Laparoscopy surgery for Diabetes
Diabetes is considered one of the top healthcare challenges society is suffering from. Diabetic patients are more prone to suffer from heart disease, stroke, renal failure, and blindness. Treatment to cure type -2 diabetes mainly focuses on lifestyle changes such as weight loss, dietary changes, exercise, etc. But sometimes despite all the efforts, people are not able to control their weight which significantly leads to type 2 diabetes.
In such cases of obesity-linked with diabetes metabolic surgery/bariatric surgery through Laparoscopy procedure is suggested. This surgery helps patients to restore the body's capacity to use sugar healthily.
The laparoscopy technique used for this procedure involves two to three small cuts in an abdomen which helps a telescope attached with a camera to perform the surgery. Through these cuts, the surgeon inserts a telescope attached with a video camera into the body cavity and operates while monitoring the internal organs on a television screen.
The various option for Laparoscopy Surgery for diabetes includes:
Pancreatic diversion with Duodenal Switch (duodenal switch):
Duodeno-ileal Bypass with Sleeve Gastrectomy
Overview of Diabetes Surgery
There is a tremendous rise in diabetes in India. The number of cases of diabetes has grown from 11.9 million in 1980 to more than 64.5 million in 2016. With the increase in the number of diabetic patients, the number of people suffering from potentially life-threatening diseases has also increased.
Diabetes mellitus, often known as Type 2 diabetes, is a fairly prevalent disorder that affects all organs of the body. In this condition, there is either a decrease in insulin synthesis or the body develops resistance to the produced insulin. Type 2 diabetes can cause a variety of additional diseases, including kidney and heart disease, blindness and obesity.
However, with recent breakthroughs in the field of diabetes surgery, a few novel treatment alternatives have emerged. Diabetes surgery in India is often referred to as metabolic surgery. In layman’s terms, it is also referred to as weight loss or bariatric surgery. These include a category of surgical treatments that entail shrinking the stomach, reducing the amount of food you can intake or decreasing the amount of food absorbed by the body. Diabetes metabolic surgery is an effective strategy in the treatment and management of diabetes.
Diabetes surgery in Gurgaon is typically performed laparoscopically through keyholes. Generally, the procedures are highly safe and there are no post-surgery complications. The post-surgery recuperation is likewise swift, with the patient usually discharged within 2–3 days.
There are several types of diabetes surgery techniques available, for example:
- Laparoscopic sleeve gastrectomy
- Gastric bypass surgery laparoscopically (Mini-gastric bypass or Roux-en-Y gastric bypass)
- Laparoscopic gastric band adjustment
Diabetes surgery In India and the science underlying it
Following surgery, the primary mode of diabetes control is hormonal control. Insulin is a common hormone that affects blood glucose levels. It lowers the blood glucose level in the body when we eat food and causes the body to absorb more and more glucose. Diabetes is frequently characterised by low insulin sensitivity, also known as insulin resistance. There is another class of hormones called incretins that boost the body’s sensitivity to insulin. High insulin sensitivity indicates that the body can utilise blood glucose more efficiently.
Hormones such as GLP 1 (glucagon-like polypeptide), gastric inhibitory peptide (GIP), ghrelin and leptin are examples of hormones that increase insulin sensitivity. GLP also has a function in glucose metabolism in the body, while it decreases glucagon secretion.
The diabetes surgery in Gurgaon seeks to increase the number of incretin such as GLP. As the food skips the stomach and enters the small intestine after metabolic surgery, the level of GLP 1 and peptide hormone rises. Because GLP 1 is released by the hindgut (ileum and jejunum), more nutrients entering the intestine immediately boost GLP secretion.
The majority of metabolic surgery decreases appetite and increases energy expenditure.
The American Society for Metabolic and Bariatric Surgery has conducted several successful clinical trials and studies demonstrating the efficacy of metabolic operations in the remission of Type 2 diabetes.
