Are you overweight?

Calculate your Body Mass Index

Obesity is defined as an excessive proportion of fat relative to the weight of a person.
The Body Mass Index (MBI) calculates the proportion of weight and height and categorises of obesity.
The Body Mass Index (BMI) is the weight of the body in kilograms divided by height in metres squared.
That is, BMI - kilograms/m²

Us versus Obesity

According to medical research, obesity is a disease in and of itself, just like diabetes and hypertension even though complications may not yet be apparent.
Treatment of the disease known as “obesity” must foresee complications and not treat complications as they arise.

The most common complications of obesity include:

• Hypertension
• Diabetes
• Myocardial infarction
• Stroke
• Heart failure
• Sleep apnoea
• Breast and uterine cancer
• Colon Cancer
• Sterility, impotence
• Discopathy
• Inguinal hernia
• Hiatal hernia and reflux
• Skin infection
• Depression, suicidal tendencies

It is estimated that in Greece 7,000 people die annually for complications of obesity. The life expectancy of a middle aged person with a BMI over 40 is 10 years less than that of a person whose weight is normal.

This is why the European Union has “declared a war” against obesity, proclaiming the years 2006-2011 as “five years against obesity”.

Prevention is the obvious solution to the problem. We should maintain our Mediterranean diet, resist fast food, reduce television viewing and increase physical activity.

However, these measures will not solve the problem of those people who are already morbidly obese and cannot be effectively treated with simple conservative methods. Only recently has an effective solution become available for the obese.

On a positive note, medicine finally holds effective weapons to treat forms of obesity which were considered untreatable just a few years ago.

Obesity surgery has levelled the playing field.

Obesity is now treatable

“Bariatric surgery”, that is obesity surgery, was developed in the 1990s.
Bariatric surgery is a new branch which specialises in surgical techniques aiming to reduce the weight of patients with severe forms of obesity. Since 1998, the World Health Organisation has arrived at the following conclusion: “Today, surgery is the most effective method of treating morbid obesity (BMI>40)”

These procedures can now be performed laparascopically, without an incision and pain and requiring minimal hospitalisation.

The “weapons” medicine uses to fight obesity

Each type of obesity can now cured of its disease by choosing the procedure which corresponds in each case. Today there three basic types of procedures: gastric band, gastric bypass and gastric sleeve (detailed descriptions to follow).

Two other techniques have very limited applications: the “intragastric balloon” and the “cholopancreatic bypass”.

The intragastric balloon is not a permanent solution and is used only in two cases: for young people (primarily) who are temporarily obese (e.g. compulsory army service, pregnancy etc.) and for the morbidly obese to lose some weight which will allow for the easier application of a permanent technique.

The cholopancreatic bypass is a major procedure which is proposed to excessively obese patients (usually over 200 kg.).

Finally, it should be noted that certain new procedures are still in the experimental stage such as the absorbable band, intestinal translocation etc. while other older techniques such as the vertical gastroplasty are no longer performed.

Which procedure is right for you?

Each bariatric procedure has its own unique characteristics and is used to treat different obesity diseases. There is no “ideal” procedure but there is an appropriate procedure for each case.

The selection of the most suitable procedure must be arrived at in cooperation with a medical team which includes a surgeon, psychologist, dietician etc. Diagnosing the category and type of obesity is the first and most essential step. This required an accurate medical history including a pathological history, diet habits, weight curve, psychological profile and specialised tests like measurement of fat which determines the fat percentage in the body etc.

The following chart will assist you in determining which procedure is right for you (this chart should not be used in place of an evaluation made by a specialised team of medical professionals).

Evangelos Niakas
Surgeon
General-Laparoscopic Surgery
Bariatric Surgery
e-mail: drevnia@hol.gr
Mobile: 6947698686
 

• Coronary Bypass Graft Surgery with the use of Extracorporeal Circulation Machine.
• Coronary Bypass without the use of Extracorporeal Circulation Machine under certain selected circumstances (Off Pump beating Heart procedures).
• Coronary Bypass are taken place with Arterial Grafts implantation/anastomosis (Mammary & Radial Artery) and Saphenous Vein Grafts, during these operating procedures are following all the safe surgical secure techniques, long term conservation of these, graft perfusion no touch technique.
• Valvuloplasty Procedures.
• Valvuloplasty Repair of Mitral, Aortic & Tricuspid Cardiac Valves, with complex operating procedures.
• Cardiac Valve Replacement with bio-prosthetic and Mechanical implantable Valves.
• Surgical Treatment of Aneurysms the Ascending Aorta & the Aortic Arch.  
• Minimally Invasive Cardiac Surgery Procedures.
• Surgical Treatment of Cardiac Arrhythmias.  
• Cardiac Redo Operations to patients with second operating surgical treatment evidences.
• Cardiac Neoplasia Surgical Operations.
• The Methods and Surgical Assessment are applied concerning the patients’ tissue integrity and organ system safety for maximum protection. During these special operations all Gold Standard protocols of the Cardiac Surgery Operations are strictly followed.  

