Bariatric Surgery

Description

THE ADVANCED SUPER-SPECIALTY UNIT FOR OBESITY SURGERY
Anaesthesiologists at Sunshine Hospitals

Sunshine Bariatric Unit provides state of-the-art treatment for all the ailments of obesity and gastrointestinal tract.
Comprehensive treatment is extended by a dedicated and trained team of medical and paramedical staff to support each and every patient through the process of achieving the desired outcome.

Bariatric Services Under One Roof

WEIGHT LOSS PROGRAMS SURGICAL SERVICES:

  • Bariatric Surgeries
  • Post-operative Follow-up Plans

NON SURGICAL SERVICES

  • Obesity Analysis
  • Diet Management
  • Lifestyle Management
  • Gastric Balloon
Types of Bariatric Surgery

Sleeve Gastrectomy
The stomach is reduced to about 25% of its original size by surgical removal of a large portion of the stomach along the greater curvature. It combines a
satisfying gastric restriction with appetite suppression.
Benefits

  • Fewer chances of compilations such as migration, erosion and infection.
  • Great appetite suppression
  • Lower risk of peptic ulcer
  • No vitamin or drugs malabsorption
Gastric Bypass ROUX-EN-Y

Combined, Restrictive/malabsorptive

Stapling is used to create a small, upper stomach pouch which restricts the amount of food to be consumed. A portion of the small bowel is bypassed thus delaying food from mixing with digestive juices to avoid complete calorie absorption.

Benefit

About 96% of associated health conditions like Sleep Apnea, High BP, Type II Diabetes, Depression, Back Pain were improved or resolved.

Mini Gastric bypass/one anastomosis gastric bypass

Combined, Restrictive/Malabsorptive

The mini gastric bypass is a less invasive alternative to standard gastric bypass but produces similar results. This procedure is performed laparoscopically, meaning the surgeon works through several small incisions and uses a tiny camera (called a laparoscope) and a television screen to guide special instruments through the incisions.
Benefits

  • MGB is low-risk surgery
  • It has excellent weight loss and minimal pain
  • It can be easily reversed or revised
Gastric Balloon

Combined, Restrictive

Intragastric balloon surgery is performed when an inflatable gastric balloon is endoscopically inserted and then inflated in the stomach to reduce capacity i.e. the balloon is inserted via the mouth and oesophagus directly into the stomach.

Immediately following the introduction of the Gastric Balloon the balloon is inflated by introducing saline into the balloon which causes it to swell and reduces a patient’s capacity and ability to consume large volumes of food and fluid. This procedure can be used in isolation to provide a short, medium term solution for patients who are struggling to cope with their moderate weight loss challenges.

Benefits
As you eat less food and absorb fewer calories, your body will stop storing excess calories and start using its fat supply for energy.

DECIDING THE SURGERY

1. One must understand that weight-loss surgery is a major undertaking and most patients enjoy an improvement in obesity-related health conditions and self-esteem after successful surgery hence decision must be taken after careful consideration and consultation with an experienced bariatric surgeon and his team.

2. The ultimate goal should be to live better, healthier and longer.

3. As part of routine evaluation for weight-loss surgery dietitian/bariatric counsellor plays a crucial role and at times guidance from a psychiatrist/therapist may also be required. This is to help establish a clear understanding of the post-operative changes in behaviour that are essential for long-term success.

4. To help patients achieve their goals as well as deal with the changes surgery and weight-loss can bring, we at SUNSHINE offers long term follow-up care that includes support groups, dieticians’ follow ups and other forms of continuing education.

5. Ultimately, the decision to have the procedure is an individual choice. However, the choice of surgery should depend upon joint consultation with the bariatric surgeon as it is based on several factors besides the obvious excess weight.

6. The ultimate success of bariatric surgery depends on strict adherence to the recommended dietary, exercise and lifestyle changes.

Do You Know – Obesity associated disease conditions

Type 2 Diabetes
People with obesity develop a resistance to the insulin that regulates blood sugar levels. Over a period, high blood sugar levels can cause severe damage to various organs in the body.

High blood pressure/heart disease

Excess body weight over-burdens the heart to function properly. This causes hypertension (high blood pressure) and can result in a stroke (brain haemorrhage, significant heart & kidney damage).

