Bariatric Surgery Lower Saxony: Prof. Dr Dr Thomas Carus

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Prof. Dr Dr habil. Thomas Carus is a specialist in bariatric surgery and head of the Department for General and Visceral Surgery at the Bassum Clinic.

The motivated and experienced team around Prof. Carus supports patients with severe overweight on their way to an easier and healthier life through an individually developed program for permanent weight reduction. In the process, necessary surgeries are carried out with the most up-to-date surgical techniques in a patient-friendly manner.

Specialist for the Treatment of Obesity (Severe Overweight) in Lower Saxony

Repeated unsuccessful attempts to lose weight, yo-yo dieting, and discomfort during exercise are incredibly frustrating for many obese patients. Therefore, to reduce secondary damage of massive overweight, also public health insurances have recognized that cost coverage for bariatric surgeries is significant from an economic point of view.

The primary goal of all bariatric surgeries is massive weight loss through the surgical reduction of the digestive tract. However, this weight loss is not an end but is intended to reduce the risk of all complications associated with massive obesity. Even the course of already manifested diseases, such as type II diabetes mellitus, high blood pressure, or sleep apnea syndrome, is usually positively influenced by massive weight reduction.

Losing Weight by Stomach Reduction

Large portions of the stomach are surgically removed in gastric reduction, where only a tubular sleeve stomach remains. Its reduced filling volume prevents excessive food intake by immediately providing a feeling of fullness. As a result, the overweight is reduced by 50% on a statistical average. However, alternative surgical techniques such as gastric bypass are preferable for patients suffering from severe heartburn.

Expert for Gastric Bypass Surgery

In a so-called Roux-en-Y gastric bypass, a small reservoir (pouch) is also formed from the upper portion of the stomach and sutured directly to the middle parts of the small intestine, bypassing the remaining portions of the stomach. This effectively reduces the intestinal surface area used for nutrient absorption so that fewer calories in the form of fats and carbohydrates can be absorbed from the food pulp. Nevertheless, the eliminated loop of the intestine must be reconnected to the draining segment to ensure mixing with digestive juices from the gallbladder and pancreas, which usually takes place in the eliminated upper segment of the small intestine.

Treatment of Overweight by Gastric Balloon

If surgery is out of the question for personal or medical reasons, Prof. Dr Dr Thomas Carus also offers a less invasive method to treat obesity effectively. A balloon is placed with an endoscope in front of the pylorus at the exit and inflated during a gastroscopy under sedative sleep when using that method. As a result, the stomach passage slows down, and the feeling of hunger is effectively lowered.

Department for Abdominoplasty in Lower Saxony

Since the skin's connective tissue is usually irreversibly overstretched after a successful weight reduction, many patients suffer from their physical appearance due to the sagging abdominal folds. Therefore, abdominoplasty is an aesthetic procedure that should principally not be carried out until the target weight has been reached. During this procedure, deeper muscle and connective tissue layers are tightened, and excess skin and fatty tissue are removed. Subsequent tightening of the skin shapes a tighter, flatter abdomen.

Suppose there is a medical indication due to secondary damage caused by the sagging abdominal wall (e.g., intertrigo). In that case, an application can be made to the health insurance company to cover the costs.

State-of-the-Art Multimodal Therapy for Obesity

Multimodal therapy for obesity is an essential component of obesity treatment and comprises three components that lead to the desired long-term success together:

1. Nutritional therapy: this involves a sustainable diet change, professionally supervised by dieticians.
2. Exercise therapy: the energy balance is kept negative with moderate exercise. For this, medical advice is essential to avoid potentially dangerous sports.
3. Behavior therapy: since self-reflection and impulse control is often a limiting factor for the long-term prospects of success of a lifestyle intervention, especially in obese patients, cognitive-behavioral therapy forms the third pillar of the multimodal model.

If bariatric surgery is to be covered by health insurance, the patient must follow the multimodal concept for six months to treat their obesity disease.

Please, visit the website of the Bassum Clinic for more information.