Weight Loss Surgery
Weight Loss Surgery
Weight loss surgery/ Bariatric surgery is a very exciting field which has revolutionized the process of weight loss. This surgery has not only given new lease of life to the patients who are severely obese but has also helped tremendously in controlling type-2 diabetes, hypertension, dyslipidemia, infertility and obstructive sleep apnea.
First description of weight loss surgery in 1960s by team of Dr. Mason and Dr. Ito. Last 25 years has seen renewed interest and popularity of weight loss surgery due to explosion in technology and wide spread use of laparoscopic weight loss surgery. Roux-en-y gastric bypass,one of the weight loss surgery was considered to be gold standard procedure for weight loss. Last 15 yrs has seen emergence of laparoscopic sleeve gastrectomy as a more popular choice as weight loss surgery all over the world.
Dr. Deep Goel is among the first few bariatric surgeons in Delhi who has made weight loss surgery/ bariatric surgery popular in India. He is not only trained and accredited internationally but also recognised as one of the best bariatric surgeon in India. He has been invited as a international faculty around the world to demonstrate live surgical weight loss surgeries and take lectures. He has trained hundreds of young practicing surgeons to do bariatric / weight loss surgery. He is a recognised teaching faculty for various associations and training institutes around the world.
Selection criteria for weight loss/ bariatric surgery
- Severely obese patient who need to lose more than 20 kg of weight.
- People with obesity and uncontrolled diabetes.
- People with obesity and uncontrolled hypertension
- People with obesity and severe joint/knee pain
- Infertility, PCOD
- Obstructive sleep apnea (people who snore while sleeping or get up during sleep because of suffocation).
- People who are suffering from reflux disease, hiatus hernia along with obesity.
Types Of Weight loss surgeries (Bariatric surgery)
Bariatric surgery is classified in three types :-
- Purely restrictive surgery
- Malabsorptive surgery
- Combination of both
Weight loss – Bariatric Surgery
Laparoscopic Sleeve Gastrectomy
Laparoscopic sleeve gastrectomy is fast becoming most popular weight loss surgeries all over the world. It is among one of the most commonly done weight loss surgeries at our centre. It is an irreversible procedure where we reduce the size of the stomach by almost 60%. The remaining portion of the stomach can only accommodate 100 to 150 ml of fluid at a time. Removed portion of the stomach reduces the hunger hormone called “grehline” to almost negligible amount. This makes person feel satisfied (early satiety) with tiny portion of food which helps in quick weight loss. Sleeve gastrectomy can help in losing between 60 – 80% of the excess weight in a period of 9-15 months.
- Simple procedure to perform
- The normal pathway of food is maintained
- Normal function of the stomach is not altered
- Less chances of vitamin and mineral deficiencies
- No dumping syndrome
- Hunger hormone (grehlin) levels are decreased to minimum
Roux-en-y Gastric Bypass
Laparoscopic roux-en-y gastric bypass is combination of restriction and minimal malabsorption approach. It is a reversible weight loss surgery where small stomach pouch is created by using staples. The size of pouch is equal to pear or egg size with capacity of 15 to 20 ml. Stomach is the bypassed by joining pouch and early portion of small intestine.
This process helps in feeling satisfied with small portion of food and also reducing absorption of calories. No portion of the stomach is removed in the surgery. Laparoscopic roux-en-y Gastric bypass surgery can help in losing between 70 to 80% of the excess weight in a period of 9 to 15 months.
The average extra weight loss after gastric bypass surgery is slightly higher as compare to purely restrictive procedure. Correction of co-morbidities like diabetes and dyslipidemia is also slightly better with gastric bypass surgery.
Because of slight malabsorption there is a minimal risk of vitamin B12, calcium and protein deficiencies. These can be easily managed with minimal medications.
Mini Gastric Bypass
Laparoscopic mini gastric bypass is a slight variation of gastric bypass surgery. A bigger and longer pouch of stomach is created in which small intestinal loop is joined. This procedure mainly works on principle of malabsorption and one loses upto 80% of their extra weight. Various nutritional supplements of proteins, calcium, iron and multivitamins are required for lifelong.
Patient can eat more amount of food as compare to other procedures and still loses desire amount of weight.
More nutritional deficiencies as compare to other procedures.Patient can have foul smelling diarrhoea upto 5-6 times a day.