Metro Doctor Speak: Bariatric (Weight Loss) Surgery
Interview
with: Dr. Jitendra Agrawal, Sr. Consultant – GI & Metabolic Surgery
& Dr. Dipankar Sankar Mitra, Consultant – GI & Metabolic Surgery
1. What are the
different types and techniques of Bariatric Surgery?
a) Gastric Bypass
Gastric Bypass surgery will help you to
lose your excess weight, this surgery will change the way your stomach and
small intestine handles the food that you eat.
The surgery includes 2 steps:
During the 1st step, the
surgeon will make your stomach smaller as he will use staples to divide your
stomach into two sections- upper section and a larger bottom section, because
of which you will eat less and eventually will lose the weight. The upper part
of your stomach which is known as pouch stores the food. The size of the pouch
is of a walnut. It can store up to 28 grams of food.
The second step of the surgery is known
as bypass. During this procedure your surgeon will connect a small part of your
small intestine which is known as jejunum to a small hole in the pouch. Now,
the food that you eat will travel from the pouch into this new opening and
later in your small intestine. As an end result, your body will consume fewer
calories.
After this surgery, the size of your
stomach will be smaller and you will feel full with less intake of food. After
the surgery, your body will not get all the calories from the food that you eat
because the food will no longer go into a large some part of your stomach.
b)
Sleeve
Gastrectomy:
Sleeve Gastrectomy is a surgical weight
loss procedure where the part of the stomach is dissected. During the
procedure, the size of the stomach is reduced down to 15% of its original size.
The reduced size of the stomach will result into a sleeve or tube like
structure. The procedure is performed laparoscopically and is irreversible in
nature. Sleeve Gastrectomy leads to permanent reduction in the size of the
stomach; however there could be some enlargement in the size of the stomach
later on in life.
Sleeve Gastrectomy is as effectual as
Gastric Bypass surgery, in the process of weight loss.
c)
Adjustable
Gastric Lap Band:
Adjustable Gastric Band is an
inflatable silicon device which is placed around the top portion of the stomach
to treat the obesity in a person. Adjustable gastric band is also known as
Lap-band, A Band or LAGB. This band will slow down the consumption of food
further reducing the amount of calories consumed.
The band is placed around the upper
part of the stomach which creates a smaller stomach pouch. The procedure will
slowly limit the intake of food which can be consumed at one time, further
giving the sense of fullness. A person who has opted for adjustable gastric
band can achieve sustained weight loss by opting healthy food habits.
Gastric banding is one of the least
invasive surgeries under the section of various weight loss surgeries and is
completely reversible, with just another “keyhole” operation. It doesn’t
require long stays at hospital, and results in faster recovery, smaller scars
and less pain than any open surgery.
d)
Endocrine
Balloon Procedure:
Endocrine Balloon is a soft biocompatible
silicon device which is filled with sterile saline solution and is placed in
stomach by a non-surgical procedure in the time frame of 20-30 minutes. With
the help of an endoscopic camera the surgeon will insert the deflated balloon
through the mouth and esophagus into the stomach. Depending on the characteristics
of the person the surgeon might use general or local anesthesia and fill the
gastric balloon with the help of fluid supply tube.
This procedure will reduce the hunger,
which will help the patient to decrease the amount of calories consumption and
eventually results in weight loss.
2.
How fast will I lose the weight after
the Weight Loss Surgery?
How fast
you will lose weight after the surgery will totally depend on the type of
surgery you have opted for and how efficiently you are following your
physician’s eating and exercising guidelines.
According
to doctors, if a patient opts for sleeve gastrectomy or gastric bypass surgery,
then they are likely to lose more weight in short time period as compared to
lap band surgery. Going over liquid diet or pureed diet will help you to lose
more weight in short span of time than going for solid diet.
3. How much weight will I lose after the
Weight Loss Surgery?
Your
weight loss will be directly proportional to your post surgery diet and
exercise regime. You are likely to lose about 5-10 kg of weight in the first
few months after the surgery. You will be losing nearly about 60% of your
excess weight in the first six months after the surgery and 77% of the excess
in the first year. Gradually the rate at which you are losing weight after the
surgery will slow down over the period of time.
4. Will I experience any health related
problems after the Weight Loss Surgery?
No, you
won’t face any health related problems after the Weight Loss Surgery. In fact
these kinds of surgeries improve all the weight related medical problems. 90%
of the patients who have opted for Gastric bypass surgery have improved their
type 2 diabetes, where gastric banding surgery have resolved the same problem
in 70% of the patients. The risk of heart disease has been lowered down in
almost half of the patients who had opted for Weight Loss Surgery. Nearly 85%
of the patients have seen improvement in their sleep disorders.
5. What are eligible criterias to opt for
Weight loss Surgery?
Weight
Loss Surgery is not advisable to everyone. Doctors generally advise it to those
people who have body mass index of 40 or more, which means about 100 pounds
overweight for men and 80 for women, people who have lower BMI but have other
serious health related problems to obesity such as heart disease, type 2
diabetes, high cholesterol, and those who have tried all the means to lose
their weight with dieting, exercising, etc.
6. How much time will it take me to return
to my work after bariatric surgery?
You won’t
be staying away long from your work after the surgery. In one or two week you
will be able to return to work. You might feel low on energy level after the
surgery for a while. Your surgeon will provide you with all the
information about what sort of work you can do after the surgery till the time
you don’t recover completely.
7. If a person has type 2 diabetes will
that make the surgery riskier for that person?
Yes, it
might be risky for that person. So it’s better to follow all the instructions
provided by your surgeon about managing the blood sugar level around the time
of the surgery. As seen by the doctors, people living with type 2 diabetes
experience big improvement after the surgery.
8.
Is it advisable to go for bariatric
surgery if someone has heart disease?
Yes, a
person can undergo bariatric surgery but the person needs to have the medical
clearance from their cardiologist. The post surgery results are very good as
they lead to the improvement of various other heart related problems such as
high blood pressure, cholesterol, lipid problems, heart enlargement (dilated
heart or abnormal thickening), vascular (artery and vein) and coronary (heart
artery)disease.
9.
I am planning for a baby, so what is
the right time to for a baby after the bariatric surgery? Will the baby be
healthy?
Doctors
recommend waiting for 12-18 months after the surgery. The risk of undergoing
problems during the phase of pregnancy (gestational diabetes, eclampsia,
macrosomia) and during childbirth is lower after the surgery. The chances of
miscarriages and stillbirths also lower down. After the bariatric surgery, the
chances of going through C section also reduce.
Yes, the
baby will be healthy and fine and will be at lower risk of being affected by
obesity later, due to activation of certain genes during fetus growth.
10.
Will the doctor put me on special diet
prior to my surgery?
Yes,
almost every bariatric surgeon puts their patients on a special diet for 2-3
weeks prior to their surgeries. These diets are very much different from the
short term diets. This diet helps liver to shrink down while the fat in the
abdomen gets reduced, which makes the procedure safe and easy.
11.
Do I have to be on diet after my
surgery?
Majority
of people thinks that dieting is a plan which leaves them hungry but actually
going on diet is all about picking up healthy food over tasty food. A person
will get their same appetite back within 6-18 months after the surgery. It’s
better to discuss all the diet and eating plans with your surgeon after the
surgery so that you can stay healthy always.
For free counseling session with our Weight-Loss Nutritionist and Bariatric Surgeon, kindly call: +919910492867 or e-mail: metro@metrohospitals.com
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