Bariatric Surgery
Obesity is due to abnormal or excess body fat. It is a chronic illness with complexmulti-factorial etiology. Metabolic, psychological and economic consequences associated with obesity derail the normal quality of life. Obesity is graded based upon Body Mass Index (BMI),Neck circumference, Waist Hip Ratio (WHR) and Waist Circumference (WC).Morbid Obesity has significant co-morbidities like Type II Diabetes Mellitus, Hypertension,
Hyperlipidemia, Coronary artery disease, Osteoarthritis, Gout, Non-Alcoholic Fatty Liver Disease (N A F L D), Obstructive sleep apnoea, depression, polycystic ovary disease and astroesophagealreflux disease
BARIATRIC SURGERY is indicated in morbidly obese with Body Mass Index (BMI) of over37.5; especially in patient’s where supervised diet or exercise and medicines have been unsuccessful. The patient should also understand the limitations of the procedure and be willing for a lifelong commitment to adhere to dietary instructions and physical activities.
Laparoscopic Bariatric Surgery is an option to reduce weight and resolve co-morbidities. Commonly performed laparoscopic bariatric surgeries are Lap Sleeve Gastrectomy (Restrictive) and Lap Roux en Y Gastric Bypass (Restrictive & Malabsorptive).
In Laparoscopic Sleeve Gastrectomy, the capacity of stomach is reduced to 200 ml from 1500ml. Patient achieves early satiety as the site of hunger hormone Ghrelin is knocked out and weight loss ensues.
A 44 year male with BMI of37.2 and weight of 122 kgwith type II DM on oral hypoglycemic agents (OHA) for 1 year, hypertensive on antihypertensive for 2 years and on treatment for gouty arthritis, could not achieve weight reduction even after dietary restrictions and lifestyle modifications.
He underwent Laparoscopic Sleeve Gastrectomy in MMM on 22nd October 2012. The team comprised of Dr.Dinesh Kumar, Anesthesiologist, Dr. P.Sriram and Dr. Ranjith from the Department of Gastro-Intestinal Surgery. The patient was fed on oral feeds from the first day, with good post-operative follow-up, supported by nursing care. The patient was discharged after the fourth day of surgery.