Bariatric Surgery

Bariatric Surgery also known as Weight Loss Surgery program involves a multidisciplinary team of weight-loss experts for proper weight management. The experienced Bariatric Surgeons at Shrimann Superspeciality Hospital have performed a high volume of weight loss surgeries and have achieved excellent outcomes. Our highly skilled and efficient Bariatric Surgery Team that specialises in treating patients with complex medical disorders related to obesity as well as weight disorders and metabolic disease.

What is Bariatric Surgery?

Bariatric Surgery or Weight Loss Surgery, is a category of surgical operations intended to help people with obesity lose weight.

Doctors may recommend Bariatric Surgery if other weight loss methods have failed and if Obesity appears to pose a greater risk to your health than surgery.

Bariatric Surgery procedures like work by modifying your digestive system — usually your stomach, and sometimes also your small intestine — to regulate how many calories you can consume and absorb. They can also reduce the hunger signals that travel from your digestive system to your brain.

Bariatric Surgery can help treat and prevent many metabolic diseases related to obesity, including diabetes and fatty liver disease. But weight loss surgery isn't an easy “quick fix”. It requires preparation before hand and long-term lifestyle changes afterward to be successful.

Bariatric Surgery recommendations:

• Bariatric Surgery is recommended for individuals with BMI ≥37.5 kg/m2, regardless of presence, absence, or severity of co-morbidities.
• Bariatric Surgery is recommended in patients with Type 2 Diabetes and BMI ≥32.5 kg/m2.
• Bariatric Surgery should be considered in individuals with BMI of 32.5 – 37.5 kg/m2 who do not achieve substantial or durable weight loss or co-morbidity improvement using nonsurgical methods.

What are obesity and overweight?

Overweight and obesity are defined as abnormal or excessive fat accumulation that may impair health.

Body Mass Index (BMI) is a simple index of weight-for-height that is commonly used to classify overweight and obesity in adults. It is defined as a person's weight in kilograms divided by the square of his height in meters (kg/m2).

For adults, WHO defines overweight and obesity as follows:

• Overweight is a BMI greater than or equal to 25; and
• Obesity is a BMI greater than or equal to 30.

BMI provides the most useful population-level measure of overweight and obesity as it is the same for both sexes and for all ages of adults. However, it should be considered a rough guide because it may not correspond to the same degree of fatness in different individuals.

What kinds of conditions can Bariatric Surgery treat?

Obesity is associated with many chronic diseases, many of which can be life-threatening. These conditions and risk factors greatly improve after surgery and weight loss. If you're a candidate for Bariatric Surgery, you may already have or be at risk of developing any of these diseases, including:

• High Cholesterol - Hyperlipidemia (high cholesterol) means your blood has too many lipids (fats) in it. These can add up and lead to blockages in your blood vessels. This is why high cholesterol can put you at risk for a stroke or heart attack.
• High Blood Pressure -  Hypertension (high blood pressure) means the force of blood flowing through your blood vessels is too high. This wears down the walls of your blood vessels and puts you at greater risk of heart attack and stroke.
• High Blood Sugar - Hyperglycemia (high blood sugar) is highly linked to insulin resistance and is considered a precursor to diabetes. Left untreated, it can damage your nerves, blood vessels, tissues and organs, increasing your risk of many diseases.
• Type 2 Diabetes - Excess fat storage can lead to insulin resistance, which can lead to adult-onset diabetes (Type 2). The risk of developing Type 2 diabetes increases by 20% for each 1 point increase on the BMI (body mass index) scale.
• Heart Disease -  Obesity can lead to impaired cardiac function and congestive heart failure. It can also cause plaque to build up inside your arteries and increases your risk of heart attack and stroke.
• Kidney Disease - Metabolic syndromes associated with obesity, including high blood pressure, insulin resistance and congestive heart failure, are major contributors to chronic kidney disease and kidney failure.
• Obstructive Sleep Apnea - People with untreated Sleep Apnea stop breathing repeatedly during their sleep when their upper respiratory tract becomes blocked. These episodes reduce oxygen flow to the vital organs and particularly endanger the heart.
• Osteoarthritis - Having excess weight puts extra pressure on joints like your knees. This makes it more likely that you'll develop osteoarthritis, a degenerative joint disease, or make it worse if you already have it.
• Non-alcohol related Fatty Liver Disease (NAFLD) - NAFLD occurs when your body begins depositing excess fat in your liver. It can lead to Non-alcohol related Steatohepatitis (NASH), chronic inflammation that can do long-term damage to your liver.
• Cancer - While the connection isn't entirely understood, obesity is correlated with an increased risk of acquiring more than a dozen types of cancer. It also increases your risk of death from cancer by more than 50%.

Types of Bariatric Surgery

• Gastric Bypass or Roux-en-Y (roo-en-wy) -  This procedure is the most common method of gastric bypass. This surgery is typically not reversible. It works by decreasing the amount of food you can eat at one sitting and reducing absorption of fat and calories. The surgeon cuts across the top of the stomach, sealing it off from the rest of the stomach. The resulting pouch is about the size of a walnut and can hold only about an ounce of food. Typically, the stomach can hold about 3 pints of food. Then, the surgeon cuts the small intestine and sews part of it directly onto the pouch. Food goes into this small pouch of stomach and then directly into the small intestine sewn to it, bypassing most of the stomach and the first section of the small intestine. Instead, food goes directly into the middle part of the small intestine.
• Sleeve Gastrectomy - With Sleeve gastrectomy, about 80% of the stomach is removed, leaving a long, tube-like pouch. This smaller stomach can't hold as much food. It also produces less of the appetite-regulating hormone ghrelin, which may lessen the desire to eat. Advantages to this procedure include significant weight loss and no rerouting of the intestines. Sleeve gastrectomy also requires a shorter hospital stay than do most other procedures.
• Biliopancreatic diversion with duodenal switch (BPD/DS) - This is a two-part surgery usually performed in one setting. The first step involves performing a sleeve gastrectomy. During the second step, the surgeon closes off the middle section of the intestine and attaches the last part directly to the first part of the small intestine, called the duodenum. This is the duodenal switch. The separated section of the intestine isn't removed from the body. Instead, it's reattached to the end of the intestine, allowing bile and pancreatic digestive juices to flow into this part of the intestine. This is the biliopancreatic diversion. This surgery both limits how much you can eat and reduces the absorption of nutrients. While it is extremely effective, it has greater risk, including malnutrition and vitamin deficiencies.
• Single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) - Like BPD/DS, the SADI-S procedure also has two steps, with the first step being a sleeve gastrectomy. During the second step of the SADI-S procedure, a section of the small intestine known as the duodenum is closed off just below the new stomach sleeve. This opening below the new stomach is then connected to a part of the lower small intestine called the ileum. This is the duodeno-ileal bypass.The bypass routes food through only about 10 feet of the small intestine, instead of the usual 25. This means there is less time and distance for the body to absorb fat and calories.

Which type of weight-loss surgery is Best for you depends on your specific situation. Your Bariatric Surgeon will take many factors into account, including body mass index, eating habits, other health issues, previous surgeries and the risks involved with each procedure.

Common myths about Bariatric Surgery

That surgery is a last resort. Bariatric surgery is the most effective long-term treatment for class III obesity. When studied scientifically, diet and exercise — alone or in combination with medications — are much less effective over the long term.

That surgery is the “easy way out.” Bariatric surgery can be thought of as a tool that allows a healthy diet and lifestyle to lead to sustained weight loss. Often, patients have made these changes before without long-term success. Surgery allows those changes to be effective.