates for surgery must have a body mass index (BMI) greater than 35 kg per square meter of body surface or about 40 kilos overweight.
Body mass index is an easier way of classifying the obesity rate which is calculated by dividing weight in kilograms by height in squared meters (weight / size2 = BMI), if this number is greater than 30 then there is obesity and you could be a candidate for any intervention by analyzing each case in particular, ranging from a procedure to surgery itself.

4. Is Bariatric surgery a simple procedure?

No, the overall experience in this field and laparoscopy have been perceived as being simple, in the right hands, it is as safe as less difficult technical procedures, while recognizing that they are important procedures but with risk, the vast majority of patients have a high rate of satisfaction.

5. Which surgery is better: GASTRIC BYPASS OR SLEEVE GASTRECTOMY?

Both procedures are effective to reduce weight in the long term, the patient's particular condition and eating habits will allow them to select the most appropriate procedure to improve the results.

6. Should medicine always be taken after surgery?

In general terms after gastric bypass surgery a supplement of oral multivitamins and B12 is recommended to offset some minor changes to the surgery. It is the surgeon who determines the frequency of the application and duration of the follow-up as scheduled.

7. Weight loss is guaranteed?

The surgery is designed to make changes in the functions of the stomach and / or intestines, which related to significant lifestyle changes such as physical exercise and improved eating habits, giving you all the available tools to maintain a significant long term weight loss and possibly reaching one third of the weight in which the process began.

8. How long does the process last?

Every patient must undergo some tests to assess their health status. These tests are usually performed 3 to 5 days prior to surgery (which is the recommended time between displacement and the surgical procedure). We recommend a minimum stay of 2 weeks after surgery for constant monitoring of their evolution and proper scarring of the stomach and / or intestine which could be put at risk by displacement air / land.

9. How many days of hospitalization after the surgery?

Overall, most patients are referred for outpatient follow-up within 24 hours. Their condition after surgery and the criteria of the surgical team will determine the need for a longer hospitalization.

10. Is plastic surgery always needed after bariatric surgery?

12-18 months after surgery and once established in the final weight, a significant percentage of patients require intervention for plastic surgery. Factors such as age, weight prior to surgery, be of the female gender and lack of physical activity after surgery are factors that increase the chances of a new intervention in the medium term.

FERTILITY

1. I am a healthy 44 year old woman, can l still get pregnant at my age?

The woman is designed to get pregnant at a young age, as you get older you lose the ability for easy pregnancy and this decrease is greater after 40 years of age. Although you can try to get pregnant through in vitro fertilization, one must know that the chances of getting pregnant are few and, to achieve pregnancy, there is a high risk of having a baby with problems (such as Down syndrome) that are more common in older women. Most women of your age and even older than you, including Hollywood celebrities, are getting pregnant by receiving donated eggs. This option provides excellent opportunities for pregnancy and also reduces the risk of fetal abnormalities.

2. My husband and I are young and healthy, but we have been trying to get pregnant for 3 years but all the medical consultations in which we have attended, no answers have been given. What could be happening?

Up to 10% of couples with infertility have found no explanation and all the issued medical tests and exams come back normal. This is known as infertility of an unknown origin. The important fact is that even if you don`t have a known cause to explain the infertility, there are things that you can do. Starting with artificial insemination cycles is usually recommended and if pregnancy is not achieved, in vitro fertilization is attempted.

3. My husband is 44 years old, is healthy and has 2 children from his first marriage (15 and 13 years old). We have tried to get pregnant for the last 2 years without being successful. We consulted in a fertility clinic and were told that his sperm were few and bad. Is this possible?

Yes testicles are like a factory that produces sperm and as in any factory production can be good, fair or poor. It is possible that several years ago, the sperm-making machinery was working perfectly, reason for the 2 children, but over the time as the circumstances change so does sperm production. We suggest a consultation with a urologist, andrologist, physicians who specialize in the reproduction from the male perspective. There are situations that can be improved but others do not.

4. I am 22 years old and I was told I have "endometriosis". My doctor advised me to get pregnant soon, because in the future, infertility is possible. Is this true?

