The rate of overweight and obesity has soared! Laparoscopic minimally invasive technology helps you "lose weight" to create a new healthy future!

The "Year of Weight Management" initiative is a three-year special campaign launched by the National Health Commission of China in collaboration with 15 departments including the Ministry of Civil Affairs and the Ministry of Education in 2024. Its aim is to foster good lifestyles and habits throughout society, such as attaching importance to weight, managing weight well, maintaining a healthy diet, and actively participating in physical exercise.

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The reason why weight management has become a topic that requires the joint attention of the whole society is that in recent years, the prevalence of overweight and obese people in China has been on the rise continuously, and it has become an important public health issue affecting the health of the nation.

According to the "2023 China Obesity Prevention and Control and Bariatric Surgery White Paper", the rate of overweight or obesity among adults in China has exceeded 50%, which means that one out of every two adults is overweight or obese. The rate of overweight or obesity among children and adolescents aged 6 to 17 is 19%, and among children under 6 years old, it is 10.4%. Some studies predict that if this trend is not effectively curbed, the rates of overweight and obesity among adults and children in China will reach 70.5% and 31.8% respectively by 2030.

Obesity is not simply a number on a scale. From a medical perspective, it is defined as an abnormal or excessive accumulation of fat that can harm health, a chronic metabolic disease, and its diagnosis requires the combination of multiple indicators.

Currently, the body Mass Index (BMI) is commonly used for judgment. BMI is calculated by dividing weight (kg) by the square of height (m). In Chinese standards, a BMI of 24 or above is considered overweight, and 28 or above is diagnosed as obese. However, BMI is not a universal yardstick. In clinical practice, it is often necessary to conduct a comprehensive assessment by combining waist circumference, body fat percentage tests, abdominal CT and other imaging methods. Obesity is influenced by multiple factors, including genetics, diet, physical activity levels, living habits, and changes in the social environment.

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Obesity is associated with the occurrence of various complications, starting from childhood and lasting until the end of life. Its harm can affect almost all organ systems in the body and is closely related to an increased risk of death. Due to the mass effect of excessive adipose tissue or its direct metabolic effect, obesity is associated with the occurrence of over 200 chronic diseases, including diabetes, stroke, coronary artery disease, hypertension, respiratory diseases, obstructive sleep apnea, osteoarthritis, and even various tumors. At the same time, obesity may lead to psychological problems and weight stigma, imposing a heavy burden on individuals, families and society.

肥胖症相关的疾病和死亡风险

Obesity is not only an individual health issue but also a heavy burden on the public health system. In 2021, The Lancet reported that over the past four decades, the prevalence of overweight and obesity among the Chinese population and related medical expenses have been increasing sharply. According to conservative estimates, by 2030, medical expenses attributed to overweight/obesity in China will account for 21.5% of the country's total medical expenses.

Obesity, as a chronic disease, its prevention and treatment in China follow the management model of common chronic diseases, with the three-level prevention and treatment of the disease as the basic principle. Patients with severe obesity should receive active treatment including comprehensive lifestyle intervention, drug therapy and bariatric surgery.

基于中国现有分级诊疗体系的肥胖症管理推荐模式

(*治疗1包括生活方式干预；†治疗2包括生活方式干预和药物治疗；‡治疗3包括生活方式干预、药物治疗和减重手术。)

Bariatric surgery refers to the use of surgical procedures to reduce gastric volume, gastrointestinal absorption, or alter the redistribution of gastrointestinal hormone levels. It aims to reduce body weight and alleviate obesity complications by restricting nutrient absorption or regulating metabolism. It can reduce BMI while alleviating diabetes, hypertension, non-alcoholic fatty liver disease, obstructive sleep apnea syndrome and polycystic ovary syndrome, etc. It is currently recognized as the only treatment method that can achieve long-term effective weight reduction.

Bariatric metabolic surgery began to be explored in China in 1982, and the first laparoscopic bariatric surgery was carried out in 2000. According to the "China Obesity and Metabolic Surgery Database: 2023 Annual Report", the actual total number of bariatric surgeries across the country in 2023 was approximately 37,249 cases. Laparoscopic sleeve gastrectomy and laparoscopic RYGB gastric bypass surgery are currently the main recommended bariatric surgical methods in China:

Laparoscopic sleeve gastrectomy (LSG) is a type of ingestion restriction surgery: by creating a sleeve or tubular stomach along the lesser curvature of the stomach, it utilizes its volume-limiting effect and the endocrine regulatory mechanism of the stomach to achieve weight loss, alleviate or treat obesity-related complications. This operation is relatively simple, with a quick postoperative recovery and few long-term complications. It has the effect of improving metabolism and is suitable for most obese people.

