BARIATRIC SURGERY
Bariatric surgery is a highly effective treatment option for people suffering with obesity and its associated diseases. In comparison to any other treatment modality, bariatric
surgery has proven to the most successful in terms of sustained and long term weight loss treatment. This hold good not only for weight lost in terms of kilograms, but it has proven to effectively treat obesity-induced medical diseases like diabetes, dyslipidemia, control of hypertension, cardiac diseases, obstructive sleep apnoea, infertility, and many more, the list can be endless.
Weight loss following bariatric surgery single handedly improves a persons quality of
life. Quality of life is the degree to which an individual is healthy, comfortable, and able to enjoy life events. Obesity induced stress, depression and anxiety are largely under diagnosed and not paid its due attention, leading to loss of interest in life as a whole, anti-social behavior changes, lowered self confidence and anger out bursts. With good
sustained and long term weight loss following bariatric surgery, it restores confidence, improves social activities and happiness.
From the perspective of a person suffering with obesity, bariatric surgery gives them a new lease of life, version 2.0, where they get to be what they have wanted to be and do what they have always wanted to do all this time.
- BMI >35 without presence of any obesity related co-morbidities or
- BMI > 30 with the presence of type 2 Diabetes / any obesity related co-morbidities
- >27.5 BMI with uncontrolled diabetes.
- Patients motivated to lose weight and commitment to long term follow up
- Patient should have attempted conservative methods of weight loss and failed
- Bariatric Surgery to be considered only between ages of 18 - 65 years
- Bariatric surgery may be considered in patients more than 65 years in the presence of severe obesity related co-morbidities / disability
- Bariatric Surgery may be considered in patients < 18 years in special situations after pediatrician / endocrinology certification , but after attainment of puberty or completion of skeletal maturity
How bariatric surgery works?
Bariatric surgery is surgical treatment for obesity where the anatomy of the GI system is changed, that brings about the weight loss. Bariatric surgeries work by two mechanisms. One is restriction, reduced capacity to eat at one particular point of time
and two is.Malabsorption, From a post bariatric point of view it causes restriction, meaning the patient eats less and that in-turn makes them loose weight. This restriction is not the only way , the science in bariatric surgery causes anorexia(reduced appetite,
reduced craving) and increase in basal metabolic rate(energy expenditure rate) by causing alteration in GUT(stomach/intestines) derived hormones by the effects of surgical manipulation.All the procedures combine one or both the mechanisms in a variable manner, meaning procedures are selected based on the outcomes that is required for that patient.
These surgeries are always performed laparoscopically.It can also be done by a single
incision laparoscopic approach or using da Vinci Robotic technology.
PURELY RESTRICTIVE
- Intragastric balloon
- Vertical-banded gastroplasty
- Gastric adjustable banding
- Sleeve Gastrectomy
- Gastric plication
RESTRICTIVE > MALABSORPTIVE
- Roux-en-Y Gastric Bypass
- DuodenoJejunal Bypass with Sleeve
- Mini Gastric Bypass
MALABSORPTIVE > RESTRICTIVE
- BPD with duodenal switch
PURELY MALABSORPTIVE
- Jejunoilieal bypass
- Jejunocolonic bypass
- Duodenojejunal bypass