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Mal Fobi interview

An interview with Dr Mathias Fobi at XIX SBCBM

Mathias Fobi praised the constant evolution of Brazilian bariatric surgeons, who, according to him, are always seeking to improve in terms of surgical techniques, as well as to offer the appropriate procedure, according to each patient

Bariatric surgeon, Dr Mathias Fobi - internationally awarded for the development ‘The Fobi Pouch’ procedure (or the banded bypass) - is in Fortaleza, capital of the state of Ceará, to participate in the XIX Brazilian Congress of Bariatric and Metabolic Surgery, promoted by the Brazilian Society of Bariatric and Metabolic Surgery (SBCBM).

This article was authored by Melina Menezes, journalist for the Brazilian Society of Bariatric and Metabolic Surgery

His signature surgery, "The Fobi Pouch", also known as a version of the stomach-shrinking gastric bypass - consists of diverting a great portion of the stomach and a slight portion of the small intestine. According to the Brazilian Society of Bariatric and Metabolic Surgery (SBCBM), in Brazil, out of the 100,000 bariatric surgeries performed annually, approximately 60,000 are performed using the gastric bypass. In an exclusive interview, Dr Mathias Fobi spoke about his signature surgery, and also praised the constant evolution of Brazilian bariatric surgeons, who, according to him, are always seeking to improve in terms of surgical techniques, as well as to offer the appropriate procedure, according to each patient.

Question -  What were the main changes that your signature surgery, "The Fobi Pouch", has gone through in recent years?

Answer -  Like any other medical procedure, it has faced some modifications. When we first put it into practice, it basically restricted the flow of food into the stomach, forcing the patient to chew and eat slowly. Over the years, we have understood that the procedure could be more effective if it were conducted in a different way. So we decided to change it. Now, what we do is limit the elastic capacity of the stomach.

Mal Fobi

The surgery is not intended to limit how much the patient can eat, even though, in practice, that is what it does. As I said, the goal is to limit the size that the stomach stretches to. So, once we understood that it was necessary to modify it, we created a gastric ring that was not too tight, so that the patient's stomach could stretch to a certain extent after eating less food, still making him feel satisfied. Currently, the surgery works very well.

Question - In your opinion, where is Brazil in this context?

Answer - Brazil is responsible for the second highest number of weight-loss surgeries in the world, being only behind the USA. Here, the doctors are really willing to learn. If you travel around the world to participate in other meetings and conventions such as the Brazilian Congress of Bariatric and Metabolic Surgery, you will see that Brazilians doctors make quite a good percentage in the attendance list. So, they are out to learn. Most of them follow very strict protocols. There are some innovations coming to Brazil, such as the endoscopic approach, which is fantastic!

Question - According to your experience, how should obesity be treated worldwide?

Answer - Obesity is a chronic and incurable disease that should be treated like any other. Surgery indications are already well established. The indication depends on each patient. We should be treating the patient, rather than often defending what we do. You see, we are driven to prove that we are good, and that our procedure is effective. We discussed the use of two or three different treatment techniques. The truth is that it doesn't matter the procedure, if you know your patient well and his clinical picture, you will know what he needs. By doing this, the surgeons will be treating the disease, just like they treat diabetes, for instance, which has approximately 400 different treatment techniques. There is not only one effective procedure, but several. Each treatment depends on the amount of weight that the patient is going to lose and in the group of people that it will be used on, which must follow the guidelines to achieve the expected results. If we treated the disease, we would not be giving up certain procedures, but using them on the right people!

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