Bariatric Surgery

Obesity can lead to many harmful diseases such as diabetes, sleep apnea, arthritis, high blood pressure and stroke. Hence, it is of prime importance to be healthy and to have the appropriate body weight. In many cases, people cannot reduce their weight by dieting and exercise. Therefore, Bariatric Surgery is performed in order to limit the amount of food intake of the patient. Bariatric Surgery has proved to be beneficial in long-term weight loss, and decreased susceptibility to diabetes and reduction in cardiac diseases. 

Know More About Surgery
Obesity can be diagnosed by measuring the BMI of the body.
 
A Bariatric Surgery is needed when the BMI is - 
  • > 37.5 
  • > 32.5 with associated diseases
  • > 27.5 with type 2 diabetes

Bariatric Surgery includes several procedures for the treatment of obese people such as-

  • Gastric bypass- This is the most standard weight loss surgery which involves the creation of a stomach pouch and the small intestine is re-routed by the creation of a bypass. This helps reducing the food quantity intake by a patient and also reduces the absorption of calories from the food.
     
  • Sleeve Gastrectomy- In this procedure, the left side of the stomach is removed which helps reduce the food intake. It reduces the feeling of hunger as the part of the stomach which produces the hormone that stimulates hunger is removed.
     
  • Mini Gastric Bypass- This procedure is a combination of a Gastric bypass and a Sleeve Gastrectomy. A sleeve of the stomach is made and connected to the bypass of the small intestine.
     
  • Ileal Transposition- This involves the interposition of the last segment of the ileum between the jejunum and the stomach. This helps in controlling diabetes as it controls blood sugar immediately. 
     
  • Biliopancreatic Division- This procedure is carried out for patients who are highly obese and have a BMI over 50. Some part of the stomach is removed and is connected to the last part of the small intestine.

There are several risks involved in a Bariatric Surgery. There are chances of pouch stretching in which the stomach may dilate over time and restore its original size which would again increase the weight of the patient. There are also possibilities of breakdown of staple lines as well as stomal stenosis in which a constriction is formed between the stomach and the small intestine causing digestive disorders. Due to the decreased pathway of absorption of food after the surgery, deficiencies in vitamins and minerals may occur. Bariatric Surgery may also result in dumping syndrome in which the food passes through the pathway too quickly. It also leads to higher risk of osteoporosis, diarrhea and malnutrition due to less absorption of nutrients.

It is essential to be on a liquid diet for at least 2 days after surgery. Only soft foods such as porridge, surd, egg whites etc. can be eaten then for about a month. The patient is recommended to walk regularly after the surgery and proper physical exercise should commence only after 3 months of surgery. The patient must take vitamin and mineral supplements to avoid deficiency diseases.

Bariatric Surgery from best Hospitals and Doctors in Mumbai

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Bariatric Surgery

Obesity can lead to many harmful diseases such as diabetes, sleep apnea, arthritis, high blood pressure and stroke. Hence, it is of prime importance to be healthy and to have the appropriate body weight. In many cases, people cannot reduce their weight by dieting and exercise. Therefore, Bariatric Surgery is performed in order to limit the amount of food intake of the patient. Bariatric Surgery has proved to be beneficial in long-term weight loss, and decreased susceptibility to diabetes and reduction in cardiac diseases. 

Diagnosis

Obesity can be diagnosed by measuring the BMI of the body.
 
A Bariatric Surgery is needed when the BMI is - 
  • > 37.5 
  • > 32.5 with associated diseases
  • > 27.5 with type 2 diabetes

Treatment

Bariatric Surgery includes several procedures for the treatment of obese people such as-

  • Gastric bypass- This is the most standard weight loss surgery which involves the creation of a stomach pouch and the small intestine is re-routed by the creation of a bypass. This helps reducing the food quantity intake by a patient and also reduces the absorption of calories from the food.
     
  • Sleeve Gastrectomy- In this procedure, the left side of the stomach is removed which helps reduce the food intake. It reduces the feeling of hunger as the part of the stomach which produces the hormone that stimulates hunger is removed.
     
  • Mini Gastric Bypass- This procedure is a combination of a Gastric bypass and a Sleeve Gastrectomy. A sleeve of the stomach is made and connected to the bypass of the small intestine.
     
  • Ileal Transposition- This involves the interposition of the last segment of the ileum between the jejunum and the stomach. This helps in controlling diabetes as it controls blood sugar immediately. 
     
  • Biliopancreatic Division- This procedure is carried out for patients who are highly obese and have a BMI over 50. Some part of the stomach is removed and is connected to the last part of the small intestine.

Risks

There are several risks involved in a Bariatric Surgery. There are chances of pouch stretching in which the stomach may dilate over time and restore its original size which would again increase the weight of the patient. There are also possibilities of breakdown of staple lines as well as stomal stenosis in which a constriction is formed between the stomach and the small intestine causing digestive disorders. Due to the decreased pathway of absorption of food after the surgery, deficiencies in vitamins and minerals may occur. Bariatric Surgery may also result in dumping syndrome in which the food passes through the pathway too quickly. It also leads to higher risk of osteoporosis, diarrhea and malnutrition due to less absorption of nutrients.

