Monumental Procedure at Hospital das Clínicas of Ribeirão to Combat Obesity and Diabetes

Pioneering Hospital in Brazil Performs First Bipartition Intestinal Transit Surgery, Prepares for First Intestine Transplant

Ribeirão Preto, brazil – December 3, 2025 – The Hospital das Clínicas de ribeirão Preto (HCRP) has cemented its position as a leading medical center with two groundbreaking achievements: the first-ever Bipartition intestinal Transit (BTI) surgery and preparations for the region’s inaugural intestine transplant.

On Monday, december 1st, HCRP surgeons successfully performed a BTI procedure – a complex operation connecting part of the intestine to the stomach to aid in weight management and diabetes control. Recognized recently by the Federal Council of Medicine (CFM), BTI is proving effective in treating severe obesity and difficult-to-control type 2 diabetes, with studies demonstrating meaningful improvements in both weight and blood glucose regulation for suitable patients. The first patient,a 42-year-old man weighing 220 kilos,is reportedly recovering well and will undergo strict monitoring to assess the long-term results.

This milestone comes as HCRP concurrently prepares for another medical first: an intestine transplant. The hospital has already secured approvals from both Conitec (National Commission for the Incorporation of Technologies into the Unified Health System) and the National Transplant System (SNT), and is awaiting final accreditation from the Unified Health system (SUS). The first transplant is anticipated to take place in the first half of 2026.

Intestine transplantation is reserved for patients facing severe intestinal failure due to non-intestinal issues like thrombosis,tumors,or inflammatory diseases. Dr. Marcelo Bonvento explained the procedure will focus on improving clinical care and restoring intestinal function in thes critical cases.

These advancements underscore HCRP’s commitment to pioneering complex surgical procedures and providing cutting-edge medical care to the region. The hospital’s dedication to innovation positions it at the forefront of medical breakthroughs in Brazil.

What specific psychological factors are assessed during the patient evaluation process to determine emotional preparedness for lifestyle changes?

Understanding the Rising Tide of Obesity and Diabetes

Obesity and type 2 diabetes are global health crises, demanding innovative and comprehensive treatment strategies. Brazil, like many nations, faces a notable burden from these interconnected conditions. Hospital das Clínicas of Ribeirão Preto (HCP), a leading medical institution affiliated with the University of São Paulo (USP), is at the forefront of tackling this challenge with a groundbreaking, multidisciplinary approach. This article details the advanced procedures and integrated care model employed at HCP, offering hope for individuals struggling with severe obesity and related metabolic disorders. We’ll explore the specifics of bariatric surgery, diabetes management, and the crucial role of a holistic, patient-centered team.

The Integrated Approach: Beyond Bariatric Surgery

HCP’s success isn’t solely based on surgical intervention. It’s the comprehensive, pre- and post-operative care that sets it apart. The program emphasizes a multidisciplinary team including:

* Bariatric Surgeons: Specialists in performing weight loss surgeries like Roux-en-Y gastric bypass, sleeve gastrectomy, and adjustable gastric banding.

* Endocrinologists: Experts in diabetes treatment, hormone regulation, and metabolic health.

* Nutritionists: Providing personalized diet plans for weight loss, maintenance, and improved metabolic control.

* Psychologists/Psychiatrists: Addressing the behavioral and emotional aspects of obesity and supporting long-term lifestyle changes.

* Physical Therapists: Developing exercise programs to enhance physical activity and improve overall fitness.

* Cardiologists: Monitoring and managing cardiovascular health, a common concern for individuals with obesity and diabetes.

This collaborative model ensures patients receive holistic care addressing the physical, psychological, and social factors contributing to their conditions.Metabolic surgery is a key component,but it’s always coupled with intensive lifestyle modification.

Surgical Techniques Employed at HCP

HCP utilizes a range of bariatric procedures, tailored to each patient’s individual needs and health profile.

* Roux-en-Y Gastric Bypass: Considered the “gold standard” for many, this procedure creates a small stomach pouch and reroutes the small intestine, limiting food intake and nutrient absorption. It frequently enough leads to significant weight loss and remission of type 2 diabetes.

* Sleeve Gastrectomy: Involves removing a large portion of the stomach, creating a smaller, tube-like stomach. This reduces appetite and promotes weight loss. It’s increasingly popular due to it’s effectiveness and relative simplicity.

* Adjustable Gastric Banding: A less invasive option, involving placing a band around the upper part of the stomach to restrict food intake. While less common now, it remains a viable option for select patients.

* Single Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy (SADI-S): A more complex procedure gaining traction for its potential for greater weight loss and diabetes remission, particularly in patients with higher BMIs.

The choice of procedure is made after a thorough evaluation, considering factors like BMI, co-morbidities, and patient preferences. Minimally invasive surgery techniques (laparoscopy and robotic surgery) are prioritized whenever possible, leading to faster recovery times and reduced complications.

Diabetes Remission and Metabolic Advancement

A remarkable outcome of bariatric surgery at HCP is the high rate of type 2 diabetes remission. Studies have shown that over 70% of patients with type 2 diabetes experience remission after undergoing bariatric surgery, often within months. This isn’t simply weight loss; it’s a essential change in metabolic function.

* Improved Insulin Sensitivity: surgery enhances the body’s response to insulin, allowing glucose to be utilized more effectively.

* Gut microbiome Changes: Bariatric surgery alters the composition of the gut microbiome, promoting the growth of beneficial bacteria associated with improved metabolic health.

* Hormonal Regulation: Surgery impacts the production of gut hormones that regulate appetite, satiety, and glucose metabolism.

HCP’s endocrinologists closely monitor patients’ blood sugar levels and adjust medication as needed, aiming for complete medication independence whenever possible. Glycemic control is a primary focus throughout the entire treatment process.

patient Selection and Pre-Operative Preparation

Rigorous patient selection is crucial for success. HCP employs strict criteria, including:

1. BMI of 40 kg/m² or higher, or a BMI of 35-39.9 kg/m² with significant obesity-related co-morbidities (like diabetes, hypertension, sleep apnea).
2. Comprehensive medical evaluation: To assess overall health and identify any contraindications to surgery.
3. Psychological evaluation: To ensure patients are emotionally prepared for the lifestyle changes required.
4. Nutritional counseling: To begin adopting a healthier diet before surgery.

pre-operative preparation includes a very low-calorie diet (VLCD) for several weeks, designed to shrink the liver and