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Bariatric Surgeon India

Bariatric Surgery: A Surgical Strike On Obesity

Obesity is a major health problem worldwide like a terrorism. Recent studies reported that it started reaching an epidemic proportion globally and continues to be a risk factor for many diseases. It often associated with significant morbidity and mortality. Obesity is one of a leading cause of death worldwide but can be treated with Bariatric surgery. It helps obese people in achieving long-term weight loss.

What Is Bariatric Surgery?

Bariatric surgery is an operation that is performed to treat people with extreme and excessive obesity. It is designed to reduce obesity indirectly by restricting the number of food calories a person can digest. It is an ideal and life-saving treatment option for the people whose weight continues to increase at a rapid rate even after considering a strict low-calorie diet and taking up a rigorous exercise regime.

Bariatric surgery is not a cosmetic procedure but widely viewed as an effective means of achieving long-term weight loss. It can give you a new lease of life because it is a metabolic surgery that helps in controlling obesity & resolving co-morbidities. It often helps in treating many obesity-related conditions including type 2 diabetes or high blood pressure.

Benefits Of Bariatric Surgery

With the Bariatric Surgery, you can:

  • Lose weight rapidly
  • Make significant improvements in health and quality of life
  • Shorter hospital stay
  • Faster recovery
  • Smaller scars
  • Less pain
  • Improvement in Obesity-related Disorders
  • Treats type 2 Diabetes in overweight and obese patients with high blood sugar levels.
  • Improve cardiovascular conditions including hypertension, high cholesterol and diabetes, asthma and obstructive sleep apnoea
  • Resolved stress incontinence
  • Get rid of weight-related aches and pains

Bariatric Surgery A Surgical Strike On1

Can I Have A Weight Loss Surgery?

Weight loss surgery is not for everyone, because it is recommended only for the people who:

  • Have a BMI of 30 and above
  • Be over the age of 18
  • Have a genuine desire to clear your obesity-related issues
  • Suffer from obesity-related health problems
  • Have tried all nonsurgical treatment but failed to lose weight
  • Mobile and medically stable
  • Have an actively involved
  • Have supportive primary care physician
  • Have a stable psychological status followed by an adequate social support system

Types Of Bariatric Surgery

Bariatric Surgery is of several types, depending on the location. The following are the common types of Bariatric Surgery:

Gastric Band: It is a type of bariatric Surgery where a band is placed at the upper part of your stomach. A ring containing an inner inflatable band will be positioned at the top part of your stomach to create a small pouch. With this placement of a band, you don’t need to eat as much to feel full.

Pros

  • Can be adjusted and reversed.
  • Short hospital stay
  • Low risk of surgery-related problems.
  • No changes to intestines.
  • Lowest chance of vitamin shortage.

Cons

  • Less weight loss compared to other bariatric surgery types.
  • Frequent follow-up visits are required to adjust the band
  • Some people may not adapt to the band
  • Possible future surgery to replace a part or all of the band system

Gastric Bypass: In this surgery, the top part of your stomach is joined to the small intestine. This bypassed section will be attached to the main part of your stomach, as a result, digestive juices can move from your stomach. This surgery makes you feel fuller sooner and you don’t need to absorb as many calories from food.

Pros

  • Greater weight loss than the gastric band.
  • No objects placed in the body.

Cons

  • Difficult to reverse.
  • Higher vitamin shortage than a gastric band or gastric sleeve.
  • The higher occurrence of surgery-related problems compared with a gastric band.
  • May increase the risk of alcohol use disorder

Sleeve Gastrectomy: In this surgery, some of the stomach is removed. Your surgeon removes most of your stomach, leaving only a banana-shaped section by closing it with staples. As a result, you can’t eat the same quantity that you could eat before and you’ll feel full sooner. This type of surgery affects gut hormones or gut bacteria. As some part of your stomach is removed completely, your surgeon cannot reverse the process.

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Pros

  • Greater weight loss than a gastric band.
  • No changes to intestines.
  • No objects placed in the body.
  • Short hospital stay.

Cons

  • Cannot be reversed.
  • Chance of vitamin shortage.
  • Higher chance of surgery-related problems than the gastric band.
  • Chance of acid reflux.

Discuss with your surgeon who can help you determine the type of Bariatric Surgery, that best suits you. Make sure that you know all risks and complications associated with each type of Bariatric Surgery, before deciding to have surgery.

How Do You Prepare?

Once you qualify for the Bariatric surgery, your healthcare team provides you with all the instructions that are to be followed before the surgery that differs for a specific type of surgery.

Preparing For Weight Loss Surgery

Getting ready for your Bariatric surgery takes several months. Being prepared helps you stay focused on the vital rest required to start your recovery.

