Dr. Viorel Dejeu is head of the Bariatric and Metabolic Surgery department, with expertise in advanced laparoscopic surgery for abdominal and oncological conditions. Annually, more than 2,000 people turn to the Doctor Dejeu Team, in Bucharest, Sibiu, Oradea, Arad, thus being the most dedicated and sought-after team for bariatric medicine in Romania. Dr. Viorel Dejeu will also perform surgeries in Cluj-Napoca as of February 2023. For more details, visit www.doctordejeu.ro.
With a wide national and international expertise, Dr. Dejeu obtained a merit scholarship in Germany, but decided to return to Romania to fulfill a dream. We talked with dr. Viorel Dejeu about his activity in Romania on obesity surgery and minimally invasive surgery, but also about Allurion, the gastric balloon without anesthesia and nutrition challenges.
Would you tell us about your path through medicine and surgery, from the early days to your multiple training and experience exchanges in excellence centers in such cities as Munich, Frankfurt of New York in obesity surgery and in the minimally invasive surgery? What drew you into these specialties?
The passion for medicine grew gradually, in parallel with the passion for biology. I think I was in kindergarten when I first thought about becoming a doctor. From then on, I envisioned my future as a person helping others to heal. Medical school was the only option I took into consideration. In my last year of college, I obtained a merit scholarship in Germany, where I also had my first contact with bariatric surgery. I thought it was truly fascinating. My initial curiosity for medicine turned into destiny with every step further.
Now I am Director of the Bariatric Surgery Department at MedLife, with over 1,500 obesity surgeries performed annually, and a doctor of medicine with a thesis on the effects of bariatric surgery. I have competence in advanced laparoscopic surgery (minimally invasive surgery) for abdominal conditions such as hiatal hernias, gastric tumors, colorectal tumors, inguinal hernias, etc., and competence in oncological surgery: breast tumors, digestive tube tumors, sphere tumors genital.
My goal is to be among the best in my specialty and to be able to help as many patients as possible, always seeking not to deviate from the principles and values that guide me and my team, namely: professionalism, seriousness, dedication, transparency, excellence in treating patients, sincerity and 24/7 availability.
What were the main lessons of the one-year residency in Munich and the acquitted knowledge?
This residency in Munich, as all my professional experience gained abroad, was an important lesson on communication with the patients, but also on practicing at an advanced level, with the help of the latest technologies and treatments. Big medical centers worldwide help any doctor to reach a higher level of competence and I am glad that I had the opportunity to work abroad at that point in my career.
What made you want to return to Romania?
Firstly, I came back home because I wanted to work with my brother, Dr. Dănuț Dejeu, fulfill a dream of setting up our own medical team and work with the highest possible standards. When you are surrounded by professional people who have the same goal, it’s simple to treat patients the way you know best. When you have your brother in the same team, you cannot ask for more.
Secondly, I wanted to give Romania a chance, to increase the quality of medical services and prove that we can achieve high standards here too.
I know you have a PhD on the effects of bariatric surgery. Please tell us more about this field. How is their development in Romania, differences from what is abroad and what we have here, etc
We have many patients from other countries. On the one hand, we are talking about Romanians who have emigrated and who use medical services in the country because they have more affordable costs or because here they have a more solid support system, i.e. family and friends with whom they can stay after a medical procedure, but on the other hand, there are also citizens of other countries who come here for the first time because they heard about the high quality medical services we offer. This phenomenon makes me believe that, at least in the private system, we have many strong points which are comparable to other European countries. We have teams of doctors and support staff who provide the most pleasant patient experience possible, showing empathy and professionalism.
At the level of the public hospitals, unfortunately, we are still struggling with numerous shortages. From a logistical point of view, old hospitals do not live up to the expectations of patients and doctors, and insufficient staff can hardly cope with the large number of patients. These are just a few issues in a long and complicated list.
How is bariatric surgery connected to cancers and oncology?
Obesity is linked to more than 14 different cancers. If you are overweight or obese, you have higher chances of developing a multitude of cancers. We have plenty of studies confirming this. Bariatric surgery is lowering the risk of these types of cancers. We can conclude that it has a prophylactic effect and it really prolongs and saves lives. Most of the people associate us with weight loss surgery, but we are also specialized in oncological surgery.
How did you begin building the specialist team in bariatric surgery in Romania and how was your activity ever since?
My brother, dr. Dănuț Dejeu, and I took one little step at a time, to ensure that we make smart decisions and build a sustainable team. We took a lot of time for research and selecting team members to be sure that we will have with us people that share the same perspective, the same values. Year by year our story expanded to more hospitals and more cities.
For us, the patient comes first, and excellence is the work standard. My team offers a full range of services, from consultation to non-invasive surgery or procedures such as the installation of an oral gastric balloon, to psychological support and nutritional advice. We offer the full range of surgical procedures and we like to personalize the treatment. We are available for patients, a phone call away, from the moment they ask us a question, until they have reached their desired state of health and/or weight. Obviously, it is very important that patients understand the information received and follow all the recommendations, so that the results are what they want.
