MOST EXPERIENCED BARIATRIC CENTER

bariatric surgery cost, bariatric surgery cost near me

Bariatric surgery cost includes a variety of procedures performed on people who are obese. Long term weight loss through standard of care procedures is largely achieved by altering gut hormone levels that are responsible for hunger and satiety, leading to a new hormonal weight set point.
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India’s one of the leading and dedicated bariatric surgery center.
 
Bariatric surgery cost ioffers Multispeciality treatment and facilities on par with the best available globally. committed to providing world-class treatment for patients from across the globe From a 24-hour ambulance service, pharmacy and diagnostic centre, to specialised services and more.

 
 50% Low Cost + Pay Monthly + Insurance + Cashless 
TREATMENT OPTIONS AVAILABLE
 


TOP 13 EXACT INFORMATION ABOUT BARIATRIC

There are Top 6 types of operations that are offered:

  1. Sleeve Gastrectomy
  2. Mini Gastric Bypass
  3. Roux En Y Gastric Bypass
  4. Intra Gastric Balloon
  5. Banded Sleeve / Bypass
  6. Endoscopic Sleeve Gastroplasty
  7. Adjustable gastric banding (AGB)
  8. Roux-en-Y gastric bypass (RYGB)
  9. Biliopancreatic diversion with a duodenal switch (BPD-DS)
  10. Vertical sleeve gastrectomy (VSG)
Dr. Bharat Kumar Nara

  • MBBS, MS – General Surgery, MCh – Surgical Gastroenterology/G.I. Surgery
  • GastroIntestinal Surgeon, Gastroenterologist, Intestine Surgeon
  • 19 Years Experience Overall  (7 years as specialist)
Get Free Consult help from
Dr. Bharat Kumar Nara: 72888 03777
Call – Whatsapp
 
  • Dr. Bharat Kumar Nara is a GastroIntestinal Surgeon,Gastroenterologist and Hepato-Biliary-Pancreatic in KPHB, and has an experience of 19 years in these fields. Dr. Bharat Kumar Nara practices at Ensure Gastro and Liver Surgery Care in KPHB, Padmaja Hospital  and Insight Diagnostics, . He completed MBBS from Kurnool Medical College, Kurnool in 2002,MS – General Surgery from Kasturba Medical College in 2008 and MCh – Surgical Gastroenterology/G.I. Surgery from Narayana Medical College, Nellore in 2014.
  • He is a member of Medical Council of India (MCI). Some of the services provided by the doctor are: Minimally Invasive Surgery,Hernia Repair Surgery, Splenectomy, Gall Bladder Surgery and Anal Fissure Surgery etc. Bariatric surgery cost
           AFTER BARIATRIC              
 
bariatric, before and after images


1. Sleeve Gastrectomy

Sleeve Gastrectomy surggery cost
  • Most Common sleeve gastrectomy performed bariatric surgery hospital worldwide.
  • Surgeon removes about 75-80 percent of stomach along , creating a long, banana-shaped stomach
Benefits of pod gastrectomy
 
  • Diabetes, high blood pressure (BP), obstructive sleep apnea (OSA), joint pain, lipid abnormalities (cholesterol), heart problems, polycystic ovarian disease (PCOS) and infertility are improved or cured in more than 75% of on a back belly
  • Weight loss is faster with the sleeve than with the gastric band.
  • No bypassing or redirecting changes in the gut and food flow.
  • No effect on the absorption of calories and nutrients in the intestine, i.e. less vitamin, calcium and protein deficiencies.
  • No foreign object such as duct tape placed in the body.
  • Shorter hospital stay and faster recovery
  • Studies show weight loss surgery reduces risk of death from obesity and improves life expectancy


2. Mini Gastric Bypass

Mini Gastric Bypass treatment cost
  • Mini Gastric Bypass or MGB is simplified type of bariatric surgery cost similar to Roux en Y Gastric bypass for weight loss.
  • Very popular in Asian Sub Contient & India
Benefits of mini gastric bypass (MGB – OAGB)
  • Fast and Sustainable Long Term Weight Loss – Excessive Body Weight Loss (EBW) – 80%
  • Safe, effective, reversible and verifiable weight loss / bariatric before and after procedure.
  • very effective in severe diabetes, super obesity (BMI> 50), metabolic syndrome and sweets
  • It is only an anastomosis (joint or connection).
  • Short hospital stay, easy and successful.
 

