Bariatric Surgery

About Bariatric Surgery

Bariatric Surgery today is the only modality offering significant, effective and sustained weight loss Surgery that is not possible with the other available and current non-surgical regimens. Usually bariatric surgery involves laparoscopic procedure (‘key-hole surgery’with 5 holes) so the rates of complications and risks are low. Hence, it is relatively safe procedure with higher acceptability.

The people requiring this treatment option are the ones who have a BMI greater than 37.5, BMI greater than 32.5 with obesity-related medical problems such as diabetes, high blood pressure, high blood cholesterol etc or when other weight reduction methods have failed.

Bariatric Surgery is done today with the latest technique of laparoscopy and the results are very gratifying. It is cosmetically safe, with minimal stay in the hospital with quick return to normal routine and day-to-day activities.


Treatment without Bariatric surgery

It is the first logical option chosen by everyone. This includes a diet low in calories, carbohydrates and fats; and rich in proteins, vitamins and minerals. This implies no fast food and consuming more and more fruits. The next is behavioural change, which indicate no snacking and only 3 sensible meals. Regular exercise is an integral part of any weight reduction programme. Anti-appetite or weight reducing drugs can be taken but under doctor's supervision.

The limitations of the above mentioned options are that no more than 5% are able to maintain weight loss for a prolonged period. Usually only 10% of total body weight loss is achieved by that person. However, 90% of the individuals regain the same weight in just one year time and sometimes even more than their previous weight.

Types of Bariatric surgery

Restrictive Bariatric Operations

It includes Laparoscopic sleeve gastrectomy, Laparoscopic gastric banding & Laparoscopic gastric banded plication.

Laparoscopic sleeve gastrectomy is a surgical procedure in which 3/4th of your stomach gets removed. Thus, a narrow tube-like structure gets formed (also known as sleeve of the stomach) through which food passes down. Only small quantities of food can pass through this. Therefore, the person starts experiencing the state of early satiety with reduced food intake.

Laparoscopic gastric banding is a surgery wherein an adjustable band is placed around the upper part of the stomach. This helps in the formation of a small pouch with a small outlet for food to pass down slowly. This restricts food intake and and results in early satiety. Hence, weight loss to the body is inevitable. The band can be adjusted by a fill-port placed under the skin near the belly button. This is one operation where the stomach is not cut or removed and is reversible. However, weight loss may not be as satisfactory as other operations.

Novel Technique: Laparoscopic gastric banded plication is a novel bariatric technique where in Gastric Plication is done along with gastric banding thus giving better results than Gastric Band alone. This is a fully reversible technique. It is meant for patients who do not want their stomach to get removed and hence, can opt for an innovative and restrictive surgery called Laparoscopic Adjustable Gastric Banded Plication. Here the stomach is made into a narrow tube by suturing and in addition, an adjustable gastric band is placed around the upper portion of stomach as in gastric banding operation mentioned before. The person will experience excessive weight loss and is as good as in sleeve gastrectomy.

Combined Restrictive and Malabsorptive Operations :

Laparoscopic gastric bypass results in the reduction of stomach to a small pouch. This in turn reduces food intake. A portion of small intestine is attached to this pouch so that the food bypasses duodenum and jejunum. The small intestine is then connected again in a manner that it is 100 cm away from the gastric pouch. So the food now is able to mix with the digestive juices. This leads to weight loss eventually. There may be requirement of life long vitamin supplements.

Post Bariatric Surgery Guidelines:
There is significant and effective weight loss after bariatric surgery in Delhi. This begins soon after the operation and it continues even after 5 years.
There is an excellent resolution of obesity-related problems like diabetes, high blood pressure, high blood cholesterol etc so much so that in 80% to 90% cases there may be no need of medicines.
There is a need to visit the doctor/surgeon regularly for follow-up. It requires a change in eating habits and some regular exercise programme

General Awareness Guidelines :
Fat or Fit?..The choice is yours.. Bariatric Surgery is the answer

Obesity : the problem

The problem of being fat, overweight or obese has become world’s leading health problem today. According to World Health Organisation, as compared to 1980, the population of obese persons has doubled. There are some diseases that get associated with obesity leading to poor quality of life and premature death. There are about 1.5 billion (15 crore) obese adult people in the world and out of these 2.8 million (28 lac) die because of this problem. According to the National Family Health Survey, carried out in 2007, every 1 Indian out of 20 is obese. No wonder obesity has truly become an epidemic of the present century!

What is Obesity?

Obesity Surgery is a medical condition in which excess body fat accumulate to such an extent that it may have an adverse effect on health leading to reduced life expectancy and or increased health problems. Obesity is measured by a formula called Body Mass Index or B.M.I. which compares a person’s weight with height.

                                                     B.M.I. =   Body weight (kg)
                                                                     height2 (m2)

According to BMI >25 is overweight, >30 is obesity, >35 is severe obesity >40 is morbid obesity. 

Why it occurs?

Obesity Surgery is a mismatch between intake and expenditure of calories. The modern change in the lifestyle involving easy availability of transport, readily available high calorie laden tasty fast food (junk food) and increasing urbanization are the main environmental factors contributing to obesity. Some familial tendency may be an important cause in a few obese people. Also in some, hormonal problems like hypothyroidism and Cushing’s syndrome may be responsible for obesity.

Why is it necessary to treat it?

The medical problems/diseases related to obesity and the risk of early death in obese people especially in those with morbid obesity make it necessary to treat Obesity Surgery in Delhi. According to a report, for every 10 extra kilograms above the stipulated body weight (measured according to height) life expectancy of a person reduces by three years. The problems associated with obesity include heart attack, high blood pressure, stroke or paralysis, high blood cholesterol, infertility, joint pains, breathing problems, breast cancer, colon and uterus cancer as well as gall stones. Obese persons may suffer from low self esteem and may be subjected to prejudice in jobs. They cannot enjoy life the way their non-obese counterparts can- no wonder it is both a physical and social handicap!

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