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Bariatric surgery

Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have a negative effect on health.

People are generally considered obese when their body mass index (BMI), a measurement obtained by dividing a person’s weight by the square of the person’s height, is over 30 kg/m2, with the range 25–30 kg/m2 defined as overweight. Cut off BMI for Indians in 2 points less.

Obesity increases the likelihood of various diseases particularly heart disease, type 2 diabetes, obstructive sleep apnea, certain types of cancer, and osteoarthritis.

Obesity is a leading preventable cause of death worldwide, with increasing rates in adults and children.

ALL SURGERIES PERFORMED LAPAROSCOPICALLY WITH 0.5 CM TO 1.2 CM INCISION WHICH USUALLY LEAVE NO SCAR AFTER FEW MONTHS

Dr. G.Moinoddin

BARIATRIC SURGERY CURES OR RELIEVES FOLLOWING OBESITY RELATED DISEASES:

  • DIABETES
  • HYPERTENSION
  • HYPERCHOLESTEREMIA
  • POLYCYSTIC OVARIAN SYNDROME
  • SLEEP APNOE
  • JOINT PAINS
  • SUB CLINICAL HYPOTHYROIDISM
  • FATTY LIVER

AND IMPROVES CARDIAC AND RENAL FUNCTION.

 

SLEEVE GASTRECTOMY

Sleeve gastrectomy, or gastric sleeve, is a surgical weight-loss procedure in which the stomach is reduced to about 15% of its original size, by surgical removal of a large portion of the stomach, following the major curve. The open edges are then attached together (typically with surgical staples, sutures, or both) to leave the stomach shaped more like a tube, or a sleeve, with a banana shape.

The procedure permanently reduces the size of the stomach. The procedure is performed laparoscopically.

Most patients can expect to lose 85 to 90 % of their excess body weight over a 6–12 months period with the sleeve gastrectomy alone.

Advantages:

  • Simple and takes half an hour to 1 hour time to operate
  • Speedy patient recovery
  • Mobilization within hours of surgery
  • Discharge in 2 days
  • Stomach volume is reduced, but it tends to function normally so most food items can be consumed in small amounts.
  • Removes the portion of the stomach that produces the hormone that stimulates hunger (Ghrelin).
  • Dumping syndrome is less likely due to the preservation of the pylorus.
  • Minimizes the chance of an ulcer occurring.
  • By avoiding the intestinal bypass, the chance of intestinal obstruction (blockage), anemia, osteoporosis, protein deficiency and vitamin deficiency are significantly reduced.
  • Appealing option for people with existing anemia, Crohn’s disease, irritable bowel syndrome, and numerous other conditions that make them too high risk for intestinal bypass procedures.

Dr. G.Moinoddin

 

ROUN Y GASTRIC BYPASS

Gastric bypass surgery refers to a surgical procedure in which the stomach is divided into a small upper pouch and a much larger lower “remnant” pouch and then the small intestine is rearranged to connect to both.

Weight loss of 80 to 90 % of excess body weight is typical of most large series of gastric bypass operations reported. The medically more significant effects include a dramatic reduction in comorbid conditions

ADVANTAGES:

  • Hyperlipidemia is corrected in over 70% of patients.
  • Essential hypertension is relieved in over 70% of patients, and medication requirements are usually reduced in the remainder.
  • Obstructive sleep apnea improves markedly with weight loss and bariatric surgery may be curative for sleep apnea. Snoring also reduces in most patients.
  • Type 2 diabetes is reversed in up to 90% of patients usually leading to a normal blood-sugar level without medication, sometimes within days of surgery. Furthermore, Type 2 diabetes is prevented by more than 30-fold in patients with pre-diabetes.
  • Gastroesophageal reflux disease is relieved in almost all patients.
  • Venous thromboembolic disease signs such as leg swelling are typically alleviated.
  • Lower-back pain and joint pain are typically relieved or improved in nearly all patients.
  • A study in a large comparative series of patients showed an 89% reduction in mortality over the five years following surgery, compared to a non-surgically treated group of patients.

Dr. G.Moinoddin

 

MINI GASTRIC BYPASS

A mini gastric bypass creates a long narrow tube of the stomach along its right border (the lesser curvature). A loop of the small gut is brought up and hooked to this tube at about 1.5 to 2 metres from the start of the intestine

The mini-gastric bypass was developed to reduce operating time, simplify the procedure and reduce complications

ADVANTAGES:

  • Takes 1 to 1 and half hour to perform
  • Patient can eat better and lose weight.
  • Shorter operating time.
  • Less re-routing of the intestines.
  • One anastomosis
  • Technically easier for the surgeon
  • Similar weight loss and recovery
  • Diabetes remission, hypertension resolution and other co morbidities resolution similar to gastric bypass

Dr. G.Moinoddin

 

Dr. Sreedhara V

Dr. Sreedhara V
MBBS,DNB(Gen Surgery), FSGE(Surg Gastroenterology)

Consultant Surg. Gastroenterology Specialized in Advanced Laparoscopic Gastro intest...

Dr. G. Moinoddin

Dr. G. Moinoddin
MS, FMAS, FALBS (MUMBAI), FBS (AHMD), F.ENDO, FRLCRS (SOUTH KOREA)

Specialised in minimally invasive Bariatric, Metabolic Surgeries and Advance Laparoscopic Surg...