3. Roux En Y Gastric Bypass

Type of bariatric Treatment for weight loss that involves

1.Creation of small stomach pouch Bariatric surgery cost
2.Connecting the new stomach pouch directly to bypass length of small intestine.

After gastric bypass, swallowed food will go into this small pouch of stomach and then directly into the small intestine, thereby bypassing most of your stomach and the first section of your small intestine.

Benefits of the Roux En Y gastric bypass

 

  • Very good short term weight loss (75 to 83% excess weight loss) Long term persistent results. Data shows that most patients maintain more than 50% of their weight loss for up to 20 years after surgery.
  • The average weight loss is greater than with other procedures such as adjustable band laparoscopy and pod gastrectomy.


    4. Intra Gastric Balloon

    Intra Gastric Balloon surgery cost
  • RYGB does not require any device or foreign object like a tape to stay inside you.
  • Excellent remission of obesity related health problems such as


       1. Resolution of type 2 diabetes in over 80 percent of patients.

       2. Resolution of high blood pressure in more than 70 percent of patients.

        3. Improvement of high cholesterol in more than 90 percent of patients.

  • The Intra gastric Balloon System is a new non surgical weight-loss procedure that involves placing a saline-filled silicone balloon in the stomach. This helps to lose weight by limiting food intake and making feel stomach full & faster.
  • It help obese patients lose weight without the need for surgery.

  5. Banded Sleeve / Bypass

Banded Sleeve / Bypass surgery cost treatment hospital
  • A silastic ring / Minimizer or Fobi ring is encircled around the upper region of  newly created sleeve. Adding band to sleeve gastrectomy increases the rate of weight loss. It is called as Bariatric surgery cost Banded Sleeve Gastrectomy. 
  • This allows long term stablization of weight and prevents weight regain.

6. Banded Gastric Bypass

Banded Gastric Bypass surgery cost

Gastric bypass band surgery is a variation of RYGB gastric bypass, where the band increases the restrictive component. The idea of adding a band to gastric bypass surgery prevents the pouch from expanding and helps maintain long-term weight loss.


Endoscopic Sleeve Gastroplasty

Endoscopic Sleeve Gastroplasty surgery cost
 
  • A silastic ring / Minimizer or Fobi ring is encircled around the upper region of  newly created sleeve. Adding band to sleeve gastrectomy increases the rate of weight loss. It is called as Bariatric surgery cost Banded Sleeve Gastrectomy. 
  • This allows long term stablization of weight and prevents weight regain.
Endoscopic gastroplasty is a new type of minimally invasive weight loss technique. In endoscopic sleeve gastroplasty, a topstitch suture device is inserted into the stomach.

Sutures are placed endoscopically into the stomach to make it smaller.

This may be an option for people who have a BMI 28-32 body mass index and diet and exercise are not working for you.

Endoscopic sleeve gastroplasty results in significant weight loss, but is less than with conventional bariatric surgery hospital. It helps you lose weight by limiting the amount you can eat.

Requires a significant commitment to a healthier lifestyle.

You need to make permanent healthy changes to your diet and exercise regularly to ensure the long term success of Endoscopic Pod Gastroplasty.

To enjoy
A little intrusive
Reduced risk of surgical complications
Quick return to daily activities

 
 
    bariatric treatment cost


    Is Bariatric Surger


    Safety of Bariatric surgery cost has increased tremendously  due to standardization , Protocols & Better Technology
    Risk of Living with Morbid Obesity is more dangerous than having top bariatric surgery or weight loss operation

     
    • Very low risk of major complications – less than 1 %.
    • It is as safe as routine surgeries like Knee replacement or Gallbladder surgery or Laparoscopic Appendix surgery.
    • Regular follow up, Motivated patients , Proper counselling are important factors for successful weight loss journey.
     