  • If you are aiming for a target weight, then you should make a lifelong commitment to making major changes to your diet and lifestyle. Be emotionally ready to achieve your target weight loss.
  • Speak to your nurse/surgeon about any medications you are taking or planning to take throughout your recovery. Don’t leave any vitamins, minerals and herbs as they would interact with your medications. Make sure that you have all the medications you will require after surgery.
  • Reduce around 5 to 10% of your excess body weight with exercises and diet before considering a weight loss surgery. This may result in a shorter hospital stay. Your pre-op diet results in more rapid postoperative weight loss.
  • Practice eating slowly, chewing food 15 times and putting the fork down between bites before the surgery itself
  • Don’t drink while eating as it can overfill your pouch. If you are having a band the fluids dilute the meals taken and pushes them through your band. As a result, you would be able to eat more and not feel full.
  • Mentally prepare yourself for the surgery and analyse your eating behaviour.
  • Analyze any triggers for comfort-eating or overeating and find the alternative ways to cope up with this.
  • Discuss with your bariatric surgeon about the realistic target weight and achievable milestones for you.
  • Prepare drinks, thin soups, purees and some meals in advance and freeze them.
  • Borrow a blender or liquidiser
  • Follow fasting instructions and it’s important to follow your surgeon’s advice.
  • Have a shower or bath the night before the surgery, as this would be difficult for a few days following the surgery
  • Have a friend or family member to drive you to and from your procedure. He or she has to stay with you for at least the first 24 hours after your operation.
  • Make sure you have someone who can help you at home for the first couple of weeks after surgery.

What Should I Take Into The Hospital?

Take the following items into the hospital:

  • Pyjamas or nightdress.
  • Dressing gown and slippers with tread
  • Mouthwash or breath spray. You will probably have bad breath because your digestive system has changed
  • just and want to resolve this easily.
  • A flat pair of shoes that slip on to go home in.
  • Books and magazines.
  • Mobile phone and Ipad or tablet as it can help you stay connected with your friends or family.

After Weight Loss Surgery

First, a few days after the surgery will have little discomfort and you have to rest. You are advised not to put any strain on your operation wound, because even the smallest task like opening a jam jar will be too much.

Eat only solid foods again. You will have a liquid-only-diet for 2 weeks, semi-solid pureed foods for 2 weeks and then solids. Your diet will be recommended by a bariatric nurse/ dietician following the surgery based on your weight loss procedure, circumstances and goals.

Eating After Bariatric Surgery

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You will begin with very small portions of meals and you will probably not feel hungry, but this often changes with time. The following are the eating guidelines for weight loss patients:

  • Keep to 6 small meals a day
  • Avoid snacking between meals. Have meals, if you are genuinely hunger
  • Eat regularly as it can stop you getting overly hungry
  • Eat too fast as it results in more weight loss
  • Eat small portions, because if you overeat it can stretch your stomach pouch resulting in a little discomfort.
  • Use a side plate as it can help you keep your portions under control
  • Put a small amount of food into your mouth, eat slowly and chew very well
  • Don’t drink with meals
  • Make sure you take at least 2 litres of fluid a day and avoid all fizzy drinks.
  • Choose foods that can satisfy your stomach

Certain foods like chewy meats, soft white bread, rice, fibrous fruit and vegetables, nuts and seeds can be a problem for some people and should be avoided initially. However, they can be re-introduced slowly once a ‘normal’ diet has been established.

Results

Bariatric surgeries provides long-standing outcomes and the amount of weight you lose is often related with the type of procedure and your lifestyle habits. You may lose half or more of your weight within 2 years.

In addition to weight loss, it often improves or resolves conditions often related to being overweight, including:

  • Gastroesophageal reflux disease
  • Heart disease
  • High blood pressure
  • Severe sleep apnea
  • Type 2 diabetes
  • Stroke

It often improves your ability to perform your normal daily activities resulting in improved quality of life.

Risks Associated With Bariatric Surgery

Bariatric surgery involves certain potential health risks, both in the short term and long term. The following are the risks associated with the surgical procedure:

  • Excessive bleeding
  • Infection
  • Adverse reactions to anaesthesia
  • Blood clots
  • Lung or breathing problems
  • Leaks in your gastrointestinal system

Long term risks and complications of weight-loss surgery differs based on the type of surgery. The long term risks and complications include:

  • Bowel obstruction
  • Dumping syndrome
  • Diarrhoea
  • Nausea or vomiting
  • Gallstones
  • Hernias
  • Low blood sugar (hypoglycemia)
  • Malnutrition
  • Stomach perforation
  • Ulcers
  • Vomiting

Risks Of Gastric Bypass:

  • Breakage
  • Dumping syndrome
  • Gallstones
  • Hernia
  • Profuse bleeding of the surgical wound
  • Leakage
  • Perforation of stomach or intestines
  • Pouch/anastomotic obstruction
  • Bowel obstruction
  • Protein or calorie malnutrition
  • Pulmonary and/or cardiac problems
  • Skin separation
  • Spleen or another organ injury
  • Stomach or intestine ulceration
  • Stricture
  • Vitamin or iron deficiency

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Risks Of Laparoscopic Adjustable Gastric Band:

  • Band slippage, erosion, deflation
  • Breakage
  • Hernia
  • Port malposition
  • Skin separation

Risks Of Gastric Sleeve:

  • Blood clots
  • Gallstones (risk increases with rapid or substantial weight loss)
  • Hernia
  • Internal bleeding of the surgical wound
  • Leakage
  • Perforation of stomach
  • Perforation of intestines
  • Skin separation
  • Stricture
  • Vitamin or iron deficiency
  • Things To Consider Before Deciding To Have Bariatric Surgery

Being qualified for bariatric surgery is only the first step. But, the decision to undergo bariatric surgery is complex and intensely personal. Before considering a Bariatric surgery, you need to consider several factors.

