Pr. Dr. Pedro Gutiérrez Contreras

11/01/2026

Témoignage de Monsieur Mohcine
Suite à son opération de traitement chirurgical de l’hernie hiatale et du reflux, réalisée par le Pr. Dr. Pedro Gutiérrez Contreras, spécialiste en chirurgie gastro-endoscopique, traitement de l’obésité ainsi que des pathologies du côlon, re**um et a**s.

📍 Je vous accueille à Témara – Rabat, Avenue Tarik Ibn Ziyad, Résidence Rayhan, IMM 57, 3ème étage, pour une prise en charge personnalisée, humaine et professionnelle.

📞 Pour réserver votre rendez-vous : +212 656 493 194
✉️ Email : amirgtzkh@gmail.com

08/01/2026

Témoignage de Monsieur Mohcine
Suite à son opération de traitement chirurgical de l’hernie hiatale et du reflux, réalisée par le Pr. Dr. Pedro Gutiérrez Contreras, spécialiste en chirurgie gastro-endoscopique, traitement de l’obésité ainsi que des pathologies du côlon, re**um et a**s.

📍 Je vous accueille à Témara – Rabat, Avenue Tarik Ibn Ziyad, Résidence Rayhan, IMM 57, 3ème étage, pour une prise en charge personnalisée, humaine et professionnelle.

📞 Pour réserver votre rendez-vous : +212 656 493 194
✉️ Email : amirgtzkh@gmail.com

08/01/2026

07/01/2026

Your family history (sister who died from ovarian cancer, mother who died from uterine cancer) suggests a moderate risk. It is necessary to rule out a hereditary syndrome.

• Risk associated with mutations (e.g., BRCA1/2 or Lynch syndrome): The evidence is clear that bilateral oophorectomy (removal of both ovaries and fallopian tubes) reduces the risk of ovarian cancer by more than 90% and is associated with a significant decrease in all-cause mortality in carriers.

• Risk without a known mutation (based solely on family history): The evidence is much more cautious. A Mayo Clinic study concludes that, in the absence of a high-risk genetic variant, oophorectomy should not be considered before age 50 or natural menopause, due to the increased risk of chronic diseases from early hormone loss.

The most crucial and universal recommendation is that you be referred to an Oncology Genetic Counseling service for a comprehensive evaluation. This involves taking a detailed family history and, most likely, undergoing genetic testing. Screening for mutations in genes such as BRCA1, BRCA2, or those associated with Lynch syndrome is an essential step in making an informed decision.

If genetic results are available, the guidelines are more specific.
Recommended age for preventive surgery based on genetic mutation (if confirmed):
• BRCA1: Between 35 and 40 years old.

• BRCA2: Between 40 and 45 years old.

• Lynch syndrome (associated genes): Consider around 40 to 45 years old, or at the time of a planned hysterectomy.

• The recommended surgery is not just an oophorectomy, but a bilateral salpingo-oophorectomy, which includes the removal of both fallopian tubes, as many cancers are believed to originate there.

• Removal of the uterus (hysterectomy) may be recommended along with ovarian surgery if there is a risk of endometrial cancer, as in Lynch syndrome.

• This is a high-impact decision. It is vital to weigh the pros and cons.
Key Benefits:
• >90% reduction in the risk of ovarian/fallopian tube cancer.

• Significant reduction in the risk of death from any cause in BRCA carriers (68% less)

07/01/2026

Your family history (sister who died from ovarian cancer, mother who died from uterine cancer) suggests a moderate risk. It is necessary to rule out a hereditary syndrome.

• Risk associated with mutations (e.g., BRCA1/2 or Lynch syndrome): The evidence is clear that bilateral oophorectomy (removal of both ovaries and fallopian tubes) reduces the risk of ovarian cancer by more than 90% and is associated with a significant decrease in all-cause mortality in carriers.

• Risk without a known mutation (based solely on family history): The evidence is much more cautious. A Mayo Clinic study concludes that, in the absence of a high-risk genetic variant, oophorectomy should not be considered before age 50 or natural menopause, due to the increased risk of chronic diseases from early hormone loss.