      Nitin Jindal
    ★★★★★ 7 days ago
    I would highly recommend everyone to choose this clinic who are in need. The clinic is so nice and u feel it like a home.
    Reply Like
      Rajesh Rao
    ★★★★★ 5 days ago
    best Bariatic surgeon, well-experienced Doctor Barath.
    Reply Like
    bariatric treatment hospital

    Modern Technology
    Latest 3D Imaging & Technology

     

    International Standards
    Ethical & Scientific approach

     

    Best Quality
    Protocol Based Treatment



    24 x 7 Availability
    Full time Super Specialist Doctors

     
      Sai chand Sukhavasi
    ★★★★★ 2 days ago
    I don’t know about all but I can say that this is best to treat a patient like a relation. Means trusted treatment on veins.
    Reply Like
      MD.Javeed
    ★★★★★ 2 days ago
    Done Bariatric treatment surgery with good results. thank you.
    Reply Like
      srikanth thodeti
    ★★★★★ a day ago
    treatment in done 2days back.I’m completely satisfied..
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    Reply Like
      Madhu Sudhan
    ★★★★★ a day ago
    They have advanced operations theaters with robotic and minimal access surgery features for advanced surgical interventions here.
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    Reply Like
     

    What is Bariatric Surgery?

    Gastric bypass and other weight-loss surgeries — known collectively as bariatric surgery — involve making changes to your gastrointestinal system to assist you reduce .Best Bariatric surgery is completed when diet and exercise haven’t worked or once you have serious health problems due to your weight.
     

    Bariatric surgery cost Treatment


    Most weight loss surgeries today are performed using minimally invasive techniques (laparoscopic surgery). the foremost common bariatric surgery procedures are gastric bypass, sleeve gastrectomy, adjustable gastric band, and biliopancreatic diversion with duodenal switch.
     

    Bariatric Symptoms

     
    • Post-gastric bypass surgery symptoms
    • Nausea and vomiting.
    • Difficulty eating.
    • Pain that hasn’t been resolved yet.
    • Nutritional deficiencies (vitamin deficiencies)
     

    Bariatric Surgery Causes


    Obesity may be a serious health condition classified by excess body fat which will greatly affect your health. it’s linked to an extended list of chronic conditions like type 2 diabetes, a heart condition, high vital sign , apnea , osteoporosis, and stroke.


    While bariatric surgery treatment can offer many benefits, all forms of weight loss surgery are important procedures that can have serious risks and side effects. You also need to make healthy changes to your diet and exercise regularly to ensure the long-term success of bariatric surgery.

     

    Why is it done?

    Bariatric surgery will help you lose weight and reduce your risk of potentially life-threatening weight-related health problems, including: Bariatric surgery cost
    • Heart disease and stroke
    • High blood pressure
    • Non-alcoholic fatty liver disease (NAFLD) or non-alcoholic steatohepatitis (NASH)
    • Sleep apnea
    • Type 2 diabetes
    • top Bariatric surgery is usually done after you’ve tried to lose weight by improving your diet and exercise habits.
     

    Who it is for


    In general, bariatric surgery can be an option for you if:

    Your body mass index (BMI) is 40 or higher (extreme obesity).
    Your BMI is between 35 and 39.9 (obesity) and you have a serious weight-related health problem such as type 2 diabetes, high blood pressure, or severe sleep apnea. In some cases, you may qualify for certain types of weight loss surgery if your BMI is between 30 and 34 and you have serious weight-related health problems.


     

    Risks


    As with any major procedure, bariatric surgery carries potential health risks in both the short and long term.

    Risks associated with surgery can include:

     
    • Heavy bleeding
    • infection
    • Side effects of anesthesia
    • Blood clots
    • Lung or breathing problems
    • Leaks in your gastrointestinal system
    • Death (rare)
    • Long-term risks and complications of weight loss surgery vary depending on the type of surgery. They can include:

    Intestinal obstruction
     
    • Dumping syndrome, which causes diarrhea, flushing, drowsiness, nausea, or vomiting
    • Gallstones
    • Hernias
    • Low blood sugar (hypoglycaemia)
    • Malnutrition
    • Ulcers
    • Vomit
    • Acid reflux
    • The need for a second or revision, surgery or procedure
    • Death (rare)
     

    How do you prepare


    If you qualify for bariatric surgery, your health care team will provide you with instructions on how to prepare for your specific surgery. You may need to have various laboratory tests and exams done before surgery. You may have restrictions on eating and drinking and the medicines you can take. You may need to start an exercise program and quit tobacco use.