LSG手术图示

Laparoscopic Roux-en-Y gastric bypass (LRYGB) is a restrictive and combined malabsorption surgery: by reducing gastric volume and altering food pathways, it aims to limit food intake and reduce small intestinal absorption, and to change nutrient metabolism and gastrointestinal hormone regulation, thereby achieving clinical effects such as weight loss and improved insulin resistance. This surgery is the gold standard for bariatric surgery and has a powerful metabolic improvement effect. It can improve various metabolic diseases such as hypertension, type 2 diabetes, hyperlipidemia, sleep apnea syndrome, and polycystic ovary syndrome.

LRYGB手术图示

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How exactly is laparoscopic bariatric surgery carried out? First, the doctor will make one or more small holes in the patient's abdomen and then insert a "mini camera" into the abdominal cavity through these holes. This high-definition lens with a built-in fill light will project the conditions inside the abdominal cavity in real time onto the screen in the operating room, just like putting "X-ray glasses" on the doctor. Then, the doctor will manipulate several slender "mechanical small chopsticks", along with miniature scissors, grippers and other tools, to enter the body through other small holes. These flexible small tools can perform various delicate operations such as cutting, suturing and hemostasis. The entire process is like an "internal micro-sculpture" carried out with a remote control handle.

Therefore, for laparoscopic bariatric surgery, there are three indispensable tools: First, auxiliary platform products expand the operating space in the abdominal cavity and provide a good environment for the surgery; Second, the "mini camera" sent into the abdominal cavity acts as the doctor's "X-ray eye", observing the conditions inside the abdominal cavity in real time. Thirdly, the slender "mechanical small chopsticks" serve as the doctor's extended arm to facilitate precise operations within the body.

In response to the current situation of laparoscopic bariatric surgery and the special needs of obese patients, KARL STORZ, a global leader in the field of endoscopy, has brought a complete specialized solution for bariatric and metabolic surgery, consisting of "three-in-one imaging + laparoscopic bariatric equipment +50L pneumoperitoneum machine" products.

Imaging products, as the "X-ray eyes" of doctors, are of vital importance for presenting the conditions inside the abdominal cavity clearly and accurately. KARL STORZ's IMAGE1 S Rubina imaging system integrates 4K, 3D imaging technology and near-infrared fluorescence (NIR/ICG) imaging technology. 4K provides a higher resolution, helping surgeons identify anatomical structures, blood vessels, etc. more accurately. 3D can provide a more realistic and three-dimensional visual experience, helping to reduce the difficulty of complex surgeries and improve surgical efficiency. By taking advantage of its own information navigation, NIR can enhance the accuracy of bariatric surgery and increase the safety of the operation.

Medical devices, as doctors' "extended arms", have made it possible for clinicians to perform surgeries within the abdominal cavity. For obese patients, abdominal fat is relatively thick, so ordinary "mechanical small chopsticks" cannot meet their needs. The weight loss specialty equipment of KARL STORZ adopts an extended design to meet the required length for mechanical operations within the abdominal cavity of obese patients and improve the surgical efficiency. At the same time, it effectively avoids the obstruction of the surgical field caused by fat accumulation, enhancing the safety during the operation. In addition, this extended "mechanical small chopstick" encompasses various forms of equipment, offering a more comprehensive combination and wider adaptability.

腹腔镜减重手术器械套

Finally, the pneumoperitoneum machine is a "capable little helper" that provides an intra-abdominal operating environment for laparoscopic bariatric surgery. In view of the characteristic of thick abdominal wall in obese patients, the ENDOFLATOR 50 high-performance 50L pneumoperitoneum machine provided by KARL STORZ has a greater flow rate and more precise adjustment method. The gas flow rate can reach 50L/min. It can quickly establish pneumoperitoneum during the operation and has higher adjustable maintenance of pneumoperitoneum during the operation. The product features both high-flow and low-flow modes, catering to different types of patients. At the same time, the gas can be heated, which can complete the surgery more safely and conveniently.

ENDOFLATOR 50 高性能 50L气腹机

From advanced imaging product lines to auxiliary platform equipment and specialized instruments, KARL STORZ can provide complete bariatric and metabolic surgery solutions for clinical practice and patients, simplifying complexity and providing specialized treatment, thus contributing to the development of bariatric medical care in China.

May 11th is World Obesity Day. The establishment of this festival is not only a health reminder but also a clarion call for action. The prevention and control of obesity requires the joint efforts of multiple parties, ranging from the individual level of "controlling diet and moving more", to the precise intervention of the medical system, and then to policy promotion. Only when the whole society gets involved can the prevention and treatment of obesity be more than just a slogan.

In response to the calls of the "Year of Weight Management" and "World Obesity Day", KARL STORZ will also bring the "Long Road Ahead - Live Streaming Week of Weight Loss Theme Activities" from May 12th to 15th, with the theme of "Precise Weight Loss, Mirror Reveals the Future", further promoting standardized laparoscopic bariatric surgery techniques and contributing to the vigorous development of bariatric and metabolic surgery. Better safeguard the physical health and life safety of patients!