Endometriosis is a disease in which there is no cure and is often progressive. People who suffer this are more likely to have fertility problems, particularly if it’s advanced endometriosis. But there is no way to predict exactly who will have trouble getting pregnant and who will not. Because the disease tends to be progressive, doctors often advise their patients to become pregnant soon, the problem is that sometimes this advice comes at a time in which pregnancy is not a possibility. The best advice is to give medical treatment to keep endometriosis under control, trying to prevent its progression, until the woman wishes to become pregnant.

5. I am 37 years old with 3 children. 4 years ago I had an tubal surgery to avoid getting pregnant. Now I regret my decision and once again want to get pregnant. What options do I have?

There are 2 ways. The first is to evaluate the possibility of having surgery to rearrange the tubes and restore fertility. This option depends on the type of initial surgery. Remember that the tubes are very thin ducts and fragile and it’s possible that during the initial surgery to stop having children, they were cut, burned or tied, etc. Depending on the damage, it’s possible to repair the fallopian tubes or not. This procedure requires expert surgeons to have a better chance of success.
The second way is in vitro fertilization, in which your eggs are fertilized with sperm from your husband outside of your body in a vitro fertilization laboratory to produce embryos. They are later placed in the womb, we wait a few days to see whether or not there was a pregnancy.

6. My companion had an operation to not have more children (has 3). What options are there for us to get pregnant?

Depends partly on the time in which your partner was operated. If he recently had surgery (less than 5 years ago) he has an excellent chance of having surgery again to reverse the initial surgery to get pregnant. If the operation is more than 10 years ago, the possibility of reversing the surgery exists, but the possibility of pregnancy is bad, because with the years, the operation will affect the production of sperm in the testicles and even if the initial surgery is reversed, it is possible that the sperm is so bad that no pregnancy is achieved. Between 5 and 10 years, anything can happen. Many accept the corrective surgery and wait to see what happens.
Some refuse the surgery and look for other options. In these cases, sperm can be extracted directly from the testicles or ducts, for ICSI. Recognizing that the concept of time is still valid and the detriment of the sperm, in other words, the more the years since the initial surgery, the disruption in the production of sperm will be more, the chance of pregnancy will be lower.

7. I am a healthy 33 year old woman, without a partner. I want a child, is this treatment possible in Colombia?

Yes, what we normally do is a comprehensive assessment to see if you can receive an artificial insemination with a donor’s semen. We also do a psychological assessment (just to be sure that the decision you have taken is the correct one) and a blood analysis. If everything is in order, we proceed to the insemination with the donor’s semen.

8. I have early menopause and was told that the only option for pregnancy is egg donation. Can my sister dónate her eggs to me?

In Concevidas, we work with an anonymous donation. Meaning you never know who is the donor and the donor never knows who you are. We try to choose your donor according to your physical characteristics, race, blood type, etc.. We do this for 2 main reasons: the first is to select very well the donors to ensure that we have eggs of excellent quality and a very good chance of pregnancy. Often, the person you wish to be the donor, is not always the world’s best donor because they may have medical conditions that may cause their eggs to not be the best. The second reason is that although in principle, it is very nice and sounds like an excellent idea to have your sister as a donor, problems may incur if you get pregnant. As your sister (even though today she swears that she won’t) will feel the right to speak and interfere in each and every one of the decisions taken regarding the baby, can even reach lawsuits, even monetary demands the day of tomorrow. It becomes an awkward situation that can end up breaking apart a close family.

9. I am 36 years old and have had an ectopic pregnancy so both my tubes were removed. According to my doctor the option for pregnancy is in vitro fertilization, but it is an expensive treatment. Could I have an artificial insemination?

No. One of the conditions for artificial insemination is that the tubes need to be fine. If you do not tubes, it is impossible to achieve pregnancy by artificial insemination. Your only option is in vitro fertilization. This treatment is designed for women like you that do not have tubes or have them very altered. In the treatment you are given medication to stimulate ovulation, eggs are removed when they are ready and fertilized with your partner's sperm, in a special laboratory. The embryos which are produced are placed in your womb 3 days after. We wait to see whether or not there is a pregnancy.