    You may also need to prepare by planning your recovery after surgery in advance. For example, find help at home if you think you will need it.

     

    Benefits / Advantages

     
    • Diabetes, Hypertension (BP) , obstructive sleep apnea (OSA), joint pain, lipid (cholesterol) abnormalities, cardiac problems , Polycystic Ovarian Disease (PCOD), Infertility are improved or cured in more than 75%  of people undergoing gastric sleeve
    • Weight loss is faster with sleeve than with gastric band.
    • No bypass or re-routing changes to intestines & food stream.
    • No effect on the absorption of calories and nutrients in the intestines, so less vitamin, calcium , protein deficiency.
    • No foreign object like band placed in body.
    • Shorter hospital stay & Fast recovery
    • Studies prove painless Bariatric surgery reduces risk of death from obesity and Improves life Expectancy
     

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    How the gastrectomy was performed

    1. How is a sleeve gastrectomy performed?

    This involves making five or six small incisions, from 0.5 cm to 1 cm, on the abdomen and performing the operation with a video camera (laparoscope) and long instruments placed through these small incisions.

    Laparoscopic procedures have many advantages, including

    Minimal bread
    Shorter hospital stay
    Faster, faster and safer recovery
    Reduced risk of wound infections or hernias.

     

    2. How long is the operation?

    The average duration is 60 to 120 minutes.
     

    3. How does the gastric cuff cause weight loss?

    Reduces the size of your stomach
    Limits the amount of food that can be eaten at one time.
    After eating a small amount, you will feel full very quickly, you will feel full for several hours.
    Loss of appetite, increased feeling of fullness. The patient begins to develop a preference for healthy eating in the brain (mind).
    Also reduces the amount of the “hunger hormone” ghrelin, which is produced in the bottom of the stomach and which contributes to weight loss.

     

    4. How is the weight loss going

    Depending on their preoperative weight, most patients can expect to lose between 60% and 70% of their body weight (EBW) in the first year after surgery.
    May lose more weight over the next 6 to 12 months. After that, the weight usually stabilizes.

     

    5. What are the chances of weight gain after a sleeve gastrectomy?

    Long-term, sustained weight loss and improvement in obesity-related health conditions only happen with a healthy diet and regular physical activity.
    Weight gain can occur, but it is usually minor as long as you make lifestyle changes.
    The laparoscopic sleeve gastrectomy (weight loss surgery) procedure is best viewed as a tool that will make these lifestyle changes lasting.

     

    6. How safe is weight loss surgery? Is it worth taking a risk?

    Weight loss surgery is just as safe as the commonly performed gallbladder removal or knee replacement surgery.

    For many overweight patients, weight loss surgery increases not only life expectancy, but also quality of life.

    For people who are morbidly obese, especially those with co-morbidities, it may be more dangerous not to have weight loss surgery than to have long-term surgery.

    In conclusion, bariatric surgery cost can be considered a safe procedure in people with diabetes, with short-term morbidity similar to common procedures such as cholecystectomy and appendectomy and a mortality rate similar to that of joint replacement. knee.

     

    Performed in mini gastric bypass

     

    7. How does it work?

    The mini gastric bypass is performed laparoscopically.

    Very small buttonhole cut from 0.5 to 1.2 cm on the belly.

    Divide about a twenty-five percent section of the stomach from the rest of the stomach.
    This gastric pouch is then connected to the small intestine above the new anastomosis. The anastomosis simply means a new surgical connection.
    This results in a “bypass” of most of the stomach and about a third of the small intestine – meaning it is not involved in the digestion or absorption of the food you eat. .

     

    * How long does the operation take?

    The average duration is 60 to 120 minutes.