Eligible Candidate for Diabetes Surgery In India
Diabetes surgery is not for everyone. Only a thorough comprehensive examination, following a visit to your surgeon, can determine your candidacy. To be eligible for this, you must meet certain specific medical conditions which are given below:
- You are classed as obese and your BMI is more than 40.
- You have a BMI of 35 or more, are overweight and have Type 2 diabetes-related comorbidities such as heart disease, stroke, high blood pressure, non-alcoholic fatty liver disease and sleep apnea.
- You are unable to lose weight naturally or control diabetes, even with medication.
- You are prepared to make lifestyle changes such as eating a nutritious diet and exercising regularly after the surgery.
Cost of Diabetes Surgery in India
The cost of diabetes surgery in India varies greatly and many factors influence the entire operation cost. The following factors can have an impact on the eventual cost of the surgery:
- The health clinic-referred to: The clinic’s location, infrastructure, procedures and the availability of current technology have a significant influence on the surgery cost. It is always recommended to select a well-established and well-known clinic which has FDA-approved equipment.
- Type of surgery required: Metabolic and diabetic surgery entails several distinct procedures. These include procedures like sleeve gastrectomy, gastric bypass, intragastric balloon. The total cost is determined by the technique chosen.
- Extent of surgery: The extent of surgery is substantially higher in severe instances where complications are more. The final cost of the surgery would go up in such cases.
- Surgeon’s expertise and competency: The expertise and competency of the surgeon as well as surgical experience, can all influence the ultimate cost. An excellent surgeon with extensive expertise may charge a greater fee, but he or she provides superior value and treatment.
- Tests and post-operative drugs: There are several tests to be performed before the procedures as well as post-operative drugs to be taken. This can have a significant influence on the final cost.
On average, the whole cost of diabetes surgery in India might range between INR 2 Lakh and INR 5–6 Lakh.
How surgery treats Diabetes:
The effect of surgery on Diabetes is immediate, long before weight loss. The most effective changes in the body after surgery are hormonal. Immediately after surgery due to re-routing of food there is a rise in levels of incretins which make the body’s more effective. Further with the weight loss, improved diet and increased exercise Diabetes gets cured in most patients after surgery. Once Diabetes treatment in Delhi is done it’s ill effects on the whole body particularly the heart, kidneys, nerves and eyes stop at an early stage.
There is now substantial evidence that bariatric surgery at an early stage in patients at high risk of developing Diabetes particularly with family history of Diabetes, prevents the disease from developing!
INTERNATIONAL DIABETES FOUNDATION POSITION STATEMENT ON BARIATRIC SURGERY IN THE TREATMENT OF TYPE 2 DIABETES
In 2011, surgeons, public health experts, diabetologists and endocrinologists in delhi convened at the 2nd World Congress on Interventional Therapies for Type 2 Diabetes in New York City. Based upon the evidence presented by these world-renowned experts, The International Diabetes Foundation (IDF) released a Position Statement calling for bariatric surgery to be considered early in the treatment of T2DM.
The document recognized that:
- In addition to behavioral and medical treatments, bariatric surgeries constitute a powerful option to ameliorate diabetes in patients affected by severe obesity.
- According to Obesity specialist doctor Bariatric surgery is an appropriate treatment for people with T2DM and obesity not achieving recommended treatment targets with medical therapies.
- Surgery should be an accepted option in people who have T2DM and a BMI of 35 or more (More than 32.5 in Asians).
- Surgery should be considered as an alternative treatment option in patients with a BMI between 30 and 35 when T2DM cannot be adequately controlled by optimal medical regimen, especially in the presence of other major cardiovascular disease risk factors.
- Bariatric surgery for treatment of T2DM is cost-effective
- The risk for complications and death with bariatric surgery is low and similar to that of well-accepted procedures such as gallbladder surgery.
Why Choose Dr Vikas Singhal
Diabetes causes a slew of complications that may be incredibly difficult to manage. This leads to a negative impact on one’s physical and mental health.
