Photo: Peter Porrini / Shutterstock / FOTODOM
Meet The Expert
Vladislav Georgievich Davydov – MD, PhD, experienced bariatric surgeon, Deputy Chief Medical Officer for Surgery, Director of the Bariatric Surgery Center at SM-Clinic. He has been practicing at SM-Clinic since 2011, specializing in minimally invasive laparoscopic surgical interventions and serving as a leading expert in bariatric surgery. Member of the Russian Society of Bariatric Surgeons, Russian Society of Endoscopic Surgeons, and the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO).
Education and Qualifications
2001 – Kazan State Medical University, General Medicine.
2004 – Residency in General and Emergency Surgery, Kazan State Medical Academy.
2007 – Graduate studies in General and Emergency Surgery, Kazan State Medical Academy.
2007 – PhD dissertation defense: «Assessment of Morpho-Functional Liver Status in Choosing Treatment Tactics for Patients with Obstructive Jaundice.»
Continuing Education
2007 – Advanced training course «High-Tech Endosurgical Operations,» Kazan State Medical Academy.
2022 – Advanced training in Surgery, Center for Medical and Corporate Education.
2024 – Advanced training program «Current Issues in Abdominal Surgery,» Educational Standard Medical Training Center.
2025 – Advanced training in Surgery, Center for Medical and Corporate Education.
Professional Experience
More than 24 years in surgery.
Performs approximately 500 operations annually, including more than 300 bariatric procedures.
Specialties: General surgery, bariatric surgery, minimally invasive laparoscopic surgical interventions.
Professional Skills
Open operations for large and giant hernias of the anterior abdominal wall (including complex and recurrent cases), diseases of the stomach, intestines, biliary tract, and pancreas.
Laparoscopic operations: bariatric procedures (sleeve gastrectomy, gastric bypass, biliopancreatic diversion with duodenal switch (SADI-S), mini gastric bypass, and others); laparoscopic Nissen fundoplication for hiatal hernia; laparoscopic Toupet fundoplication for hiatal hernia; laparoscopic repair of inguinal and umbilical hernias; laparoscopic and open repair of incisional hernias; laparoscopic and open repair of diastasis recti; laparoscopic Heller myotomy for achalasia; laparoscopic cholecystectomy for gallstone disease, chronic calculous cholecystitis, and gallbladder polyps; laparoscopic sigmoid resection; laparoscopic left hemicolectomy; laparoscopic appendectomy for acute appendicitis; laparoscopic repair of perforated gastric and duodenal ulcers.
When Weight Becomes a Prison
Mikhail (name changed for privacy) was only 31 years old, but his life had become dangerously constrained by his weight. A businessman and naturally social person, he tried to maintain connections with family, friends, and colleagues. But at 182 cm tall and 183 kg, with a body mass index of 55, more than double the healthy range, his obesity was killing him. The comorbidities were alarming: hypertension, cardiac arrhythmias, transient ischemic attacks (mini-strokes), and severe obstructive sleep apnea. The sleep apnea was particularly dangerous – he would stop breathing repeatedly during the night, leaving him chronically exhausted and at risk of falling asleep anywhere: at work, on vacation, or worst of all, behind the wheel.
Like many patients with severe obesity, Mikhail was hesitant about surgery. «His mother brought him in,» Dr. Davydov recalls. «Despite his young age, the medical complications had become so serious that doing nothing was no longer an option. Many patients are initially resistant to the idea of weight loss surgery, but their perspective changes after we talk. When they understand what life could be like after the procedure, how much weight they can lose, how their health will improve – everything shifts. They start to see it as an opportunity to get their life back.»
Why Diet and Exercise Weren't Enough
For someone at Mikhail's weight, traditional weight loss methods – calorie restriction and increased physical activity – simply don't work, and it's not for lack of trying. At extreme levels of obesity, the body's metabolism becomes profoundly disrupted. Hormones that regulate hunger, satiety, and energy storage go haywire. The body actively resists weight loss, defending its elevated weight as if it were normal. In Mikhail's case, these metabolic changes were so severe that only surgical intervention could reset his system. Understanding this biological reality was crucial to his decision to pursue treatment at SM-Clinic.
Preparing for Surgery
Before surgery, Mikhail underwent extensive evaluation. Cardiology workup including Holter monitoring and echocardiography showed that despite his hypertension and arrhythmia, his heart could withstand the surgical procedure. He also had upper endoscopy, abdominal ultrasound, and comprehensive laboratory testing.
The surgical team chose sleeve gastrectomy (also called gastric sleeve surgery).
«For a patient with BMI 55 and most of his fat concentrated in the abdomen, this operation makes the most sense technically,» Dr. Davydov explains. «It's also easier to manage long-term than gastric bypass, which requires more intensive vitamin monitoring for life – something young men aren't always good at keeping up with.»
