Centre For Bariatric Surgery 

What is Bariatric Surgery?

Obesity can be treated. It requires multi-disciplinary assessment by endocrinologist, psychiatrist, cardiologist, bariatric surgeon and others depending on the associated conditions.

Treatment is Patient Specific
Medical management:
• Psychological support
• Diet, exercise and behavioral therapy
• Medicines

Life after Surgery
1.Diet
• Immediately after bariatric surgery, the patient is restricted to a clear liquid diet, which includes foods such as clear broth, diluted fruit juices or sugar-free gelatin desserts. This diet is continued until the gastrointestinal tract has partially recovered from the surgery. Diet is to be strictly followed and is tailor made for each patient
• Food to be chewed thoroughly before swallowing
• Avoid desert or sugary items, carbonated drinks, high fat food and high fibre food
• Avoid alcohol and smoking
• Limit snacking between meals
• The diet plan is usually:
     – Upto 2 weeks: liquid diet
     – 4-6 weeks after surgery: 600-800 calories/day solid diet
     – 1-2 months after surgery: 1000-1200 calories/day

2.Return to Work
• This depends on the nature of work and associated co-morbid conditions
• Most patients return to work after a week and full activity within six weeks of procedure

3.Birth Control and Pregnancy
• It is preferable to avoid pregnancy for 12 -18 months following surgery
• The reason being, pregnancy places additional demands on the body

Long Term Follow-up
• Nutritional deficiencies may occur over the course of many years post-surgery
• Anemia, Vitamin B12 deficiency, reduced folate and iron levels can occur
• Follow up with the surgeon and blood tests are required every 3-6 months in the first year and then every 1-2 years for life
• It is important to attend periodic support group meetings to remain committed to weight loss

Expected Results
• Loss of 60-70 % excess weight by the end of 1-2 years
• Improvement in associated diseases like diabetes
• Greater capacity for physical activity
• Improvement in quality of life and appearance

Patients who will benefit from Bariatric Surgery
• Patient with BMI > 35 or > 32 .5 with co-morbid conditions
• Multiple attempts of weight reduction by diet and exercises have failed
• No treatable underlying endocrine disorder is found
• No major psychiatric illness is found
• Patient is committed to post-operative diet and lifestyle modifications

Health Benefits of Surgery
• In Type 2 diabetics, sugar levels are known to come down after bariatric surgery and in some cases the medications are no longer needed
• Relief of sleep apnoea is seen and hence better of quality of sleep
• Hypertension improves and in some patients medication is no longer needed
• Cholesterol level comes down drastically and patients can lower or stop lipid lowering medicines
• Improvement in diabetes, hypertension and cholesterol levels has a direct effect on reducing the risk of heart diseases
• Post-surgery patients are known to have fewer and less severe asthmatic attacks. There is increased efficiency of breathing and exercise tolerance
• Those with Gastro Esophageal Reflux Disease (GERD) show relief of all symptoms of reflux within a few days
• Stress incontinence responds dramatically to weight loss
• Post-surgery, patients get tremendous relief from low back ache and joint diseases
• Women with polycystic ovarian syndrome show a return to normal regular menstrual cycles after weight loss surgery. Further level of fertility also show improvement

Bariatric Surgery Suitable Candidates
Individuals who should go for a bariatric surgery are those with a Body Mass Index (BMI) of 35 or more. It is also a suitable surgical option for those who have a serious health ailment, like high blood pressure, cardiac disorder or diabetes. These conditions can only be improved through reliable ways of weight loss.

This obesity treatment should be opted only by those unable to lose or maintain healthy weight for at least six months by non-surgical methods like diet and exercise. Suitable candidates also include individuals who are healthy enough to undergo the surgery. They should be able to withstand anesthesia or intravenous sedatives.

In addition to the above, only those who are willing to provide a commitment for long-term follow up treatment at a specialized obesity service should go for bariatric surgery.

Types of bariatric surgery are restrictive or malabsorption. While considering this surgical option your doctor will recommend one of the following procedures that best suits you:
• Roux-en-Y gastric bypass surgery
• Laparoscopic adjustable gastric banding
• Sleeve gastrectomy
• Duodenal switch with biliopancreatic diversion

Types of Bariatric Surgery
All types of bariatric surgeries are done under general anaesthesia. These are minimally invasive surgeries which require a short stay in hospital, recovery after surgery is faster and resumption of routine activities is also possible earlier. Since such procedures are as the name implies minimally invasive (key hole), there is usually less blood loss and damage to tissues, hospital stay is shorter (about 2-5 days) and no post-operative ICU stay or bed rest.

Gastric banding

  • Laparoscopic Sleeve Gastrectomy
  • Gastric bypass
  • Dr Richa Rajput
  • Dr Sandip Bodhke
  • Dr Vaibhav Gandhi
  • Dr Nilesh Bhute
  • Dr Pawar
  • Dr Angad Shitole