Bariatric Surgery

Bariatric Surgery

Bariatric surgery indicates a variety of gastrointestinal (GI) surgical procedures originally designed to induce weight reduction in morbidly obese patients. Benefits of bariatric surgery, however, extend well beyond weight loss and include dramatic improvement of type 2 diabetes, hypertension, dyslipidemia, and reduction of overall mortality.

Criteria for Bariatric Surgery (Weight loss Surgery)

  • BMI > 37.5kg/mt2
  • BMI 32.5kg/mt2 or >  with associated  problems like diabetes, hypertension, lipid abnormalities, artritis, Infertility, Breathing difficulties etc.
  • Age between 18-65 years

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

  • 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
  • Malabsorptive procedure – to decrease absorption of digested food i.e less calories absorption e.g.-Bilio-Pancreatic Diversion/Duodenal switch
  • 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.

Technique

  • Bariatric surgery done laproscopically(by making hole) like other Gastro-intestinal Surgery now a day  and this technique popularise Bariatric Surgery .
  • Small holes made over the abdominal wall and insert instruments  into the abdominal cavity, with guidence of a surgical telescope with a video camera  and real time  video seen over monitor to perform surgery under General Anaesthesia.


Surgical Option

Most commonly done procedure are

  •  Laproscopic Sleeve Gastrectomy            
  • Laproscopic Gastric Bypass


Other procedures are

  • Laproscopic Mini-gastric bypass
  • Laproscopic BPD with duodenal switch
  • Laproscopic Gastric Banding
  • Laproscopic  Banded Sleeve Gastrectomy
  • Laproscopic Banded Gastric Bypass
  • Laproscopic SADI
  • Laproscopic revisional Bariatric surgeries like Band removal,sleeve gastrectomy and Mini -gastric bypass and Gastric bypass.

 

**Type of bariatric surgery which perform upon you will decides after your  full assessment and evaluation and surgeon will  take decision which procedure will suitable for you according to your condition.


**The average operating time for surgery is 1.5-2 hours and we generally  dishcharched on next postoperative days and  patient can join work within 10-14 days.It will varies patient to patient condition and will power.

 

Results of Bariatric Surgery
 Over weight-loss

  • Considerable and durable weight loss up to 65-75% of excess body weight within 12-18 months.

Over Type 2 Diabetes

  • improvement (in >85%)and remission(in 78%) of Type 2 diabetes mellitus .


Over other disease or problems

  •  improvement or remission of a wide range of obesity-related co-morbidities like hyperlipedemias(80%), hypertension (75%) obstructive sleep apnea(80%), obstructive sleep apnoea (90% chance of resolution),reduces Gastro-esophageal reflux disease,improvement in liver diseases,improvement or cure of infertility and PCOD and cancer - reduced by 75-78% .

 

On healthcare costs

  • its reduce or stop


On survival

  • As obesity increases 10 kg it will reduces life by 3years.The mortality rate in those not undergone surgery was 28% compared to 9% in the surgical group . If you go to  natural history of morbid obesity study,you will hardly found long life span of morbid population who have  mortrality rate 50-80%   and  Mortality rate by baritric surgery varies from 0 to 1.6% and is very low considering the complexity of the surgery and the associated diseases  due to morbid obesity. Bariatric surgery remains the best available option for long term weight loss and increase longevity of morbid obese  patients.

Over Quality of Life and Psychological condition

  • Physical activities such as mobility, body image, self-confidence, work, social interactions, economical condition and sexual function these all improves after surgery along  with depression and anxiety .

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