“gastric bypass surgery being a preferred modality to treat obesity patients that requires strict patient screening and expert doctors. India is becoming a hub for global patients for world class gastric bypass procedures and affordable cost.”
Overview
Gastric bypass surgery is considered as one of the most effective cure alternative to get rid of morbid obesity as well as maintaining the weight in long term. In India, the cost of bariatric surgery is much lower than the western countries, despite having global standards of care. The procedure is also combined with other dietary programs or gastric restriction clubbed with malabsorption. Most of the bariatric surgeries are performed through laparoscopic or minimally invasive procedures. Best hospitals in India offer following advanced procedures for bariatric surgery including:
Obesity has become a global problem in past few decades and causes more deaths as compared to underweight populations. Besides, over thinking about looks and personality is also inducing a feeling of low-confidence among overweight individuals, thus affecting their personal and professional lives at large. Normally, doctors suggest a bariatric procedure, when other dietary, lifestyle measures and exercise methods doesn’t work for a person and he/she continues to gain weight. Beyond a point, obesity (or severe obesity) becomes irreversible as non-surgical options such as lifestyle management, exercise, medication, or dieting fail to deliver desired outcomes. In such cases, surgical intervention is required to contain the progression of obesity and related disorders such as hypertension and Type 2 diabetes. A thorough examination of the patient is done by a team of expert doctors and a suitable surgical procedure is adopted after proper counseling of the patient.
Types of Bariatric Surgery
There are various minimally invasive surgical procedures available for obese patients nowadays such as Gastric Bypass, Single Anastomosis Bypass, Gastric Balloon Procedure and Sleeve Gastrectomy (or Gastric Sleeve Surgery).
Gastric Bypass Surgery
Gastric bypass surgery is one of the most common weight-loss procedures. Like any other bariatric surgery, gastric bypass refers to making surgical changes in patient’s stomach as well as the digestive system to restrict the food intake and nutrient absorption causing the weight loss.
However, not all candidates qualify for gastric bypass surgery procedure and have its own set of post surgical side effects and health risks. Moreover, this procedure also requires permanent lifestyle changes to make a long lasting weight loss management. Some evaluation parameters for gastric bypass surgery candidate comprise:
- Body mass index (BMI) is 40 or above
- Unsuccessful in losing weight by other means
- BMI is above 35 with serous obesity-linked health issues, such as severe sleep apnea, high BP or type 2 diabetes
Single Anastomosis Bypass
Also known as Mini-gastric bypass surgery, Single Anastomosis Bypass is useful for primary weight loss program, which results in less post operative complications and decreased operation time. In this procedure, around 6 feet of intestine part is bypassed that leads to decreased absorption of consumed food in the body.
Gastric Balloon Procedure
This is an endoscopic procedure, in which a silicon balloon filled with saline solution is placed inside patient’s stomach. The balloon occupies partial space inside the stomach and gives false feeling of full stomach to individuals resulting in less food intake. Later, the balloon is removed after a certain period of time.
Gastric Sleeve Surgery or Sleeve Gastrectomy
Sleeve Gastrectomy is performed through a keyhole surgery to remove a large part of stomach (about 75%), but the stomach functions normally after the surgery. This reduced size of stomach helps patient to lose around 50-70% excess weight within a year. If patients follow a prescribed diet, they may lose more excess weight also. Actually, the procedure involves removal of stomach part that secrets ‘hunger hormone’ thus significantly reducing the calorie intake of an individual.
Benefits of Gastric Sleeve procedure include significant results after the surgery and by retaining unaltered functionality of the stomach to digest the nutrients. Apart from these direct advantages, the surgery also helps in managing diabetes, hypertension and infertility in turn re-establishing the self-confidence as well as productivity of an individual.
Risk Factors
After weight loss surgery, some patients may experience temporary health issues after weight loss surgery such as anastigmatic leaks, infection, blood clotting in legs, bleeding and anesthesia problems. The long term effect may include deficiency of Vitamin B12 that can be managed with medication.