Going to a competent doctor who is well-informed about the operations you’ll be undergoing, plays a significant role in your treatment as well as your emotional stability.
You would not want to put yourself in the hands of someone who has less experience.
Dr Vikas Singhal is a top surgeon in Gurgaon who specialises in metabolic and diabetic surgery. He is regarded as a pioneer in metabolic surgery and diabetes treatment, having treated countless patients throughout his medical career. He has acquired a diverse surgical experience by treating patients of all ages and a variety of conditions. Apart from this, Dr Vikas Singhal is also a member of several prominent institutes and research organisations. This keeps him up to date on the most recent research in the field of metabolic operations and diabetes treatments. He will not just assure you a successful operation but also ensure that you get superior aftercare and comfortable treatment.
Consult Dr Vikas today to find an effective solution for diabetes and take your first step towards a healthier life.
Benefits of Laparoscopy Surgery for diabetes:
People opting for Laparoscopy surgery for diabetes in Delhi not only experience speedy recovery and quick healing they are also allowed to resume their daily activities within a short time period. Less pain, less scar, and better cosmetic outcomes as compared with a traditional surgical approach are also some added advantages.
To add on the list benefits for diabetic individuals are:
These procedures are effective in Type-II diabetes and are ineffective in Type-I diabetes.
These procedures show significant improvement in blood sugar levels of patients whose pancreas is capable of producing a sufficient amount of insulin.
These surgeries are far more effective in people who are young and have diabetes for a short time( a few years)than in people who have already injured their end organs, such as the kidney, eye, or heart.
These surgeries reduce the risk of developing comorbidities of diabetes like cholesterol, sleep apnoea, joint discomfort, cardiac illness, hypertension, kidney issues, eye problems, etc.
It helps people to cure, treat or reduce medicine dependency on diabetes.
Is Bariatric Surgery safe for diabetic patients?
Bariatric surgeries are surgical treatments that are done Laparoscopically (keyhole cuts) that involve shrinking the stomach, limiting the amount of food you can consume, or minimizing the amount of food absorbed by the body. With a reasonable level of blood sugar control in the immediate period for few days before surgery it is very safe and after surgery the blood sugar control improves significantly.
All these procedures are performed under general anesthesia, and the patient is monitored in the hospital for two to three days. These are performed using laparoscopic or robotic techniques and equipment such as staplers and harmonic scalpels. As a result, these procedures are extremely safe. With quick recovery after the surgery, the patients are extremely comfortable and can resume normal activity within a few days.
Which surgery is most effective for diabetes?
Bariatric surgery is the most successful type 2 diabetes treatment, and it can result in remission (the ability to stop taking all drugs) or improvement in nearly all patients. Bariatric surgery is excellent for patients with type 2 diabetes and even lesser degrees of obesity. It is the most effective method for resolving the illness and eliminating the need for medicines.
Almost all people who have diabetes surgery (also known as metabolic surgery) see an improvement in their diabetes, often as soon as the day after surgery. These operations result in reduced food consumption and fewer calories consumed. Most critically, these surgeries cause metabolic changes that impact intestinal hormones that frequently regulate blood sugar management before the patient loses weight.
Can diabetes be cured permanently by surgery?
Yes. Diabetes can now be cured with Metabolic and Bariatric Surgery. There was no permanent treatment for diabetes until a few years ago. New research, however, indicates that a permanent cure for diabetes is now accessible. The American Society for Metabolic and Bariatric Surgery has successfully undertaken various clinical trials and studies demonstrating the usefulness of metabolic operations in Type 2 diabetic remission.
Various types of operations can effectively control diabetes. Which type of surgery is best for you is determined by your weight, any health conditions you may have, the experience of your surgeon, and other factors.
How much does diabetes surgery cost?
