The Rodin weight loss team of Chengdu Fifth People's Hospital admitted a special patient, Daming 27 years old, 178cm tall, 526 pounds, waist circumference 199cm, thigh circumference 121cm, body mass index (BMI) up to 83kg/m2, body fat content as high as 142kg, body fat rate of 54.2% (normal male 15% to 18%). Dr. Luo Dan, a weight loss expert in the General Surgery Department of Chengdu Fifth People's Hospital, introduced: According to the "Guidelines for the Prevention and Control of Overweight and Obesity in Adults in China", BMI greater than or equal to 24 kg/m2 is overweight, greater than or equal to 28 kg/m2 is obese, posing a danger to health, and Daming's BMI value is 83kg/m2, which has been seriously exploded.
When Daming was admitted to the hospital
When Daming was born, he almost turned 8 pounds, and 8 pounds is called giant child in medicine. Due to his parents' limited maternity leave, he was sent to a friend's house for foster care when he was half old in April, and was taken by his friend's parents. One of the characteristics of the old man with the baby is that if you don't raise a white and fat, you are sorry for this living expense. In addition, Daming is not picky eaters, and those who come do not refuse, and soon grow into a small fat mound.
Daming and his mother have played well since childhood, and when they grow up, they will not worry about the amount of food, and every few bowls of white rice will not be a word, and they will all let go of eating. Parents realize that the child seems to be a little too fat. Think about it for a moment: when he grows taller, he will "draw strips". In this case without any restrictions, Daming slowly grew into a big fat of more than 500 pounds.
Dr. Rodin and Daming
"You should be able to see that I don't care about weight" "I've been fat since I was a kid and used to it. "Daming's memory of his weight at each stage is blurred." Because I don't care about the number on the scale at all. Others fat ten pounds may exclaim, I stand on the scale is full of confusion, how many pounds before, is there fat? Forget it. Anyway, no matter what stage I was, I was the heaviest in the school. At that time, I didn't feel any difference between myself and the people around me. "Daming has a very good mentality and is also a very energetic person. He said: "Because I look a few circles older than others, it is always strange for others to look at me. No matter where I am, my return rate is higher than that of beautiful women, and even some people come to secretly photograph me. I can actually understand what they think, and I don't think it affects me whether they take pictures or not. "As soon as the words fell, I heard a click, and Daming turned his head and pointed to a big aunt next to him: Delete the photo I just took, and empty the recycle bin." "But after all, I was secretly photographing me, no matter what." Daming said solemnly.
Because of his weight, Daming also made jokes. When he was young and careless, he made an appointment with a few friends to go to the water park to play. "Don't ask me why a big fat man still has to go to the water park, can't a fat man still have a little freedom to pursue happiness?" Big next year less light crazy, already ready to splash a happy sweat in the water park. Buy a ticket to go in to know that people's play items are limited to 180 pounds. "I was so angry that I charged me 200 yuan, but I was asked to splash water in the wave pool." In fact, it is not 200 yuan that Daming is angry, but the freedom to pursue happiness is gone. Daming later learned that happiness is not only in the water park, but also in red wine, white wine and beer. When asked about the amount of alcohol, Daming put up a finger. Everyone has speculated: a bottle of liquor? A case of beer? Daming put away his fingers and said slowly: "Keep drinking." I have a lot of alcohol and anesthesia. Although the optimistic and cheerful Daming is fat, he has a good personality, and his popularity has been good since elementary school, and the people around him do not care about the Michelin tires on him. Daming felt that as long as I wasn't fat and couldn't move, I was just like everyone else. I have also lost weight and "slimmed down".
In 2018, Daming gradually realized that something was wrong with his body, and he began to be unable to walk. "Two steps to breathe, every day is either sitting or lying down, every step you move, you have to make a lot of effort." Blood pressure also began to rise, Daming recalled that time, said: "If you get fatter, people will be gone." "He knows that fat is going to kill people. He chose to walk into a professional weight loss center and began a year-long fully enclosed weight loss road. In the past year, the weight has been successfully reduced from 500 pounds to 300 pounds. But the good times did not last long, after bidding farewell to extreme diet and strong exercise, the weight gradually rebounded, the weight broke through 500 pounds again to 526 pounds, and all the troubles of obesity came back.
Sleep in a prone position after admission
After learning about bariatric surgery and communicating with dr. Luo Dan, a weight loss expert, he decided to choose Dr. Luo Dan of Chengdu Fifth People's Hospital to complete the bariatric surgery and realize the transformation of his life. On the day of admission, Daming came to the ward breathlessly dragging a suitcase that was a few laps smaller than himself, attracting the attention of everyone present, and we quickly let him sit down and rest. Due to the long-term compression of his overweight, he had some degree of damage to his spine and knee joints. The sleep apnea caused by super obesity has left his brain in a long-term state of hypoxia, and now he can only sleep on his stomach. The examination also found that Daming had severe hypertension, long-term heart and lung overload, and death from cardiac arrest could occur at any time. Because the body was too large, we couldn't cram him into the MRI machine. The hospital's only enlarged and widened CT machine could barely accommodate his body, but we used the maximum radiation dose and could not penetrate his thick fat.