Minimally Invasive Video-Assisted Parathyroidectomy (MIVAP)

This technique is being used with extraordinary results in several specialized medical centers in Europe, the USA and other institutions around the world. The technique has been established by P. Miccoli, Professor of Endocrine Surgery, Pisa University.

The preoperative localization of the glands is a prerequisite for patients who are candidates for MIVAP. The ultrasound and the TC- Sestamibi-scan constitute the standard techniques, while in some rare occasions additional methods are required for the localization of the pathological parathyroid glands.

INDICATIONS FOR MIVAP

• Solitary adenoma
• Screening confirmation
• Absence of indications for multiple endocrine neoplasia (MEN) or familiar hyperparathyroidism
• Absence of a large goiter
• Absence of malignancy
• Absence of any history of neck irradiation

ABOUT THE TECHNIQUE

The operation is performed through a small incision above the suprasternal notch. Through this incision along with the aid of special surgical tools, the abnormal parathyroid gland is accessed. Operating field visualisation is enabled with the use of a high definition micro camera. The use of the neurostimulator for the identification and preservation of the recurrent laryngeal nerve is essential.

The operation is completed with the removal of the pathological parathyroid gland(s) and the intraoperative confirmation of the decrease of parathormone levels(quickPTH) in a specific time. In this manner we confirm, by means of laboratory, the biochemical healing of the patient.

THE ADVANTAGES OF MIVAP ΤECHNIQUES

The most important advantages of the technique are:

• Postoperative pain is less, which results in reduced demand and therefore reduced use of analgesics.
• With regard to the aesthetic result, patients who have been operated on with the MIVAP technique are mostly satisfied.

CONCLUSION

The Minimally Invasive Video-Assisted Parathyroidectomy (MIVAP) technique has excellent results. It can be performed only under certain circumstances and with specific indications. Only a certified endocrine surgeon is capable of selecting patients who may be operated on with the MIVAP technique.

https://www.youtube.com/watch?v=gibECOlxtws

Since its inception, the Central Clinic of Athens has offered an innovative and fully equipped General Surgery department which is staffed with experienced, specialised and highly trained medical and nursing professionals.

The goal of the General Surgery Clinic is to provide reliable, high quality diagnostic and treatment services across the spectrum of General Surgery which enforces cutting edge medical breakthroughs and modern medicine while always adhering to the dictates of medical science.

The General Surgery department performs all General Surgery procedures for acute and chronic diseases, namely minor, major and medium risk surgeries in the outpatient clinic, emergency care centre and Department of Surgery.

The General Surgery department offers:

• Endoabdominal organ diseases: Liver, gall bladder, pancreatic, spleen, ascending and descending colon, oesophagus, stomach, colon and rectum surgery
• Endocrine surgery (thyroid, parathyroid glands and adrenal glands)
• Breast surgery
• Surgical treatment of abdominal wall hernias
• Innovative centre for the treatment of hemorrhoidopathy
• Laparoscopic Surgery in Surgical Oncology and Trauma Surgery
• Weight loss Surgery

Today, our Clinic performs all minimally invasive-laparoscopic procedures including: Cholecystectomy, Appendectomy, Oophorectomy (ovary removal surgery), Adrenalectomy, Colostomy, Thyroidectomy, Parathyroidectomy, laparoscopic treatment of diaphragmatic hernias and other benign colon conditions.

The Department of Surgery operates 24 hours a day, year round for emergency surgical procedures in the greater Attica area.

APPOINTMENTS

The General Surgery office is located on the 1st floor. For further information and appointments, please contact the office between 8.00h and 15.00h daily by phone on 210 3674132 and by Fax on 210 3610223.
 

Plastic Surgery, and in particular aesthetic surgery, is one of the most popular specialties world-wide. Within one year 550,000 aesthetic and 1.5 million Botox procedures took place in the USA alone. As the number of patients increases so, proportionately, does the responsibility of the Plastic Surgeon. How can we, as doctors, deal with the tremendous demand for our specialty

For us, the safety of the patient and the Hippocratic Oath “to benefit, not harm” are paramount. The aesthetic effect is equally important as it must be impressive but also natural. The following is required in order to achieve the desired results:

1. That the plastic surgeon have a deep knowledge of what is considered beautiful
2. In-depth knowledge of the specialty
3. Thorough knowledge of new technologies and the skill of knowing when to apply them.

Analytically:

SAFETY OF THE PATIENT

The patient has the right to be extensively informed about the surgery or treatment. The appointment with the doctor must last long enough for the patient to be fully aware of what will happen. An appointment with the doctor usually lasts at least 30 minutes depending on the type of procedure. In this meeting the positive effects will be stressed, however, special emphasis is also placed on potential complications no matter how rare they may be.

