Does Bariatric Surgery means Liposuction?
No. Liposuction is a cosmetic surgery / body sculpting surgery, where excess amount of localized fat is sucked out giving a proper shape to that part. Whereas bariatric surgery is a surgery done on intestinal system to reduce calorie consumption and metabolism.
Who is eligible for bariatric Surgery?
- Patient’s BMI > 35 with 2 nos Co-Morbidities (Hypertension & Diabetes)
- BMI > 40 with or without Co-morbidities
- Patients having BMI > 40 or weighing 30 kg more than the normal weight
- Patients who have failed medically managed weight-loss programmes
- Age between 16-80 years
- Persistently morbidly obese for at least 3-5 years
- Capability to tolerate surgery
- Absence of alcoholism
What are the types of surgery?
Basically two types of procedure
Restrictive Procedure (Aimed to reduce the food intake by reducing the size of the stomach)
- Adjustable gastric band
- Lap Sleeve Gastrectomy
Malabsorptive / Combination (Aimed to prevent absorption of the food along with reduction of the size of the stomach)
- Roux-en-Y Gastric Bypass
LAP ADJUSTABLE GASTRIC BANDING
- An adjustable silicon band is placed around the upper part of stomach which induces weight loss by restricting food intake.
- Surgery can be reversed.
- Digestion and obsorption is normal.
- Pt looses 50% excess body wt. in 1st year. Maintains a wt. loss of 60% of excess body wt. even after 5 yrs.
Lower morbidity rate.
LAP SLEEVE RESECTION
- Its safer that other surgeries.
- 80% of stomach is stapled which induces weight loss by restricting food intake and early satiety due to loss of hunger hormones.
- Digestion and absorption is normal.
- 50% of excess weight loss in first year and 70 – 80% at the end of two years.
LAP ROUX-EN-Y GASTRIC BYPASS
- Stapling is used to create as small, upper stomach pouch which restricts the amount of food to be consumed.
- A portion of small bowel is bypassed that delays food from mixing with digestive juices.
- Average of 77% of excess body weight loss a year after surgery.
ADVANTAGES OF SURGERY ON CO-MORBIDITIES
- Quality of the life gets improves in 95% of patients.
- Mortality reduced by 90% in a 5 years period.
- Hypertension – reduced by 70%
- Diabetes – reduced by 82% to 98% (No insulin or medicines required after 6 months).
- Hypercholesterolemia – reduced by 65%
- Osteo-arthritis reduced by 40%
- Depression – reduced by 50%
CAN THE SURGERY BE DONE LAPAROSCOPICALLY
Yes. They are done laparoscopically, giving the advantages of
- Short hospital stay i.e., 2 days
- Less pain
- Early return to work
- Good cosmesis
- All major surgery involves a certain level of risk.
- Risks involved with weight loss surgery very according to procedure performed.
- Re-operation rate 1%
- Anastomotic leak 2%
- Anastomotic stricture 3%
- Wound infection 1%
- Intestinal Obstruction 5%
- Deep vein thrombosis 1%
- Restriction of eating small meal indefinitely
- Occasional Vomiting / Regurgitation
- Minor hair loss
- Loose / Boggy skin (Later Body contouring)