Awkward CT tour
Dr. Rodin, a weight loss specialist, has more than 1,000 successful cases of bariatric surgery, and has experience in the treatment of super obesity, and has treated super obesity weighing up to 540 pounds. He formulated a detailed preoperative weight loss plan for Daming, invited Liu Fei, a teacher from the Nutrition Department, to carry out low-calorie diet intervention, zhong Jiafang, a teacher of the Rehabilitation Department, to guide him on exercise exercises, to carry out cardiopulmonary rehabilitation training, to control blood pressure, and to correct bad living and eating habits such as staying up late. After more than 2 months of hard work, Daming successfully lost 56 pounds and dropped to 470 pounds. Daming said: "When I lose 10 pounds, I feel much more relaxed, and these 10 pounds are like 200 pounds. ”
Before the operation, Rodin's attending physician invited the departments of anesthesia, cardiology, respiration, intensive care, nutrition rehabilitation and other departments to discuss the MDT of the whole hospital, and sorted out the surgical process and formulated a plan. Well prepared for the operation.
Director Liu Jian presided over the preoperative discussion
Dr. Rodin decided to perform laparoscopic sleeve gastrectomy for Daming, which is a minimally invasive operation, the principle of surgery is to turn the water-bagged stomach into a slender banana shape through 4 to 5 small incisions in the abdominal wall, while removing the bottom of the stomach and most of the secretory cells of the stomach body, while reducing the amount of food, reducing the secretion of ghrelin, thereby reducing the patient's hunger. Daming weighs 263kg, half of which is fat, and his abdominal wall fat thickness is several times that of ordinary people. As a result, ordinary laparoscopic instruments simply cannot enter the abdomen. Dr. Rodin customized special instruments such as a 20cm extended air needle, a laparoscopic 42cm extended lens, and a specially lengthened 43cm laparoscopic enteric forceps. The 64cm upper arm circumference made the ordinary sphygmomanometer helpless, and the weight loss team also customized a widened and lengthened cuff for him to ensure the accuracy of blood pressure measurement. Short neck and thick neck fat make it difficult to intubate the trachea, and The director of the Department of Anesthesiology, Yi Liangming, Dr. Yin Hong, has repeatedly checked the patient before surgery, assessed the patient's condition, and formulated anesthesia plan to ensure the smooth progress of anesthesia. The head nurse of the operating room, Ao Yongqiong, Li Yang, and Teacher Zhang Yu, transformed and widened the operating bed to ensure that Daming could lie down smoothly and the flesh on his stomach would not fall. Against all odds,
Lengthened surgical instruments
Successful surgery On August 25, 2021, at 8:00 a.m., Daming was pushed into the operating room. He looked in a good mood and couldn't see a hint of nervousness: "I'm not afraid at all, anyway, go in and lie down and close your eyes and sleep, it's over, the headache is you." This sentence made everyone in the operating room laugh, and we teased him: "Then don't look for your mother when you wake up from surgery, your mother is outside the operating room, but she can't come in." In the laughter of everyone, the tense atmosphere in the early morning gradually dissipated.
Dr. Rodin and Daming
Under the guidance of Yi Liangming, Director of the Department of Anesthesiology, Dr. Yin Hong, Dr. Yuan Feng and Dr. Wan Jialu completed radial artery puncture and internal jugular venous catheterization in an orderly and skilled manner. Successful completion of endotracheal intubation. In order to reduce postoperative abdominal pain, Director Yi Mingliang of the Department of Anesthesiology instructed Dr. Cai Min to complete the abdominal nerve block under ultrasound guidance, and the preparation process for anesthesia Ultrasound guided nerve block at the same time,
Operating room Li Yang, Teacher Cao Lu,
The preparation of the nurses and teachers is also proceeding in an orderly manner. The smooth anesthesia strengthened our confidence, Dr. Rodin began the operation, and everyone held their breath and watched the movement of the operation. Smoothly entering the abdomen and establishing the qi abdomen, the first step means a good start, as long as the surgical instruments can be extended into the belly of Daming more than ten centimeters thick, it is equivalent to half of the successful operation. Through laparoscopy, it can be seen that Daming's fatty liver is very serious, the omentum is fatty, and almost the entire abdominal cavity is stuffed, resulting in an extremely narrow operating space for surgery.
Dr. Rodin began the operation
Rodin weight loss team Wang Haibo, teacher Li Qin cooperated with the operation
At 11:10, the operation was successfully completed after 1 hour and 20 minutes. "The operation was a success!" Chief surgeon Rodin walked out of the operating room and conveyed the good news to Daming's mother, who was waiting outside the operating room. After the operation, according to the results of the examination, Daming's physical condition was very stable. Less than 24 hours after the operation, he resumed the gastrointestinal motility function and was able to drink water gradually. On the second day after the operation, he can get out of bed moderately. The success of the operation has given Daming more confidence on the road to weight loss, and it is expected to lose 250-300 pounds in 1 year. Daming's weight loss career is still continuing, and we sincerely wish him a healthy and sunny life for the rest of his days!