BEAUTY AND THE PLASTIC SURGEON

Beauty cannot be defined. For us, beauty is all about proportion and thus we adore classic beauty. If we had to choose between Leonardo Da Vinci and Picasso, we would certainly choose Da Vinci. We do not advise patients to greatly enlarge their breasts or lips or to have their faces stretched excessively. An excessively stretched face is reminiscent of someone emerging from a wind tunnel. Beauty is also about sensitivity - sensitivity for individuality and uniqueness. All our patients have the opportunity to peruse many photographs of patients who have also undergone the same procedure at our clinic. By seeing the result, one can form an opinion on our aesthetic perception and effectiveness.

KNOWLEDGE

Doctors, and therefore plastic surgeons, are distinguished by six necessary characteristics:

1. Ethics
2. Personal contact with the patient
3. In-depth theoretical knowledge of the specialty
4. Surgical experience
5. Articles published in medical journals
6. Presentations at medical conferences

Evangelos Keramidas
Plastic Surgeon MD, EBOPRAS
Website: http://www.keramidasevangelos.gr

The Central Clinic of Athens is able to diagnose and treat all forms of vascular disorders. An organised team comprised of specialised medical and paramedical professionals who undertake the holistic care of vascular patients on a diagnostic, preventative and treatment level is on hand.

Vascular disorders fall into the following categories: arterial, venous and lymphatic.

VASCULAR DISORDERS

• Abdominal aortic aneurysm
• Thoracic aortic aneurysm
• Stenosis - arterial obstruction
• Arterial embolism
• Renal artery disease, mesenteric vascular disease
• Thoracic outlet syndrome
• Vascular Dysplasia
• Buerger’s Disease
• Diabetic foot
• Arterial trauma

VEIN DISEASES

• Venous insufficiency, spider veins, varicose veins
• Vein thrombosis

LYMPHATIC CONDITIONS

• Lymphedema

VENOUS ACCESS

• Permanent central venous catheters, dialysis catheters, ports

TREATMENT INTERVENTION

• Arterial bypass with autologous or synthetic grafts
• Angioplasty and Stenting (stents)
• Endovascular repair and traditional open heart surgery for aortic aneurysms
• Arterial embolectomy
• Arterial thromboendarterectomy
• Vascular injury repair
• Thrombolysis
• Vein insufficiency treatment with stripping or laser ablation
• Sclerotherapy for varicose veins
• AV Fistula for patients on dialysis
• Medication for obstructive vascular disease

THE CLINIC

The Urologic Surgery clinic deals with the diagnosis, treatment and surgical procedures required for urological conditions.

TESTS
Cystourethroscopy, ureteroscopy, urinary catheterisation, retrograde uretero-pyelogram.

SURGICAL PROCEDURES

General Urology performs all surgical procedures such as circumcision, plastic surgery for the fraenum, prostate biopsy with the use of an ultrasound, varicocele repair, hyrdocele repair, orchidopexy, testicular biopsy, sheath biopsy, sizeable kidney and epididymis cysts, testicular prosthesis insertion, ectropion urethra, repair of vaginal cysts and urethrovaginal fistula, bladder diverticulum removal, plastic surgery for the pyelo-ureteral junction, internal urethrotomy and narrowing of the urethra using the Holmium Laser etc.

The Urologic Oncology Department can deal with all neoplasms in modern surgical oncology (transurethral resection of the bladder-TURB, radical prostatectomy, radical cystectomy, radical and partial kidney removal (nephrectomoy), nephro-ureterectomy, radical penisectomy, and radical orchiectomy.

In cases of benign prostatic hyperplasia, the Clinic offers selective vaporization of the prostate by laser (EVOLVE diode Laser System), the most modern procedure available today. This method does not require an incision and the patient returns home the next morning having stayed in the hospital for fewer than 20 hours. In addition, open transcystic prostatectomy and transurethral resection of the prostate (TURP) are performed either with the traditional method or with the new, quick and safe bipolar transurethral resection in saline (TURIS) method.

In the management of urinary tract lithotripsy, the modern method using endocorporial lithotripsy (ureterolithotripsy, cystolithotripsy) employing the Holmium Laser resulting in the safe and effective fragmentation of stones which does not require open surgery is the method of choice.

In the management of urinary incontinence, both for women with urethral sling surgery and for men with the placement of an artificial inflatable sphincter, surgery is the method of choice. In addition, cystocoele is managed with the placement of a pessary.

Finally, andrology places special emphasis on the diagnosis and treatment of erectile dysfunction with medication and surgery (inflatable penile prosthesis). In addition, plastic surgery is performed for the bent penis.