The following are the few things, you need to consider, before deciding to have Bariatric Surgery:

  • Benefits versus risks
  • Finances and insurance
  • Type of bariatric surgery

Bariatric Surgery Revisions

Revision weight loss surgery is a procedure done to correct problems associated with bariatric surgery. Bariatric surgery revisions are required for the patients, who have experienced problems from their initial procedure. This problem could be:

  • Poor weight loss
  • Significant weight regain
  • Chronic nausea
  • Intolerance of the previous surgery
  • Ulcers
  • Band slippage
  • Other procedure-related complications
  • Excessive weight loss
  • Nutritional deficiencies

Other conditions requiring a revisional Bariatric surgery.

  • Lap-Band failure
  • Pouch enlargement
  • Sleeve failure
  • Gastrogastric fistula
  • Weight Regain

Revision Surgery can be from

  • Adjustable Gastric Band to Sleeve
  • Adjustable Gastric Band to DS
  • Adjustable Gastric Band to Bypass
  • Sleeve to Sleeve
  • Sleeve to Duodenal Switch
  • Sleeve to Gastric Bypass

Cost Of Bariatric surgery In Hyderabad

India is one of the least expensive nations for bariatric surgeries. The cost of treatment is low in India compared to the US or the UK. The cost of each Bariatric surgery differs depending on the hospital and the surgeon. The breakdown of cost is made depending on the type of procedure:

  • Gastric Banding Surgery- INR 2 to 5.5 Lakh
  • Gastric Bypass Surgery- INR 4 to 7 Lakh
  • Gastric Sleeve Surgery- INR 3 to 6 Lakh

Cost of bariatric surgery depends on several factors, including:

  • Bariatric Surgeons operating fee
  • Anaesthesia fee
  • Medicine expenses during procedure & stay
  • Hospital facilities charges including Two days stay

Conclusion

Discuss with your surgeon about your weight-loss goals and concerns, before deciding to have surgery. Make sure that you choose the appropriate weight-loss surgery and it should be made only upon the advice of a qualified surgeon.

Bariatric procedures are safe if done by the highly experienced surgeons who have successfully overseen many bariatric procedures. However, all bariatric procedures are effective if performed:

  • By the right experts who are qualified and experienced to perform these procedures
  • With the right aftercare programme including diet, physical activity and prescribed medications
  • To the right patient who are dedicated to the weight-loss programme

Bariatric Surgery FAQs

I have heart disease, Can I have Bariatric surgery?

Yes, you can have surgery. Medical clearance from your cardiologist is considered as must. It can improve most heart diseases including:

  • High Blood Pressure
  • Cholesterol
  • Lipid problems
  • Heart enlargement
  • Vascular disease
  • Coronary disease

How much weight can I expect to lose?

It totally depends on the type of surgery performed. Your level of commitment to nutrition and exercise goals will also have a significant impact on the amount of weight loss.

How long will I stay in Hospital after the Bariatric Surgery?

It depends on the procedure, you opted for:

Laparoscopic adjustable gastric band surgery – one day and one overnight stay.
Gastric bypass surgery – two to three days
gastric sleeve surgery – two to three days

You will likely go home after your surgery if you are:

  • Drinking all your fluids
  • Doing well walking
  • Going to the bathroom
  • Not having uncontrolled nausea or vomiting

Will I have any problem with eating certain foods after surgery?

Intolerance to certain foods following the Bariatric Surgery varies from person to person. The most common problem-foods after the surgery include:

  • Pasta
  • Red meat
  • Soft bread
  • White rice

Will I have local or general anaesthetic?

Bariatric Surgery is generally performed under general anaesthetic.

What if I am a get pregnant?

Discuss with your surgeon. He may change the care pathway to reflect your condition. You will be monitored very closely by your surgeon or healthcare team to ensure that you and your baby are kept healthy.

Can I drive?

Avoid driving until you stop taking pain medicine. You can drive if you are pain-free for twenty-four hours.

Is there any outcome difference in the surgery between men and women?

Men and women respond equally to this Bariatric surgery. However, men lose weight slightly faster than women do.

How can I reduce Bariatric Surgery Risks?

You can reduce the risks and possible side effects of Bariatric surgery by:

  • Decreasing your Body Mass Index (BMI)
  • Increasing your amount of exercise
  • Stopping smoking