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Bariatric and metabolic surgery

The 21st-century world, with it’s changing choices and lifestyle, is prey to weight gain and obesity. Obesity represents nothing but threats to human health inviting a chain of diseases and challenges in day to day life. As a result of obesity, metabolic disorders are on a rising side across the globe. According to recent studies, 20% of people in India are obese, making us the country with the world’s largest diabetic population. Since there is a correlation between metabolic diseases (diabetes), metabolic syndrome, and obesity, the medical field is making a number of attempts to resolve it.
Though non-surgical treatments like exercise and caloric restriction work fairly good for people with a BMI of less than 32.5, it doesn’t work really well for people with a BMI of more than 32.5 who are morbidly obese.
We at Bhatwal Surgical and Maternity Hospital are well aware of the social and psychological stress that morbidly obese individuals / patients go through in day to day life. We become a part of their lives to help them bring a remarkable change in their journey towards normalcy.

Bariatric surgery is a treatment for morbid obesity, a condition that can lead to the development of many serious metabolic diseases and other health problems, such as diabetes (type 2), hypertension, respiratory problems, cardiovascular disease, sleep apnoea, and skeletal joint problems. By providing significant weight loss, bariatric surgery helps patients to treat many of the associated illnesses.
Diabetes (type 2) is a brilliant example of obesity-related metabolic issues that can be efficiently treated with Bariatric- Metabolic surgical procedures. It may or may not have a direct relation with weight-loss and reduction of obesity. That’s when Bariatric surgery evolves as bariatric and metabolic surgery. By performing this surgical procedure, the metabolic operations thoroughly influence the hormonal secretion and hence over-all well-being.

With Bariatric and Metabolic surgeries in place, there is a remarkable change in the perception of metabolic disorders like diabetes (type 2), hypertension, and heart strokes from the experts. Most bariatric surgeons, diabetologists, and other medical specialists believe that disorders like diabetes (type 2), have evolved from initially a medical disease to a condition where bariatric surgeons have a major role to play in the management of the health conditions of the patient.

There are three different types of Bariatric procedures which are done by laparoscopy/keyhole surgeries that offer all the mentioned advantages depending upon the purpose of the surgery and the condition to be treated:

Laparoscopic Sleeve Gastrectomy

Laparoscopic sleeve gastrectomy (LSG) is a standalone restrictive type of procedure for the surgical management of morbid obesity.  It is a rapid and less traumatic operation and thus far is demonstrating good remission of co-morbidities and good weight loss. In this type of surgery, about 75% of the stomach is cut out. Ideal approximate capacity of the stomach after the procedure is about 80-100 ml pouch. But, as the gastrointestinal function is preserved the person has restrictions on his/her eating choices. This surgical procedure facilitates a weight loss treatment since the stomach becomes much smaller in size and cannot hold much food. Another advantage of the procedure is that the stomach secrets less appetite-regulating hormones which in turn reduces the desire for food.

Laparoscopic Gastric Bypass Surgery

Gastric bypass procedure for Bariatric and Metabolic Surgery is a form of restrictive as well as malabsorptive procedure (combined procedure). Caloric Restriction: Combined effect of smaller gastric pouch & the hormonal action suppressing appetite & improving satiety together reduce the overall caloric intake. Malabsorption: Rerouting of the intestines/bypass of some part of the intestine with rapid intestinal transit leaves relatively lesser length of the small bowel for absorption. This induces fat malabsorption resulting in weight loss. There are two types of gastric bypass procedure which are being done routinely: Laparoscopic Roux-en-Y Gastric Bypass and Laparoscopic Mini-Gastric bypass. This surgery is generally recommended for patients with long standing diabetes and higher BMI. Level I Evidence from high quality studies shows better remission of diabetes type 2 and other comorbidities along with sustained weight loss in patients with gastric bypass.

Laparoscopic Roux En Y Gastric Bypass

Laparoscopic Mini Gastric Bypass

Endoscopic Intragastric Balloon Placement

Endoscopic Intragastric balloon placement is a procedure that is done as a weight-loss treatment and a weight control treatment. It involves placing a silicone balloon filled with saline in the patient’s stomach. It is done to help the patient to lose weight by limiting the food intake and making the patient feel fuller faster. The intragastric balloon procedure may be an option if the patient has concerns about his/her weight, and diet and exercise haven’t worked well. Like other weight-loss procedures, an intragastric balloon also requires a commitment to a healthier lifestyle. The patient needs to make permanent healthy changes to his/her diet and a routine of regular exercises to help ensure the long-term success of the procedure. It also acts as a litmus test to choose the type of surgery in a young adult without any comorbidities.

Apart from helping patients in remitting the disease, Bariatric and Metabolic Surgery, also halts the progression of secondary complications due to comorbidities and helps in improving the overall quality of life (QoL). World literature suggests 89% reduction in 5 years mortality rate and 95% improvement in quality of life post Bariatric and metabolic surgery. This is not a cosmetic surgery. It is life modifying surgery.

We at Bhatwal Surgical & Maternity Hospital, walk along the path of wellbeing with our patients and achieve the desired goal.