Bariatric ( Obesity) Surgery

Background 

Bariatric ( obesity) surgery involves surgery of the patients suffering from obesity and metabolic disorders. This surgery has evolved with advancements in laparoscopic Surgery sure to its inherited benefits in recovery of the patients especially obese where the risk and morbidity with wound infections is also high with conventional open surgery. The laparoscopic surgery is performed by placing the specialised instruments in the abdomain and performing surgery on the monitor under complete vision. 

The evidence of performing safe bariatric surgeries with minimal invasive techniques has tremendously improved with multiple clinical researches  and trials. 

Bariatric surgery involve surgeries of stomach and intestine which are considered to be major surgeries and involves appropriate team work. With the advancements of techniques and improvisation of surgical skills the surgical results of major liver resections have become excellent with time. 

The types of bariatric surgery performed either via laparoscopic or robotic  surgery are Sleeve Gastrectomy, Gastric by pass surgery , Mini gastric bypass surgery, gastric banding procedures, Banded sleeve surgery, Duodenal jejunal bypass surgery, illeal interposition surgery and endoscopic sleeve( endoscopic gastric plication surgery) 

Indication of Bariatric surgery 

The various societies for bariatric and metabolic surgery have laid down Numerous guidelines for treatment of the patients according the demographic sciences and patients behavioural aspects. 

  1. BMI ( body mass index) more then 40
  2. BMI more then 35 with multiple comorbidities associated with obesity like Diabetics mellitus, Hypertension, obstructive sleep apnoea, joint pains, Gastro Esophageal reflux disease, Dyslipidemia, obesity related pschyological stress, infertility etc.  
  3. Adolescent obesity disease
  4. Obesity related metabolic syndrome.
  5. Patients who have failed conservative measures diet, drugs and exercise. 

Technical Insights 

Once you are planned for surgery the surgeon will explain all the details , it’s risk involved , informed consent and recovery protocols after  the surgery they are  planning to perform. Usually the length of the procedure will depend upon the extent of the surgery.  

  1. Surgery is performed under General anaesthesia
  2. Particular position of the patients according to the area of the surgery is to the patient (commonly done in supine position) 
  3. In laparoscopic surgery, Small hole are made to enter the abdomain using video scope to assess the complete abdominal cavity and area of the disease.
  4. Mobilisation of the stomach and assessment of the extent of the resection is done 
  5. Surgery is performed using specialised instruments, energy sources , clips , staplers  to separate the diseased stomach and maintaining the healthy margin . The continuity of alimentary canal is restored. 
  6. The technique might differ with different surgical procedures. 

Recovery after surgery 

  1. The patient is kept in surgical intensive care unit for initial observation and management. Bleeding, infection and leak are major risks involve after these surgeries. 
  1. Intensive chest physiotherapy is advised for enhanced recovery of the patients as breathing might because of obesity and pain at entry sites. 
  1. Diet is usually started once your bowel function starts returning after surgery. The intensive diet program is followed to make the patients adjust the changes of the body and to maintain the requirements. 
  1. Early mobilisation of the patient is recommended.
  1. Routine check up up of your blood will be performed to study your recovery and chances of infection. Micronutrients are supplemented . 
  1. Diet is managed with the help of the dietician to enhance your recovery and protein supplements are added.
  1. Gradual brisk exercises and walking is introduced to enhance the recovery. 

Advantages of bariatric  surgery

It acts like critical first step in weight loss journey as it provides the catalyst and encouragement towards weight loss journey.

  1. Recovery is fast 
  2. Early mobilisation of the patient 
  3. Minimal scar 
  4. Results of weight loss  visible in the duration of 3-6 months which improves with 1-3 years 
  5. Better physiological and pschyological outcomes for the patients 
  6. Resolution of metabolic abnormalities like diabetes mellitus, hypertension and dyslipidemia 
  7. Resolution of obesity related problems as mentioned above. 

To consult with best team of General, minimal access and bariatric surgeons available at  The Surgeons House (SHL) in different global locations, please click this link for more details. 

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