It is also known that your team is the only one in Romania that uses Allurion, the gastric balloon without anesthesia and without endoscopy. If you want to provide more information…what the intervention consists of?
Gastric balloons have existed for several years, but not one as high-performing as Allurion. The side effects (cramps, nausea) using Allurion are very discreet, compared to older generation balloons. We waited several years until it arrived in Romania. It went through several stages of development, and finally, last year we got it and we have been using it since then for patients in Romania.
With Allurion, there is no need for general anesthesia, not even endoscopy, as you mentioned. The procedure is very simple – it takes only ten minutes: the patient swallows the capsule-balloon, it reaches the stomach, we fill the balloon with liquid and after this, the patient returns to a normal life.
We already have over 250 patients who have or had this balloon. The results are amazing!
Patients can expect to lose between 10-20% of their body weight. It is important to note that it is not just about a balloon, it’s an entire program that the patient enters. We have an excellent team of nutritionists and psychologists who assist the patient in this process. In addition to the effects of the balloon itself, we help patients learn to eat healthy and correctly, so that the lost pounds do not return.
You have recently received the international recognition and accreditation of Surgeon of Excellence in Bariatric and Metabolic Surgery, a certification that few doctors in Romania have. What exactly does this represent?
This certification recognizes the commitment and high standard of providing patient care services, as well as a special concern, by myself and my entire team, for their safety and comfort. Health care facilities and surgeons seeking an SRC accreditation undergo an extensive assessment and inspection process to ensure the applicant meets SRC’s proven standards and requirements. These requirements include surgical volumes, facility equipment, clinical pathways and standardized operating procedures, an emphasis on patient education and continuous quality assessment. Inspectors educate staff in the accredited departments on best practices to help an organization improve its care and services.
I am thrilled by this international recognition from SRC, a renowned independent institution, because it shows that our hard work and dedication have the results we wanted, we offer the highest quality standards.
What about pediatric bariatric surgery? There are such many cases in Romania? How are they different and what challenges do they pose?
In recent years, bariatric surgery has gained a lot of ground, being recognized internationally for its beneficial effects. Many parents come to us when diets have stopped working and their children’s weight has gotten out of control. Unfortunately, there is an obesity epidemic among children and adolescents. We also operate on adolescents, after training and after an assessment corresponding to their level of understanding.
I want to emphasize something. The patients need to have a level of maturity to be able to understand what is happening to them. Pediatric patients take much longer to evaluate and prepare, thus we also need to prepare their parents – without their support, the child has no way of succeeding in regaining control of his or her weight. We start with psychological therapy sessions, both with the child and the parent, and if the entire team of specialists believes that a bariatric intervention can benefit the child, it can be performed.
Dr. Dejeu’s team is standing by the patients on long term, including with dedicated nutrition plans, customized for each patient. Is this vital for post-surgery success?
It is vital, without doubt. We are making this clear from the beginning, from the very first call with a patient – it’s not only a surgery, it’s a process and a program he has to undergo, with our help, listening to our team’s recommendations and information.
For sure it’s not a common process, for sure many of our patients go through this for the first time so what comes next is unknown. That’s why we are preparing them for everything, we offer our support along this program and this is important not only for the recovery, but also for their mental health and for their nutrition stages.
They are all in one, like a puzzle – if one piece is missing, then the progress will not go as we expect and want to.
I am very glad that my team’s method is a very good one, with proven results and great positive feedback from our patients. We are like a family, sharing experiences and asking questions – for this we have a private group on Facebook – there are now 35k members interested in bariatric surgery.
Speaking about the patients, how are the Romanian ones, self-conscious and dutiful or rather difficult, resisting the treatment and nutrition plans?
We live in a globalized world. I don’t see many differences between countries and patients. After all, we are humans and obesity is a global pandemic. The fight is hard and it takes a lifetime to win it.
How is obesity perceived in Romania now? Are people more conscious that this is an important health issue or they still prefer to ignore it?
I’ll start by saying that there are also patients who call for prevention and who come to me when it’s not very late, that is, not to ask about a surgical intervention, but only about the gastric balloon, but their percentage is not a large one, Unfortunately. Next, it seems that we are used to leaving things for the last hundred meters, to neglect our health until a symptom or even a disease appears, which raises questions and prompts us to go to the doctor. In general, patients try all kinds of diets, but they are almost always a trap from which they cannot get out on their own. The more diets you try, the slower your metabolism becomes. There are many diets or drugs on the market that have nothing to do with evidence-based medicine. Obesity is very difficult to overcome and changes are needed on several levels, so that the effects are long-term. Basically, you need a team of specialists to guide and support you. This is what we do. Even after surgery there is a risk of weight gain if the patient thinks surgery is all they need.
What about the authorities? There has been long talking about obesity becoming a national health priority. What has been achieved so far? I presume not much. In this case, what needs to be done?
In Romania, these procedures are not covered by insurance (private or public). This reality is still ignored, though we know that it’s cheaper to cover a bariatric procedure than to offer treatment for all the diseases caused by obesity. We hope that in the near future we will have a national program for bariatric surgery and at least a number of patients will get the surgery for free. We are working on that.