The most crucial and universal recommendation is that you be referred to an Oncology Genetic Counseling service for a comprehensive evaluation. This involves taking a detailed family history and, most likely, undergoing genetic testing. Screening for mutations in genes such as BRCA1, BRCA2, or those associated with Lynch syndrome is an essential step in making an informed decision.

If genetic results are available, the guidelines are more specific.
Recommended age for preventive surgery based on genetic mutation (if confirmed):
• BRCA1: Between 35 and 40 years old.

• BRCA2: Between 40 and 45 years old.

• Lynch syndrome (associated genes): Consider around 40 to 45 years old, or at the time of a planned hysterectomy.

• The recommended surgery is not just an oophorectomy, but a bilateral salpingo-oophorectomy, which includes the removal of both fallopian tubes, as many cancers are believed to originate there.

• Removal of the uterus (hysterectomy) may be recommended along with ovarian surgery if there is a risk of endometrial cancer, as in Lynch syndrome.

• This is a high-impact decision. It is vital to weigh the pros and cons.
Key Benefits:
• >90% reduction in the risk of ovarian/fallopian tube cancer.

• Significant reduction in the risk of death from any cause in BRCA carriers (68% less).

30/12/2025

Specific Considerations for Trauma

1. Priority: Bronchoscopy in trauma is primarily diagnostic and for decontamination, not therapeutic in the acute phase, unless it is to remove an obstructing foreign body.

2. Major Airway Injury: If a large tracheal or bronchial laceration is identified, stop manipulation. Repair is surgical. Immediately inform the thoracic surgeon/trauma surgeon.

3. Hypoxemia: Bronchoscopy can worsen oxygenation. Have a plan ready to ventilate/oxygenate the patient.

4. Cervical Instability: In blunt trauma, assume cervical spine injury. Perform bronchoscopy with manual stabilization in line, preferably with the airway already secured (endotracheal tube).

Summary in one sentence:

"Before you begin, think SOS-A. During the procedure, rigorously follow the ABCD-VT: from the lips to the most distal segments, looking for injuries, leaks, and obstructions, always remembering that your priority is to diagnose and secure the airway, not worsen the injury."

This systematic approach ensures a thorough assessment, reduces the risk of omissions, and keeps the focus on the safety of the trauma patient.

30/12/2025

26/12/2025

The liquid gastric balloon is a temporary medical device designed to aid weight loss in people with obesity (BMI ≥ 30) or overweight (BMI 27-30) with comorbidities. Its mechanism of action is based on physical restriction and hormonal modification, supported by scientific evidence.

How does it work?

1. Partial stomach occupancy:

• The balloon is inserted endoscopically (without surgery) and filled with sterile saline solution (400-700 ml).

• It reduces gastric capacity, limiting food intake and generating early satiety.

2. Delayed gastric emptying:

• Studies (e.g., Obesity Surgery, 2019) show that the balloon slows the passage of food into the intestine, prolonging the feeling of fullness.

3. Hormonal Modulation:

• Decreases ghrelin (hunger hormone) and increases peptide YY and GLP-1 (satiety hormones), according to research in Gastroenterology.
Evidence-Based Effectiveness
• Weight Loss:
• Meta-analysis (Clinical Gastroenterology and Hepatology, 2020) reports a 10-15% reduction in body weight over 6 months.

• Greater effectiveness when combined with diet, exercise, and behavioral therapy.

• Metabolic Improvement:
• Reduction in insulin resistance, blood pressure, and lipid profile (Endocrine Practice, 2021).

Limitations and Risks
• Common adverse effects (first few weeks): nausea, vomiting, and reflux.

• Rare complications: migration or perforation (≤1%, according to Surgical Endoscopy). It is not permanent: it is removed after 6-12 months, requiring lifestyle changes to maintain results.

The liquid gastric balloon is a validated aid for moderate weight loss, using both physical and hormonal mechanisms. Its success depends on a multidisciplinary approach. It should always be prescribed and monitored by an obesity specialist.