Bariatric Surgery
(Weight Loss Surgery)
30+ Years of surgical experience
What is Obesity?
The definition of Underweight, Ideal weight, Overweight and Obesity are based on Body Mass Index (BMI). BMI is a ratio of weight to height and is calculated as Weight (kg)/Height (mt2). See the Weight Chart.
What is the cause of Obesity?
Obesity can be due to endocrine disturbances, such as thyroid insufficiency and steroid excess, and if present should be treated. Usually obesity is due to mismatch between calorie intake and calorie used, especially in those with a genetic predisposition.
Is Obesity just a cosmetic issue?
Obesity is not just a cosmetic issue; it is a major health problem with difficulty in walking and breathing, decreased life expectancy and quality, and a high risk of
- Type II diabetes
- High blood pressure / heart disease
- Infertility / menstrual irregularities
- Osteoarthritis of weight bearing joints
- Sleep apnea / respiratory problems
- Gastro-oesophageal reflux / heartburn
- Depression
- Dyslipidemia (lipid metabolism abnormalities)
- Risk of breast cancer
- Intertrigo -infection in the skin folds
These can be improved or resolved with weight loss.
For whom is weight loss surgery suitable?
Bariatric (weight loss) surgery is offered to those who have
- Severe Obesity (BMI>35) with one or more of the above listed health conditions
- 45 kg or more above the ideal body weight or Morbid, Super Obesity (BMI>40)
- Obese individuals with many failed weight loss attempts
Who is unsuitable for weight loss surgery?
Individuals unfit to undergo general anaesthesia, or suffering alcohol, drug abuse or major psychiatric disorders or major bowel diseases are not considered suitable for Bariatric surgery. Bariatric surgery is also avoided in children and in pregnancy.
What are the options in weight loss surgery?
Restrictive surgery – these restrict intake of food and reduce appetite.
- Gastric Banding – reversible
- Sleeve gastrectomy – not reversible
Malabsorptive surgery – these divert food past the part of the gut where food is digested and absorbed and also restrict intake of food. These are permanent changes to your gut and your ability to digest food.
- RNY (Roux-en-Y) Gastric Bypass
- BP (Biliopancreatic) Diversion
- Duodenal Switch with BPD
Other Procedures – these are non-restrictive and non-malabsorptive but have not been effective enough
- Gastric Pacemaker
- Gastric Balloon
What is Gastric Banding ?
Gastric banding (FDA approved since 2001) is a popular weight loss surgery because it is a laparoscopic (Key Hole), reversible surgical procedure that does not alter the alimentary system or disturb the normal digestive process. It does not involve any cutting or removal of any part of the stomach or intestines. The Swedish Adjustable Gastric Band (other such bands are also available) is an inflatable silicone strap around device that fits around the upper part of the stomach and gives the stomach an hour glass shape with a small upper part and a large lower part (Gastric Band Image). A small amount of food is adequate to fill the upper part and provide a sense of fullness. This is helps reduce food intake and lose weight on a long term. The diameter of the Gastric band can be adjusted to suit the weight loss requirements by injecting or removing fluid through a port placed under the skin. For reduced eating to succeed, the individual should avoid high calorie sweets and confectionaries. Following the Dietary, Exercise and Medical Guidelines is vital for the success of the procedure. The Gastric band is retained for life. It can be removed by laparoscopic (Key Hole) surgery if so desired . The need for re-operation is very low. In laparoscopic (Key Hole) surgery, a miniature telescope with a small high resolution video system is used to visualize the insides of the body and perform desired procedures through small holes thus avoiding long incisions on the body.
This reduces
- Pain
- Disability
- Wound infections
- Incisional hernias, and enables rapid recovery and early return to normal activity
What are the permanent changes in malabsorptive weight loss surgeries?
In Malabsorptive Bariatric (weight loss) surgeries like RNY gastric bypass, BP Diversion, Duodenal Switch, major permanent alterations are made to the alimentary tract and the digestive process by partial removal and rerouting. These procedures cause food to be less digested and incompletely absorbed and hence nutritional supplements, drugs are required after surgery.
What are the complications of weight loss surgery?
All major surgery involves a certain level of risk of complications like infection, bleeding, leak, DVT, death. Risks involved vary according to the procedure performed and are far less with laparoscopic than by open approach and with restrictive than malabsorptive Bariatric surgeries. Mortality rate with gastric banding is 1 in 2000, with RNY gastric bypass surgery it is 1 in 200 . Possible complications of Gastric banding include infection, migration or leakage of the device. Intake of food more than the capacity of the upper part of the stomach can lead to food regurgitation. An inadequately chewed large morsel of food can get stuck at the narrowing caused by the band. A problem following Malabsorptive surgeries is the Gastric dumping syndrome. It is due to rapid flow of food leading to stomach cramps, sweating, nausea, faintness, diarrhea some time after taking food.
Will Insurance cover the cost of my operation?
It depends on the type of policy you have and on your insurance company. Weight Loss Surgery is a part of management of medical problems associated with obesity.
How quickly can I get operated?
Please contact us for a mutually convenient date. This can be as early as a few days if all preoperative criteria are met.
What do I need to do before the operation?
You need to undergo thorough and extensive investigations including an overnight stay in the Sleep (respiratory) Lab. You also need to be assessed by the surgeon and other members of the team.
How long will it take to recover and get back to work?
Usually patients need to take about a week to a month off from work. There are individual differences. Patients who are self-employed or work from home are able to get back to work earlier.
Will I have pain after surgery?
As explained earlier this is a laparoscopic surgery with low post-operative pain that can easily be managed with pain killers.