Before the operation, the former "fat friends" cheered up Mr. Zhou with tea instead of wine. Photo by correspondent Li Han

　　At 8:30 am on August 3, Mr. Zhou, who weighed 556 kg, was admitted to Zhongnan Hospital of Wuhan University for 63 days, and finally waited for the stomach reduction surgery he was looking forward to for many days.

　　After 6 hours of surgery, 80% of his stomach was removed. "Mr. Zhou's minimally invasive surgery is very successful. It is estimated that the weight can be reduced to about 300 kg within a year after the operation." said Li Zhen, deputy director of the Center for Obesity and Metabolic Diseases, Zhongnan Hospital of Wuhan University.

　　He grew 200 kg in 5 months, and the surgical conditions were once not up to standard

　　Mr. Zhou is 26 years old this year and is a staff member of an Internet cafe in Wuchang. From chubby to big, at the end of last year, he was only 175 cm tall and his weight exceeded 350 kg. During the epidemic prevention and control period, he stayed at home for 5 months and his weight increased by more than 200 kilograms. The huge weight load caused him to have symptoms such as breathing difficulties and heart failure. On June 1, he was taken to Wuhan University Zhongnan Hospital by his family overnight in a truck. After more than a week of treatment in the hospital's ICU, Mr. Zhou's condition gradually came under control. On June 11, he got out of danger and was transferred to a general ward.

　　"When Mr. Zhou was first admitted to the hospital, his body fat was too thick, his cardiopulmonary function was poor, and the risk of surgery was very high. He can only hope that he can reduce more than 50 catties within 2 months by adjusting his diet and work rest, so that the risk of surgery will be reduced. A lot." Li Zhen said.

　　Therefore, in order to smoothly help Mr. Zhou perform gastric reduction surgery, the hospital's Obesity and Metabolic Disease Surgery Center, Rehabilitation Department, Endocrinology Department and other departments jointly performed internal medicine weight loss for him.

　　The Orthopedic Rehabilitation Department has carried out standing training, breathing training, upper and lower limb training for Mr. Zhou for nearly 2 months to help strengthen the muscles of the limbs, reduce fat, and improve cardiopulmonary function. Dai Zhe, deputy director of the Department of Endocrinology, formulated weight-loss nutritional meals for him, strictly controlled his diet, and achieved obvious weight-loss effects through internal medical methods such as weight-loss injections.

　　At the end of July, Mr. Zhou lost more than 60 kilograms in weight, his cardiopulmonary function was significantly improved, and he was able to sit up, stand and walk short distances independently.

　　On the afternoon of July 23, more than ten departments including Otorhinolaryngology Head and Neck Surgery, Obesity and Metabolic Disease Surgery Center, Critical Care Medicine, Endocrinology, Anesthesiology and other departments of Zhongnan Hospital formulated a surgical plan for Mr. Zhou and discussed Mr. Zhou’s bariatric surgery. difficulty.

　　After evaluation, Mr. Zhou's physical indicators can be used for stomach contraction surgery. Experts believe that Mr. Zhou's weight loss treatment has entered the "bottleneck stage", and the effect of medical weight loss is not obvious. Continuous effective weight loss can only be achieved through gastric reduction surgery.

Mr. Zhou is in operation. Photo by correspondent Li Han

　　The total value is over one million yuan, surgical instruments must be customized

　　Although Mr. Zhou's surgical plan was only confirmed at the end of July, the pre-operative preparations began more than a month ago.

　　Li Zhen, deputy director of the Obesity and Metabolic Disease Surgery Center of Zhongnan Hospital, revealed that he started to "plan" Mr. Zhou's surgery at the end of June: contacting the medical device manufacturer to customize surgical instruments for Mr. Zhou, and talking to Mr. Zhou and his The family members repeatedly communicated to clarify the importance and pros and cons of the operation and dispel their doubts.

　　"Mr. Zhou's operating table and surgical instruments are all lengthened or specially made, with a total value of more than one million yuan." Li Zhen said, because Mr. Zhou weighs too much and takes up too much space, the special operating table is not only more expensive than ordinary operating tables. It is firm and reliable, and can adjust the angle of the back like a beach chair. The limbs can be fixed on the operating table and can also be opened like a "big" character to prevent the heart and lungs from being compressed during lying down operations.

　　As Mr. Zhou’s abdomen fat is too thick, the hospital has also customized an “independent and movable multifunctional surgical bed frame”, which can temporarily “hang up” Mr. Zhou’s thick abdomen during the operation, helping the doctor to obtain a relatively open field of vision and Operating space.

　　On July 30, after completing the preoperative talk with the doctor and his family, Mr. Zhou signed the informed consent form for the operation. "Although the operation risk is very high, I believe you!" Mr. Zhou's father held the hand of the medical staff and "entrusted" his son to them.

　　So far, Li Zhen, who has successfully completed more than 300 gastric reduction surgeries, said frankly that although he is confident in his technique, it is the first time he has encountered a patient weighing more than 500 kilograms, and he is inevitably a little nervous.

　　In order to ensure that there is nothing wrong, Li Zhen and the medical staff performed multiple simulated operations, and even "exercised" twice how to send Mr. Zhou into the operating room from the ward and then onto the operating table.

　　With a capacity of 3000ml, the cut stomach is as big as a basketball

　　The operation started at 9 o'clock in the morning.

　　First of all, the anesthesiologist overcomes the adverse conditions of Mr. Zhou's heart failure and hypoxemia, and successfully completes general anesthesia in more than one hour. Then, the chief surgeon Pan Dingyu and Li Zhen made 5 small holes in Mr. Zhou's abdominal wall and performed sleeve gastrectomy for him through a lengthened laparoscope. The operation was over at 3 pm, and Mr. Zhou’s stomach was cut off by 80%, with a capacity of 3000 ml and a diameter the size of a basketball.

　　After the operation, more than a dozen medical staff spent 10 minutes working together to lift Mr. Zhou from the operating table to the transfer bed, and then to the ICU ward. Two or three days later, when Mr. Zhou's vital signs continue to stabilize and the circulation is stable, he can be transferred to the general ward.

　　Li Zhen said that because Mr. Zhou’s “initial weight” was too large, even if he lost his weight after a stomach contraction operation, he still belongs to the category of obesity, and the burden of cardiopulmonary function is still heavy. Therefore, he does not rule out laparoscopic bowel bypass surgery in the future. Further limit his absorption of excessive nutrients and ensure that his weight continues to fall to the normal range. Reporter Zhang Jian, correspondent Li Han