     

    * How the mini gastric bypass works

    It makes the stomach smaller and redirects the intestines.

    Due to the small size of the stomach, you will feel full sooner while eating.

    The intestines that absorb nutrients are rerouted / shortened, forcing the body to absorb fewer calories and minerals.

     

    * how the mini gastric bypass helps you lose weight

    Limitation: The new small gastric pouch limits food intake

    Malabsorption: Bypassing any part of the MGB will result in the absorption of fewer calories, leading to rapid and lasting weight loss. Bariatric surgery cost

    Hormonal: Ghrelin, called the “hunger hormone”, is responsible for hunger and appetite. The level of ghrelin is lowered after the bypass and leads to less hunger and appetite.

    * Advantage or difference between gastric bypass and sleeve


    High resolution of diabetes, high blood pressure – high blood pressure, high cholesterol / lipid profile, obstructive sleep apnea (OSA) / snoring.

    No risk of side effects or complications related to the tape or device.

    Bariatric surgery cost / long term sustainable weight loss as it expands less due to the low pressure in the bag due to the greater output compared to old conventional bariatric / weight loss surgical techniques

    Relatively larger pouch and outlet that gives foodies / gourmets / dessert lovers the luxury of consuming a moderate amount of diet while losing significant weight.

     

    How is the gastric balloon inserted?


    How does an intragastric balloon cause weight loss?
    Decrease the amount of food you can eat.

    Increases the feeling of full stomach and decreases cravings and appetite.

    Correctly adjusted to fit the stomach

     

    How does an intragastric balloon work?

    It is implanted in the stomach on an outpatient basis by endoscopy using the camera while the patient is lightly sedated for 30 minutes.

    After insertion, the balloon device is filled with sterile saline water. The balloon partially fills the stomach to create a feeling of fullness.

    What is life like after the procedure and when will the balloon be removed?
    The balloon is removed after six months to a year.

    Patients stay on a structured diet plan to maintain weight loss.

    Average weight loss of 10.2% of body weight.

    Successful intragastric balloon placement also depends on participation in nutrition and exercise programs which are an important part of our comprehensive balloon therapy program.

    Includes the teamwork of the interventional endoscopist and surgeon performing the procedure, as well as the nutritionist, nutritionist, and exercise director.

     

    Am I the right candidate for an intragastric balloon?

    If you are overweight and want the chance to reset your life through lifestyle changes, you can visit Kiran Hospital in Surat for more information.

    These devices are FDA approved for use in obese adult patients with a Body Mass Index between 30 and 40.

     

    Is it insured or cashless?

    Currently, most companies do not offer insurance or medical coverage for intragastric balloon therapy.
     

    What to expect

    Bariatric surgery is performed in the hospital under general anesthesia. This means that you will be passed out during the procedure.

    The details of your surgery will depend on your individual situation, the type of weight loss surgery, and the practices of the hospital or doctor. Some weight loss surgeries are done with traditional wide or open cuts in your abdomen.

     

    Types of weight loss surgery

    Each type of weight loss surgery has advantages and disadvantages. Be sure to talk to your doctor. Here is an overview of the common types of weight loss surgery:

    Roux-en-Y gastric bypass (roo-en-wy). This procedure is the most common gastric bypass method. This surgery is generally not reversible. It decreases the amount of food you can eat in one sitting and decreases your absorption of nutrients.

    The surgeon cuts off the top of your stomach and seals it from the rest of your stomach. The resulting pouch is about the size of a walnut and can only hold about an ounce of food. Typically, your stomach can hold about 3 liters of food.

    Then the surgeon cuts the small intestine and sews part of it directly onto the pouch. The food then enters this small gastric pouch and then directly into the small intestine sewn on it. Food bypasses most of your stomach and the first section of your small intestine and goes straight to the middle part of your small intestine.

    Gastrectomy Pod. A sleeve gastrectomy removes about 80% of the stomach, leaving a long tubular pocket. That little stomach can’t hold that much food. It also produces less ghrelin, a hormone that regulates appetite, which can decrease your cravings for food.