Outcomes of Bariatric Surgery
Bariatric surgery may offer lasting weight loss outcomes, however amount of weight loss depends upon selected procedure and lifestyle change adopted by an individual. A person can lose upto 70% of the excess weight over a period of 24 months, if he/she sticks to the doctor’s advice on various parameters related to the surgery and recovery protocol. In addition to the weight loss, bariatric surgery also offers relief in life threatening disease induced by obesity such as high BP, joint pain, infertility, heart disease, gastro esophageal reflux, sleeping disorders and Type 2 diabetes. Moreover, bariatric surgery helps improve quality of life for enabling him exercise routine activities with ease.
Gastric Bypass Surgery Procedure
Doctor will administer general anesthesia before gastric bypass procedure for a pain-free operation.
Step 1
During first step, the stomach size is reduced using staples. The surgeon uses staples to divide the stomach into two uneven separate sections. The small part called pouch will hold very less amount of food causing low intake and subsequent weight loss.
Step 2
The second step is known as bypass, in which surgeon connects a tiny part of small intestine to pouch. This arrangement will allow food to direct enter into small intestine, resulting in low calorie absorption.
There are two procedures to perform gastric bypass surgery including open surgery and laparoscopy. In open surgery, surgeon makes a big incision in stomach to do bypass, while laparoscopic procedure uses a small incision to insert the laparoscope – a device fitted with camera to see the internal organs and perform the bypass surgery.
In laparoscopy:
- Doctor will make 4 to 6 small incisions in belly.
- The instruments and scope required to do the surgery are inserted via these cuts.
- The camera device is liked to a video monitor to view the entire belly and perform the procedure.
Benefits of laparoscopy:
- Quick recovery and smaller hospital stay
- Less pain
- Less scars and reduced risk infection or hernia
Gastric bypass surgery takes around 2 to 4 hours to complete.
Gastric bypass is considered the best among all bariatric procedures and is performed quite often. The surgery offers lower complications and very safe as compared to open procedure. Doctor advises the patient to follow proper diet and healthy life style to make long lasting impact. An extensive patient screening is performed to before the procedure to endure safety and success of gastric bypass surgery. A consistent follow-up plan needs to be followed to observe patient’s medical conditions, lifestyle and behavior, nutrition profile.
Post Procedure Care:
- Post gastric bypass procedure, stomach is kept empty for two days, for allow proper healing to let stomach and digestive tract.
- A specific diet is recommended for 12 weeks, which comprises mainly liquids and soft foods for some time before resuming normal diet.
- Some restriction may also be put on amount of food to be consumed.
- Regular follow up tests also performed.
After surgery, patient may experience some health related changes such as fatigue, cold, hair thinning, body aches, mood swings and dry skin.
Gastric bypass surgery in India
India offers a range of bariatric treatments at affordable price that makes it a preferred healthcare destination among global patients. The county also provides advanced hospitals and treatment facilities with best in class services for comfort of the patient. The success rate for the gastric bypass surgery is around 98%.
Any bariatric surgical interventions need a surgeon who has rich hand on experience in performing laparoscopic bariatric surgeries. Cost of gastric bypass surgery in India is varies from US$ 3000 to US$ 7000, which is much lower than the western counterparts. India has an exceptional track record by Indian surgeons, who had successfully performed various bariatric and gastric bypass surgeries across the country. These experienced surgeons are available through dedicated healthcare network, which assists the patients throughout the procedure right from counseling to selection of doctor and procedure to stay in India.
Author:
Dr. Jaydeep H. Palep
Director & Head,
Department Of Bariatric & Minimal Access Surgery,
Nanavati Super specialty Hospital,
Mumbai, India
Consultant GI & Bariatric Surgeon(Lap & Robotic)
Dr. Palep’s Weight Loss and Gastro Clinic
Lilavati Hospital
Jaslok Hospital
Breach Candy Hospital
Hinduja HealthCare, Khar