Sleeve gastrectomy is a bariatric procedure designed to treat obesity, particularly effective for patients with very high BMI and abdominal fat distribution.
Who Is a Candidate
- BMI ≥ 40 kg/m², or ≥ 35 kg/m² with obesity-related health problems (such as type 2 diabetes)
- Failure to achieve lasting weight loss through diet, exercise, and medications
- Technically preferred when significant abdominal obesity is present
How It Works
- The surgeon removes approximately 80% of the stomach, creating a narrow tube or «sleeve»
- This removes the part of the stomach that produces ghrelin, the hunger hormone, which reduces appetite
- The smaller stomach holds less food, so patients feel full sooner and eat less
- Unlike gastric bypass, the procedure doesn't reroute the intestines, which reduces certain complications
- Requires less intensive vitamin supplementation than bypass procedures
Who Should Not Have This Surgery
- Uncontrolled medical conditions
- Active alcohol abuse or untreated psychiatric disorders
- Active stomach or duodenal ulcers
- Severe diseases that make anesthesia too dangerous
- Pregnancy or breastfeeding
- Untreated cancer
«Surgery isn't a quick fix,» Dr. Davydov emphasizes. «It requires a fundamental shift in how you think about food and lifestyle. But for the right patient, it offers a real chance at dramatic health improvement.»
The Surgery and Recovery
The operation was technically difficult due to extensive abdominal fat and an enlarged liver, but it went well. Mikhail spent his first postoperative day in the ICU where staff closely monitored his blood pressure, heart rate, oxygen levels, and urine output. He was then moved to a regular hospital room. On the second day, he had an upper GI contrast study to ensure his new stomach was functioning properly and the surgical connections were intact.
The typical recovery involves intravenous fluids initially, then clear liquids starting the day after surgery, followed by a gradual progression over a month from liquids to pureed foods to regular food. This gives the stomach and esophagus time to adjust to their new configuration. Most patients lose 60-80% of their excess body weight over the following one to two years.
«About a month after going home, Mikhail hit a rough patch – he developed nausea and vomiting. The medical team ruled out mechanical problems with the surgery. The culprit turned out to be psychological: stress and difficulty adjusting to his new eating patterns. Working with a psychotherapist helped him work through these issues. This case really highlights the importance of comprehensive care. Success after bariatric surgery isn't just about the operation itself. It requires medical follow-up, nutritional guidance, and often psychological support to help patients manage stress and adapt to their new reality,» Dr. Davydov notes.
The Results
Mikhail's transformation was remarkable:
- 5 months post-surgery: 75 kg lost.
- 11 months post-surgery: 103 kg lost.
- Final weight: 80 kg.
- Health improvements:
– Blood pressure normalized without medication;
– Blood sugar stabilized;
– Sleep apnea completely resolved – Mikhail now sleeps through the night.
A New Life
The change in Mikhail's quality of life has been profound. Beyond the numbers on the scale, patients like Mikhail report feeling better overall, having more energy, being more physically active, and seeing many of their chronic health problems – like high blood pressure and type 2 diabetes – improve or disappear entirely.
The psychological and social transformation is equally dramatic. Patients describe improved self-confidence, less anxiety, renewed interest in being active, and greater engagement with friends and family.
Mikhail, who used to spend most of his time lying down due to exhaustion, now takes the lead in planning family activities, exercises regularly, and feels emotionally lighter.
His success was supported by comprehensive care: ongoing surgical follow-up, psychotherapy when he needed it, and nutritional counseling.
Why This Case Matters
«I want to explain why I chose to feature Mikhail's case,» Dr. Davydov says. «First, it demonstrates SM-Clinic's commitment to taking on complex cases – patients with extremely high BMI and multiple serious health problems. Second, it shows our true multidisciplinary approach: cardiology to optimize his health before surgery, ICU care for safety, psychotherapy to help with adjustment challenges. And third, it shows that we don't just do technically challenging surgery – we provide the long-term support needed for lasting success.»
Bariatric Surgery Saves Lives
Research shows that bariatric surgery dramatically reduces health risks. After surgery: heart failure risk decreases by approximately 40%, cardiovascular events decrease by 47%, stroke risk decreases by 41%, and the need for coronary interventions decreases by 53%. Overall mortality decreases by 44% and stays reduced for many years.
«Bariatric surgery isn't cosmetic,» Dr. Davydov stresses. «It's a powerful way to prevent heart attacks, strokes, and devastating diabetes complications. The biggest mistake people with severe obesity make is endless cycles of trying one more diet, getting disappointed, trying another, getting disappointed again. When your own efforts aren't working, don't wait – see a bariatric surgeon. Modern surgery isn't a last resort – it's the beginning of a new life. The most important message is that even in what seems like a hopeless situation, there is a solution.»