Doctor of Medicine Proves Combined Surgical Techniques Have the Potential to Increase the Effectiveness of Obesity Treatment

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• Senin, 15 September 2025
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Doctor of Medicine Proves Combined Surgical Techniques Have the Potential to Increase the Effectiveness of Obesity Treatment

Held in the A.A. Djelantik Room, Faculty of Medicine Building, Udayana University, Denpasar Campus, the Doctor of Medicine Study Program, Faculty of Medicine, Udayana University, held an open doctoral promotion examination with Dr. Gede Eka Rusdi Antara, Sp.B-KBD, MARS., M.H., with the title "Comparison of the Combined Sleeve Gastrectomy-Ileal Anastomosis Technique with Sleeve Gastrectomy and One Anastomosis Gastric Bypass in Reducing Interleukin-6, Tumor Necrosis Factor-α, and C-Reactive Protein Levels, as well as Body Weight in Male Wistar Rats (Rattus Novergicus L.) Obesity Model." (September 9, 2025)

Obesity is a global public health challenge characterized by increased fat accumulation closely associated with systemic inflammation through proinflammatory cytokines such as interleukin-6, tumor necrosis factor-α, and C-reactive protein. Although bariatric surgeries, such as Sleeve Gastrectomy (SG) and One Anastomosis Gastric Bypass (OAGB), have provided solutions, each still has limitations, particularly in maintaining stable weight loss and sustaining inflammation reduction. This study aimed to evaluate the effectiveness of the innovative combined technique of Sleeve Gastrectomy with Ileal Anastomosis compared to SG and OAGB, as seen in lower levels of IL-6, TNF-α, and CRP, as well as lower body weight in male Wistar rats, a model of obesity.

An experimental study design with random allocation was used to divide the animal subjects into a control group (SG and OAGB) and a treatment group (Sleeve Gastrectomy-Ileal Anastomosis). Obesity was induced through a high-fat diet, followed by surgical procedures according to the group. Data analysis was performed using one-way ANOVA and post-hoc tests for comparisons of IL-6, TNF-α, and body weight between groups, as well as Kruskall-Wallis and Mann-Whitney tests for CRP, with a significance level set at p< 0.05. Overall, the Sleeve Gastrectomy-Ileal Anastomosis group demonstrated significantly reduced levels of IL-6, TNF-α, and CRP, as well as more optimal weight loss compared to the SG and OAGB groups. Regression testing using a Structural Equation Model (SEM) showed that the combined surgical technique significantly reduced IL-6 levels (B: -3.854; p: 0.019), TNF-α (B: -36.408; p: 0.000), CRP (B: -1.055; p: 0.015), and body weight (B: 21.675; p: 0.002). Weight loss also had a significant effect on reducing TNF-α levels (B: -0.709; p: 0.005).

Surgery using the combined Sleeve Gastrectomy-Ileal Anastomosis technique has the potential to be a superior alternative in obesity management, capable of lowering IL-6, TNF-α, and CRP levels, as well as body weight, more effectively than the SG or OAGB methods.

This test was led by the Vice Dean for General Affairs and Finance, Faculty of Medicine, Udayana University, Prof. Dr. dr. I Made Sudarmaja, M.Kes., with the following examining team:

1. Prof. Dr. dr. Sri Maliawan, Sp.BS (K), FICS (Promoter)

2. Prof. Dr. dr. Tjokorda Gde Bagus Mahadewa, M.Kes., Sp.BS(K)., Spinal, FICS.FINSS (Co-Promoter I)

3. Dr. dr. Made Ratna Saraswati, Sp.PD, KEMD., FINASIM (Co-Promoter II)

4. Prof. Dr. dr. I Made Jawi, M.Kes

5. Prof. Dr. Ir. Ida Bagus Putra Manuaba, M.Phil

6. Prof. Dr. dr. I Wayan Putu Sutirta Yasa, M.Si

7. Prof. Dr. dr. I Made Sudarmaja, M.Kes

8. Prof. Dr. dr. Warsinggih, M.Kes., Sp.B.Subsp.BD(K)

9. Dr. dr. I Nyoman Golden, Sp.BS (K)

10. Dr. dr. I Gusti Ngurah Wien Aryana, S.Ked., Sp.OT(K)

By academic invitation:

1. Dr. dr. I Made Pande Dwipayana, Sp.PD-KEMD, FINASIM

2. Dr. dr. I Made Mulyawan, Sp.B.Sub., Sp.BD(K)

3. Dr. dr. Made Agus Dwianthara Sueta, S.Ked., Sp.B(K)-KBD

4. Dr. dr. I Gusti Putu Hendra Sanjaya, Sp.B., Sp.BP-RE., Subsp.LBL(K)

5. Dr. dr. I Ketut Mariadi, Sp.PD., KGEH, FACG, FINASIM

In this exam, Dr. dr. Gede Eka Rusdi Antara, Sp.B-KBD, MARS, M.H., was declared to have graduated as the 472nd Doctoral Graduate of the Doctoral Program in Medical Sciences, Faculty of Medicine, Udayana University with the predicate Very Satisfactory.

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