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Bariatric-surgery

Bariatric Surgery

Bariatric Surgery is truly a life changing surgery! It can help you lead on to a new chapter in your life towards a HEALTHIER YOU!! This is a big step towards your health.

Bariatric Surgery is the only proven method which helps with sustained weight loss over a long term and gives you significant long term health benefits like resolution of diabetes, high BP, high cholesterol, obstructive sleep apnea, etc. in more than 3/4th of the patients. It can help you lose around two third of the fat. Most importantly, it can give you a good “Quality of Life”.

What is it and how does it work?

Weight loss surgery, also called bariatric surgery, alters the digestive process so as to achieve rapid weight loss. The surgery will either:
1. Limit how much the stomach can hold (restrictive surgery)
2. Limit how well nutrients are absorbed in the intestine (malabsorptive) or
3. Limit how much the stomach can hold AND limit how well nutrients are absorbed in the intestine (combined).

Weight loss surgeries commonly performed:

1. Laparoscopic Sleeve Gastrectomy
2. Laparoscopic Gastric bypass (Mini-Gastric Bypass or Roux-En-Y- Gastric Bypass)
3. Laparoscopic Adjustable Gastric Band

Bariatric Balance

1. Vertical Sleeve Gastrectomy: It generates rapid weight loss by restricting the amount of food that can be eaten, it involves removal of two third of the stomach. It is a restrictive procedure and patients feel satisfied after very small meals. It also decreases levels of “Ghrelin”, the hunger hormone that stomach produces. Expected loss of excess weight is approximately 60-70%. It is now becoming the most frequently performed weight loss surgery worldwide.

Advantages:

  • Excellent weight loss results achieved
  • Procedure can be performed in around 1-2 hours
  • No rearranging of the anatomy
  • Less need for multivitamin and calcium supplementation

Disadvantages:

  • Because the stomach is removed, it is not reversible. It can be converted to almost any other weight loss procedure.
  • Could in some patients make heartburn or acid reflux symptoms worse.

2. Gastric Bypass: This surgery works by cutting the stomach into a small pouch and connecting it to the small intestine. This results in both reduced food intake and absorption as well. This is therefore a combined restrictive and malabsorptive procedure. This leads to loss of about 70-80% of excess weight. Patients also get “dumping syndrome” if they eat sugary food.

Advantages:

  • Most effective and time-tested procedure for weight loss.
  • Great procedure for patients with uncontrolled diabetes or reflux disease

Disadvantages:

  • Requires life long vitamin and calcium supplementation
  • Can never smoke since smoking leads to frequent ulcer formation (we consider this as an all round health advantage)
  • Can not take ibuprofen or other similar anti-inflammatory medications (other than paracetamol)

3. Adjustable Gastric Banding (also known as the LAP-BAND): In this procedure, a hollow, inflatable band made of silicone rubber is placed around the stomach near its upper end to create a small pouch and a narrow passage into the rest of the stomach. To change the size of the passage, the band can be loosened or tightened which is done by adjusting the amount of fluid in the inflatable band. This is a restrictive procedure with loss of 40-50% of excess weight.

Advantages:

  • Removable
  • No removal of any part of the stomach or intestines with a short recovery period.
  • No nutritional deficiencies.

Disadvantages:

  • Highest long-term complication rate amongst the bariatric procedures such as band erosion/migration/balloon leakage.
  • Requires frequent visits for optimal adjustment.
  • Less effective with sweet eaters.

Who is a candidate for Weight Loss Surgery?

People who are tired of trying non-surgical approaches to weight loss can certainly be benefitted by Bariatric or weight loss surgery. You may be a candidate for weight loss surgery (Asian population) if you have:

  • BMI over 37.5 or
  • BMI more than 32.5 and a serious obesity-related health problem such as type 2 diabetes, heart disease, arthritis, sleep apnea (when breathing stops for short periods during sleep) etc

Benefits of Weight Loss surgery

Apart from losing the excess weight the major benefit of Bariatric surgery is it’s great effects on weight associated comorbidities. Most problems are cured in the majority of patients. Some of the benefits are outlined below.

  1.  Type 2 diabetes – 82% complete resolution (Pories et al. 1995); 87% show resolution/improvement.
  2.  Dyslipidemia (High cholesterol) – improved in 70%.
  3.  Hypertension (High blood pressure) – 62% resolution; 79% show improvement.
  4.  Obstructive sleep apnea (Excessive snoring associated with obstruction of air flow to lungs) – improved in 80%. This is a serious medical condition which is underdiagnosed and can lead to heart failure.
  5.  Heart failure
  6.  Asthma
  7.  Back strain and disk disease
  8.  Arthritis (Hip and knee pain needing joint replacement over long term)
  9.  Acid reflux disease
  10.  Non alcoholic fatty liver disease and cirrhosis (liver failure)
  11.  Stress incontinence (Leakage of urine on straining)
  12.  Polycystic ovarian syndrome
  13.  Intertriginous dermatitis
  14.  Pseudotumor cerebri (Headaches, nausea, visual disturbance)
  15.  Depression

With all these benefits, multiple studies have now shown that there is prolongation of life in patients undergoing bariatric surgery – with a significant 89% decrease in mortality at 5 years. In the study by Christou et al they showed that in the control group the mortality was 6.17% at 5 years compared to 0.68% for patients undergoing bariatric surgery (Christou et al. 2004).

JOURNEY TO WEIGHT LOSS & FITNESS

Weight loss is not an event in one’s life but is a journey, which can be easier if you have some support along the way! This is what we want to provide as a team at our Centre. Morbid obesity frequently is associated with so many severe and chronic medical problems, we do a detailed comprehensive evaluation to help optimize your medical condition before the surgery so as to get the maximum benefits and minimize the risks associated with surgery.

The first step in the process is the “Initial Consultation”, in which we explain the process to you in detail including the types of surgery, expected benefits and risks of them, what to expect before, during and after the surgery. This will help you understand the procedures and help you make an informed decision about what would be the best for you. Being well informed prior to the surgery helps to enhance the long-term success.

Revisional Bariatric Surgery Video

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