After Procedure

It is essential to be on a liquid diet for at least 2 days after surgery. Only soft foods such as porridge, surd, egg whites etc. can be eaten then for about a month. The patient is recommended to walk regularly after the surgery and proper physical exercise should commence only after 3 months of surgery. The patient must take vitamin and mineral supplements to avoid deficiency diseases.

FAQ Section

1) What is bariatric surgery?

Bariatric surgery is a surgical procedure performed to cause weight loss by restricting the amount of food the stomach can accommodate. It is carried out with an aim to cause malabsorption of nutrients and gastric restriction. Procedures falling under Bariatric surgery often hormonal changes and entail their own risks.

2) Who can qualify for bariatric surgery?

A person with body mass index (BMI) of 40 or higher.
Someone with BMI 35 or more and has a serious weight-related health problem like type 2 diabetes, high blood pressure, or severe sleep apnea.
A teenager who's gone through puberty and his BMI is 35 or more and has serious obesity-related health problems like type 2 diabetes or severe sleep apnea.
A person whose efforts to lose weight with diet and exercise have been unsuccessful.

3) What are the risk factors for bariatric surgery?

Risks associated with the surgical procedure in gastric bypass surgery can include:
1.Excessive bleeding
2.Blood clots
3.Infection
4.Adverse reactions to anesthesia
5.Leaks in your gastrointestinal system
6.Lung or breathing problems
7.Death (rare)

Longer term risks and complications of bypass surgery vary depending on the type of surgery and can
include:
1.Bowel obstruction
2.Ulcers
3.Vomiting
4.Dumping syndrome, causing diarrhea, nausea or vomiting
5.Gallstones
6.Hernias
7.Low blood sugar (hypoglycemia)
8.Malnutrition
9.Stomach perforation
10.Death (rare)

4) How effective is bariatric surgery?

Bariatric Surgery is able to lead to an average of 50% excessive weight loss after two years, which makes the procedure quite effective.

5) What is the cost of bariatric surgery in India?

A bariatric surgery, in India, can cost anywhere between Rs 2.5 to Rs 5 lakh, and the equipment and technology alone can fetch around Rs1.75 lakh.

6) What kind of foodstuff can be and can't be eaten after bariatric surgery?

A gastric bypass diet helps people who are recovering from gastric bypass surgery, which is also known as Roux-en-Y gastric bypass surgery, and to heal and to change their eating habits.
Liquids
For the first day or so after surgery, the patient is only allowed to drink clear liquids. Once the patient
starts handling clear liquids, they can start having other liquids, such as:
1.Milk
2.Unsweetened juice
3.Decaffeinated tea or coffee
4.Sugar-free gelatin or popsicles

About one week after consuming nothing else but liquids, the patient is allowed to have mashed up food.
1.Soft scrambled eggs
2.Lean ground meat, poultry or fish
3.Cottage cheese
4.Strained cream soups
5.Soft fruits and cooked vegetables
A few weeks after that, the patient can move to soft food like rice and eggs. And then after completing around eight weeks of the gastric diet, the patient can return to eating solid food.

7) Does stomach hurt after bariatric surgery?

Yes, you may have to endure some pain for a few weeks after bariatric surgery as abdominal pain is one of the most common and nagging problems after the procedure.

8) Different types of bariatric surgeries?

Gastric bypass is one of the most common types of bariatric surgery in the world. It is done when diet and exercise haven't shown you any results or when you have serious health problems because of your weight. Roux-en-Y gastric bypass or simply called gastric bypass is a type of weight-loss surgery that involves creating a small pouch from the stomach and connecting the newly created sack directly to the small intestine. After gastric bypass, swallowed food goes into this small pouch of the stomach and then directly into the small intestine, whereby bypassing most of the stomach and the first section of the small intestine.

Laparoscopic adjustable gastric banding: In the laparoscopic adjustable gastric banding procedure, a band containing an inflatable balloon is put encompassing the upper part of the stomach and fixed in place, creating a small stomach pouch above the band with a very narrow opening to the rest of the stomach, restricting the amount of food that your stomach can hold, making you feel full sooner.

Sleeve Gastrectomy: A section of the stomach is separated and removed from the body and the remaining section of the stomach is formed into a tubelike structure.

9) Are bariatric surgeries dangerous?

All forms of bariatric surgery, including gastric bypass, are major procedures in someone's life and even can pose serious risks and side effects.

10) What is the duration of recovery for the bariatric surgeries?

If one follows the doctor's diet plan along with other medication, the recovery can be made within ten weeks.

11) Are the bariatric surgeries reversible?

Most procedures in bariatric surgeries are not reversible as in addition to reducing the size of the stomach, the procedures also rearrange the digestive system and also causes alterations in gut hormones, improving satiety, changing the absorption rate of calories, and restricting the amount of food consumed.

12) Do the benefits of bariatric surgeries really outweighs risks?

All major surgeries present their risks which usually vary with each patient. The same can be said for bariatric procedures, however, in the appropriate patients, the health risks from obesity far outweigh the risks associated with procedures like bypass surgery or sleeve gastrectomy. Most of the surgeries are now associated with major reductions in risk of premature death over a 5-year period versus not
having surgeries.