Obesity And Metabolic Surgery

Also known as vertical sleeve gastrectomy, it is a weight loss procedure in which a stomach reduces about 15% of its original size, resulting into a sleeve or tube like structure. Thereby, restricting the amount of food one can eat on a daily basis.

How Is Sleeve Gastrectomy Performed? 

It is laparoscopic surgery that involves the removal of most of the stomach by resizing it.  A surgeon makes a few small incisions in the upper abdomen and perform the surgery using a laparoscope and small instruments that are inserted into the body through these incisions. The surgeon then vertically creates a narrow section in the upper part of the stomach which is in the shape of a sleeve and is called a gastric sleeve, by removing the larger, curved part of the stomach. The surgery restricts the amount of food one can eat and also curb the hunger hormone, ghrelin.

What Are The Advantages Of Sleeve Gastrectomy?

• Stomach reduced without loss of function
• Ideal for morbidly obese personality 
• 70-80% expected weight loss
• A lower risk of the infection
• Less pain
• Smaller scars 
• Quicker recovery
• Shorter hospital stay

It is one of the most common weight loss procedure that alters the functioning of the stomach and small intestine. After the surgery, the stomach will become small and a patient will eat a small amount of food, thereby, absorbing fewer calories. 

How Is Gastric Bypass Performed? 
Also known as "Roux-en-Y" gastric bypass or RYGB is a minimally invasive surgery that is performed in two parts 

• Part 1: The surgeon staples your stomach, creating a small pouch of the stomach. This staple makes the stomach smaller, thereby making less space food which makes you feel full sooner. 
• Part 2: The surgeon cuts the small intestine and attaches the lower part of it directly to the small stomach pouch. The food a person eats goes directly to the small intestine bypassing the stomach, so the body absorbs very few calories.The surgery is performed using a laparoscope. A surgeon makes small incisions and inserts a thin laparoscope with a camera on its top, inside the body to perform surgery.

What Are The Advantages Of Gastric Bypass?

• A patient loses around 70-80% of their excess weight within 2 years
• Resolving comorbidities such as diabetes, sleep apnoea, hypertension, heart disease, and dyslipidaemia 
• A lower risk of the infection
• Less pain
• Smaller scars 
• Quicker recovery
• Shorter hospital stay

It is a newer type of weight-loss procedure which shrinks the size of the stomach using an endoscopic suturing device without the need of the surgery.
How Is Endoscopic Sleeve Gastroplasty Performed? 
Endoscopic Sleeve Gastroplasty (ESG) is a non-invasive, advanced day-care endoscopic procedure that involves the use of a thin, flexible endoscope with a camera and an endoscopic suturing device attached to its tip. The doctor inserts the endoscope orally down the patient’s throat into the stomach and operates inside the stomach without making an incision in the abdomen.With the help of the camera attached to an endoscope, the doctor looks inside the patient’s stomach on the monitor and performs the surgery by placing approximately 12 sutures in the stomach. Thereby, changing the shape of the stomach, which after surgery, looks like a tube (as the gastric volume of the stomach reduces by 50 – 60%). This helps in restricting the number of calories a patient intake.

What Are The Advantages Of Endoscopic Sleeve Gastroplasty?
Endoscopic Sleeve Gastroplasty (ESG) is one the advanced procedure that helps in losing weight without surgery. It is a life-altering weight loss transformation that offers many advantages, such as:

• The safe, incisionless procedure with no external scar
• The day-care procedure with same-day discharge
• Significant weight loss of up to 20% of the total body weight
• Reduced risk and rapid recovery
• No removal of body parts

The Bariatric Surgery procedures offered at the centre not only results in impressive weight reduction but also for the remarkable control of blood sugar levels in Diabetes Mellitus and curing snoring due to life-threatening Obstructive Sleep Apnoea has been extensively studied in the Centre and papers presented in national and international journals and conferences.

A person has to undergo Obesity & Metabolic Surgery if he encounters conditions such as:

• If you have a body mass index (BMI) is equal to or greater than 40 (extreme obesity)
• If your body mass index (BMI) is in between 35 to 39.9 (obesity) and you are a candidate for potentially life-threatening weight-related health problems, such as:
  • Gastroesophageal Reflux Disease
  • Heart Disease
  • High Blood Pressure
  • Severe Sleep Apnoea
  • Type 2 Diabetes
  • Stroke

In rare cases, a patient might be prescribed to undergo weight-loss surgery if his/her BMI is 30 to 34 and is suffering from serious weight-related health problems.

A doctor might evaluate the patient’s current medical condition to know whether he/she is a candidate for Obesity & Metabolic Surgery. You may advise undergoing general, gastric bypass and other weight-loss surgeries if you have:

• Severe obesity -BMI equals to or greater than 40 or a patient weighing more than 100 pounds over ideal body weight
• Severe obesity with significant obesity-related conditions -BMI >40, BMI 35-40 with significant obesity-related conditions (type 2 diabetes, high blood pressure, sleep apnea or high cholesterol)

A patient is considered for surgery if he/she shows:

• Acceptable operative risk
• Understands surgery and risks
• Absence of drug or alcohol problem
• No endocrine causes of obesity
• No uncontrolled psychological conditions
• Failed attempts at medical weight-loss (diets, other weight-loss options)

The patient must follow the following precautions after the Liver Transplant:

• Avoiding drinking alcohol 
• Take prescribed medicine on time
• Go on regular check-up with the doctor.
• Eating less fatty foods, including red meat, eggs and cheese
• While you eat, be slow and chew small bites of food
• Exercise daily as suggested by your doctor
• Maintain a healthy weight.
• Control of metabolic risk factors like:
  • High blood pressure
  • Diabetes
  • Cholesterol
• Cutting down the intake of sugar salt in the diet
•  Avoid eating wild mushrooms

Obesity & Metabolic Surgery also called bariatric surgery, is one of the safest and most effective treatment options for people affected by severe obesity. It is surgery of the stomach and/or intestines to help the patient lose weight by making a change in the digestive system. However, the surgery might offer mild complications, such as:
Risks associated with the surgical procedure can include:

• Bleeding
• Blood clots
• Leaks in your gastrointestinal system
• Lung or breathing problems
• Infection at the site of incision
• Adverse reactions to anaesthesia
• Dumping syndrome, causing
  • Diarrhoea 
  • Nausea or vomiting

A patient might overcome the complication by properly discussing them with the doctor and taking the required precautions.