Bariatric surgery (Metabolic Surgery) is the minimally invasive surgery for Type 2 diabetes. Diabetes is treated with this surgery that regulates the amount of sugar in the blood.
Diabetes surgery costs vary widely in India, and several factors determine the total cost of the operation. During your appointment, the experts will normally outline the cost of the procedure in detail. The following factors may influence the final cost of the surgery:
- The type of surgery (sleeve gastrectomy, gastric bypass)
- Expertise and competency of a surgeon
- The hospital or type of facility where the surgery is performed.
- Infrastructure, equipment, and technology used
- Accommodation options for your hospital stay
- Hospital stay duration
- Tests and post-operative medications
In India, the total cost of diabetes surgery may range between INR 3 Lakh to 5 Lakh depending on the above factors.
What is a safe blood sugar level for surgery?
Maintaining glycemic and metabolic control in diabetes individuals undergoing surgery is crucial. In the week before surgery, it is critical to self-monitor glucose levels often so that insulin regimens can be changed as needed.
The American Diabetes Association (ADA) recommends a perioperative glucose range of 80 to 180 mg/dl for the majority of patients.
Although the best glycemic target remains unknown, maintaining blood glucose in the range of 140 to 180 mg/dl with the purpose of avoiding both hypoglycemia (less than 70 mg/dl) and severe hyperglycemia (more than 180 mg/dl) is an acceptable goal in the majority of peri-operative patients.
Obesity when it becomes morbid associated with diabetes becomes fatal. In such cases, doctors advise metabolic surgery to control weight and elevated levels of sugar. One of the best Laparoscopic surgery for diabetes in Delhi is offered under the guidance of Dr. Vikas Singhal.With the world’s best team and surgeons of Delhi experience the high-class international standards treatment. His clinical expertise lies in laparoscopic bariatric & metabolic surgery, laparoscopic gastric surgery, laparoscopic anti-reflux surgery, and intraoperative endoscopy. He has experience in diverse surgical areas of all ages and a variety of conditions. He believes in ethical patient care driven with an evidence-based medicinal approach
Diabetes surgery can result in considerable improvements in blood sugar management and, in most cases, diabetes remission or resolution. However, the degree of improvement varies from person to person, and not everyone will experience quick or lasting remission. Long-term lifestyle adjustments, such as diet and exercise, are required to preserve the benefits of diabetes surgery.
Following diabetic surgery, lifestyle modifications, particularly regarding food and physical activity, are critical. Adopting a healthy, balanced diet and regular exercise routines can help with weight loss, long-term metabolic regulation, and weight loss prevention. Close monitoring by healthcare specialists, such as dietitians and endocrinologists, is usually recommended to achieve the best possible results after a diabetes surgery.
Diabetic surgery, like any other surgical operation, carries risks. However, metabolic surgery is a relatively safe procedure with a lengthy track record of success. The major complications may occur in the first few days after surgery due to complications such as bleeding and leakage from the staple line, infections, and medical problems such as breathing difficulties, deep-vein thrombosis, and unpleasant reactions to anesthesia. Discussing these concerns with your healthcare physician and having a complete preoperative and postoperative evaluation is critical. Following your surgery, you will be advised to modify your diet and lifestyle long-term. Long-term consequences are uncommon, but weight regain is possible if you overeat frequently.
You will have a thorough consultation to determine which metabolic surgery method is appropriate for you and your medical condition. You will also be subjected to blood testing, abdominal ultrasound, and gastroscopy to assess your suitability for metabolic surgery. Your surgeon will head a multidisciplinary team of dieticians, physiotherapists, and other medical professionals to ensure that all perioperative medical concerns are treated.
The surgical procedure typically takes roughly 2 hours and is conducted under general anesthesia. You will be kept on a liquid diet for a few days before slowly moving to softer meals. Most patients will remain in the hospital for 2 to 3 days. You will be able to move around the same day following your surgery, and most patients are able to resume normal activities and exercise within 2 weeks.
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