Osteoarthritis of weight-bearing joints
An additional weight placed on joints, particularly knees and hips, results in rapid wearing out of these joints, along with pain caused by inflammation.

Sleep apnea/respiratory problems
Fat deposits in the tongue and neck can intermittent obstruction of the air passage e° interrupted sleep. Loss of sleep often results in daytime drowsiness and headaches.

Gastro oesophagal reflux/heartburn

Obese people are susceptible to acid escaping into the oesophagus through a weak or overloaded value at the top of the stomach.

Depression
Repeated failure with dieting, disapproval from family and friends, sneers and remarks from strangers, constant struggle with fat put immense mental strain, pushing patients into depression.

Infertility

An inability or diminished ability to produce offspring.

Fatty liver or hepatic lipidosis
Fatty liver disease is the accumulation of fat in liver cells. The greater the percentage of fat in the liver, the greater the risk of developing liver inflammation, fibrosis or cirrhosis (moderate or severe scarring of the liver).

Others

Other problems include swollen legs/skin ulcers, urinary stress incontinence, menstrual irregularities, lower extremity venous stasis, idiopathic intracranial hypertension (IIH), dyslipidemia (lipid metabolism abnormalities), pulmonary embolism and cancer.

Before surgery

To prepare for surgery, you may be asked to:

  • Stop smoking
  • Lose weight by following a special diet
  • Stop taking certain medications, including aspirin and anti-inflammatories.
  • Ask your surgeon what medications you can continue taking.
  • Be sure to mention any herbs or supplements you take
  • Do not binge on food before surgery
  • Stop eating and drinking after midnight on the night before surgery, or as instructed
Change your eating habits

What and how you eat will change after surgery. And you will need to eat this way for life. Follow your meal plan and any instructions that you are given. To stay healthy, you may be given guidelines such as:

  • Choose high-protein foods to help prevent nutritional problems
  • Eat slowly. Take small bites. Chew each bite well before swallowing it
  • Stop eating as soon as you feel full
  • Do not snack between scheduled meals
  • Drink sugar-free liquids, such as water.
  • Drink them between (not with) meals. Wait 1 hour after meals before drinking liquids
  • Take vitamins as directed
  • Avoid fibrous foods, such as celery, string beans, and unprocessed meat
  • Avoid alcohol and carbonated drinks
THE EFFECT OF BARIATRIC SURGERY

1. Migraines 57% resolved
2. Pseudotumor Cerebri 96% resolved
3. Depression 55 % Resolved
4. Obstructive Sleep Apnea 74-98% resolved
5. Asthma 82% Resolved 82% improved or resolved
6. Dyslipidemia Hypercholesterolemia 63% resolved
7. Cardiovascular Disease 82% risk reduction
8. Hypertension 52-92% resolved
9. Non-Alcoholic Fatty Liver Disease

  • 90% improved steatosis,
  • 37% resolution of inflammation,
  • 20% resolution of fibrosis

10. Metabolic Syndrome 80% resolved
11. GERD 72-98% resolved
12. Type II Diabetes Mellitus 83% resolved
13. Polycystic Ovarian Syndrome 79% resolution of hirsutism, 100% resolution of menstrual dysfunction
14. Stress Urinary Incontinence 44-88% resolved
15. Degenerative Joint Disease 41-78% resolved
16. Venous Stasis Disease 95% resolved
17. Gout 77% resolved

Quality of life improved in 95% of patients Mortality 89% reduction in 5-year mortality
ASK YOUR DOCTOR…

Surgery carries minimal complication risk as per international guidelines. All the critical surgeries involve some degree of risk. Risks involved with weight loss surgery vary according to procedure performed.

There may be certain Complications like Re-operation rate-6%, Anastomotic leak – 2 %, Anastomotic Stricture – 3 %, Wound infection -1 %, Obstruction – 5 %.

Side effects which may occur:
1. Restriction of eating small meal indefinitely
2. Vomiting/Regurgitations
3. Minor hair loss
4. Loose/Boggy skin
5. Deficiency of protein/vitamins – some patients have difficulty taking fluids in the very beginning because there may be swelling around the operated areas. You will stay on liquids the first 1 week, then 3 weeks on mashed/pureed food and then after 4 weeks you may go on a normal die
6. Deep vein thrombosis

Appointments
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