Why Morbid Obesity requires Baritric surgery?

Morbid Obesity is a chronic multifactorial disease and risky stage of obesity which associated with multiple whole body and systemic problems such as Diabetes,Hypertension, heart diseases, Lipid disorder, Arthritis, Infertility, Depression, anxiety, breathing difficulty during walking, snoring, sudden holding of breath, loss of urine control, hernia of abdominal wall , linked with several cancers and hampers daily normal life physical activities and impact on socio-economics of individuals. Commonly obesity patient try for conservative method like do dieting and take low calories diets, increase physical activities such as jogging, cycling, swimming, join work out centers and applying commercial weight-loss program but after some time you realize that you are trapped in a vicious cycle of weight loss and again weight gain and feels only you fighting with your weight. So it is very difficult to maintain long term weight loss by conservative method only and as long since six decade National Institute of Health (NIH) ,America found only bariatric surgery (weight loss surgery) as a very effective tool for maintain long term weight-loss in morbid obese population.

How Can Bariatric Surgery Help Me?

Morbid obesity related problems such as Diabetes, Hypertension, Lipid disorder, Fatty liver disease, Gastro-esophageal reflux disease, Arthritis, breathing difficulty, snoring, increase urination control, increase fertility and reduces risk for cancer. So your medication for other problems will stop or decreases drug requirement after bariatric surgery. With time after much weight -loss it improves your health,quality life and economical conditions, change your body image and view of society towards you.

How much time take in surgery and dishcharge?

The average operating time for surgery is 1.5-2 hours and we generally discharged on next postoperative days and varies patient to patient condition

How Does Bariatric Surgery Work?

Today there are several bariatric surgical procedures that lead to sustained weight loss in patients with morbid obesity. These are classified by their presumed mode of action as below 1.Restritive procedure – restrict on the intake quantity of food i.e. less amount of calories intake e.g.- Intra-gastric Ballooning/Gastric Banding/Sleeve Gastrectomy 2.Malabsorptive procedure –to decrease absorption of digested food i.e less calories absorption e.g.-Bilio-Pancreatic Diversion/Duodenal switch 3. Combined procedure – i.e.-both restriction and malabsorption of calories e.g-Roux-en-Y-Gastric-Bypass These different procedures works to restrict amount of food intake at one time, to decrease absorption of digested food and changes the level of gut harmones so patient get early feeling of satiety(decrease hunger) and increase the metabolism of glucose and fats. Increasingly, hormonal changes are being recognized as an important mechanism of post surgical weight loss. It may varies patient to patient and depends upon opted procedure,associated co-morbidities, patients motivation ,hospital and family supports but most of patients average time to join their work is 10-14 days and patients whose work related to more physical activities and weight lifting will require 3 - 4 weeks. But patient should follow your surgeons post-operative instructions and protocols.

Which procedure suits me?

Type of bariatric surgery depends upon after full assessment and evaluation of patient and surgeon take decision which procedure will suitable for you.

What are the risk in Bariatric Surgery ?

Like any other Gastro-intesstinal Surgery, bariatric surgery associted risk but incidence of risk is very low and comparable to other surgery and risk to life is 0.1-1% . Immediate complications are seen like bleeding,anastomotic leaks(0.5%), DVT(blood clot in deep veins of leg), pulmonary embolism(blood clots in lung blood vessels), infections and late complications are seen like malnutrition(defficiency of multi-vitamines and multi-minerals),ulcer and perforation(0.8%) in gastric pouch,internal small bowel hernia(<1%) and weight gain in some cases.What measure and prophylaxis are you take for prevention of risk? The anastomotic site between the stomach pouch and jejunum reinforce by hand-sewn to minimise the risk of leak and leak test done at the end of surgery with a methylene blue dye to make sure for “no leak”. If leak will happens then we go for a diagnostic laproscopy procedure for confirmation of leak and manage according to situations. To prevent gastric ulcer, we generally prescribe proton pump inhibitor for 3 month after surgery to our patient.For prevention of DVT we routinely recommended elastic stockings and heparin injection to our patient before and after surgery but it occurs very rarely.For prevention of malnutrition we prescribe supplements of multivitamins and multi-minerals for lon life to our patients and we follow protocol of checkup at regular interval of the level of vitamins and minerals.