10. My husband and I received an in vitro fertilization treatment, in which 3 embryos were transferred. We thought that with this we were pregnant, but we weren’t. Could you explain to me what happened?

When performing an in vitro fertilization treatment where embryos are placed into your uterus, you're still not pregnant. Although embryos are alive and growing, once placed into the uterus of women, they should be able to join in (implant). Some embryos are able to do this and some are not. The "glue" to adhere them has yet to be invented. That is why in vitro fertilization does not guarantee 100% pregnancy. After a few days in which embryos were transferred, we will know who has embryos that implanted and who hasn’t, in other words, who is pregnant and who is not.

11. An in vitro fertilization treatment was recommended, but we fear it because it seems so artificial. What are the risks?

The general risks of the procedures to achieve pregnancy (in vitro fertilization, ICSI, artificial insemination, etc.) are:

  • Not getting pregnant, no treatment is currently offering a 100% guarantee of pregnancy. The possibility of getting pregnant depends on the diagnosis of each partner, maternal age, length of infertility and type of treatment.
  • Multiple pregnancy: all treatments are accompanied by an induction of ovulation, increasing the risk of multiple pregnancy. The sound control of ovulation induction and defining the number of embryos transferred can help keep this possibility in a reasonable range.
  • No response to ovulation, as treatment involves an induction of ovulation, some women
    occasionally do not respond well to medication that stimulates ovulation and do not produce enough eggs for the procedure. It is more common in women over 40 years of age and it may be necessary to suspend the proceedings to determine whether or not to try again.
  • Ovarian hyperstimulation syndrome: occurs in women who respond excessively to ovulation induction, producing an immense amount of eggs, which causes a general imbalance in the female body. It is rare but more common in young women. The controls carried out during induction help to catch it early and also helps to take timely corrective measures, but it may be necessary to interrupt the procedure.
  • Fetal malformations: no increased risk exists of having a baby with an abnormality when using infertility treatments, but this possibility can't not be ruled out either. In other words, fertility treatments do not produce more nor less defects that a couple naturally getting pregnant would.

11. Several years ago I had to remove my uterus. Do I need Gestational surrogacy or a surrogate, can l do it with you in Colombia?

The surrogacy or gestational surrogacy is a process that is not covered by Colombian law, which means it is not illegal to do so, but it's not legal. There is an enormous gap in the law, which possess a great risk in case the surrogate mother repents and wants to keep the child, because according to how the law is read today, she has everything to gain and could keep the baby. So we do not do this type of procedure. There are countries in the world which have legal clarity on this issue and have programs specifically designed to protect the rights of surrogate mothers, parents who hire them and everyone involved in the process. Our recommendation is to visit one of them.

12. My wife and I do not live together, for work reasons, I constantly travel. So we have had difficulty having a child, because my work keeps us from being together during her fertile days. What can we do?

There is the possibility to freeze your semen, to use in artificial insemination when your wife is ovulating. To freeze the semen in our bank , it is essential to verify by blood tests that you do not have AIDS, hepatitis B, hepatitis C or syphilis. Depending on the quality of your sperm will define the number of your semen samples advised to save.

13. I am 33 years old and have thyroid and prolactin problems. My doctor tells me this is why I do not get pregnant, is this true?

The regulation of ovulation is a complex and delicate process that involves many hormones. Two of them are the thyroid and prolactin, which if are in abnormal levels causes the ovulation to not function properly, ovulating poorly or untimely, making the process of getting pregnant difficult. A medical treatment exists for both problems with medicine that helps control both hormones getting them back to regular and timely ovulation.

14. I am 28 years old and have polycystic ovary syndrome. Does that mean I have to operate my ovarian cysts?

No. Those with polycystic ovary syndrome, have their ovaries with tiny multiple cysts (are less than 1 cm) and do not require surgery. Women with this problem often have difficulty ovulating, it is as if their ovaries were lazy and did not ovulate well. When having this syndrome and pregnancy is desired, you may need treatment with medicine that stimulates ovulation to improve the chances of pregnancy.

 






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