    The benefits of this procedure include significant weight loss and no bowel bypass. Sleeve gastrectomy also requires a shorter hospital stay than most other procedures.

    Biliopancreatic distraction with duodenal switch. This is a two-part surgery where the first step is a procedure similar to a sleeve gastrectomy. The second operation is to connect the end section of the intestine to the duodenum near the stomach (duodenal switch and biliopancreatic bypass), bypassing most of the intestine.

    This surgery limits both the amount you can eat and the absorption of nutrients. Although extremely effective, it carries a higher risk, including malnutrition and vitamin deficiencies.

     

    Results

    Gastric bypass surgery and other bariatric surgeries can lead to long-term weight loss. The amount of weight you lose depends on your type of surgery and lifestyle changes. It may be possible to lose half or even more of your excess weight in two years.

    In addition to weight loss, gastric bypass surgery can improve or correct conditions often related to obesity, including:

     
    • Heart disease
    • Arterial hypertension
    • Obstructive sleep apnea
    • Type 2 diabetes
    • Non-alcoholic fatty liver disease (NAFLD) or non-alcoholic steatohepatitis (NASH)
    • Gastroesophageal reflux disease (GERD)
    • Osteoarthritis (joint pain) Bariatric surgery cost

    Bariatric surgery in Hyderabad

    Bariatric Surgery

    Listed below is the step by step procedure of bariatric surgery:

    1. What is Bariatric Surgery?
    2. Why is Bariatric Surgery Required?
    3. Pre-operative Preparation
    4. Day Before Surgery
    5. Procedure Day
    6. Methods/Techniques of Bariatric Surgery
    7. Post Procedure
    8. Risks and Complications
    9. What is Bariatric Surgery?

    All the surgical procedures, which aid in weight loss by altering the digestive system suitably , are included in bariatric surgery. The stomach and lower intestines are restructured in such a way that the quantity of food which a person can consume is lessened. This also leads to reduced absorption of nutrients. Both these help in stimulating weight loss. Bariatric surgeries, eventually change the person’s appetite.

    what is bariatric surgery?

    They may also alter the digestive functions in such a way that the person does not feel hungry between two meals. All these weight loss surgeries are collectively termed as bariatric surgery.

    Why is Bariatric Surgery Required?

    Bariatric surgery is indicated in obese people. The term ‘obese’ does not apply to everyone who is overweight. Obesity is a medical term and by definition is applicable to people whose BMI (Body Mass Index) is more than normal. BMI is the ratio of body weight and height. Obesity is graded depending upon the patient’s BMI. It is treatable with exercise and methods. At times however, surgery is indicated as the only choice of treatment. A few indications of bariatric surgery are mentioned below:

    High B.M.I

    As explained above, obesity is diagnosed based on the BMI. A BMI ranging between 19-25 is considered healthy. People having BMI above 25 fall in the overweight category. Obesity can be diagnosed in people who have BMI above 35. Obese people having BMI of 40 and above are likely candidates for bariatric surgery.

    Health Conditions Due to Obesity
    Obese people are likely to be victims of diseases like diabetes, cardiac problems, hypertension. If weight loss does not occur in such patients, the other health conditions might progressively worse. Bariatric surgery might be advised to these patients.

    Low B.M.I with Associated Health Conditions
    Patients who do not have B.M.I. As high as 40, but who suffer from health conditions because of obesity are likely to be advised bariatric surgery. Sleep disorders, diabetes, high cholesterol are some of these conditions.

    Failure of other weight loss Methods

    Obese patients can try exercise, medicines, herbal products, massage to try and lose weight. Sometimes these methods help the patient to achieve the desired weight loss. But in cases where no amount of effort helps weight loss, bariatric surgery remains the only treatment option.

    Before qualifying for bariatric surgery the patient undergoes extensive medical examination and investigations. If all these are within the required limits and any one of the above indications is noticed in the patient, only then they are chosen to undergo bariatric surgery.

    Pre-operative Preparations

    Bariatric surgery is different from other surgeries. It needs more extensive preparation which may begin as early as a month or two before the actual date of operation. The patient and doctor have to work together to achieve all pre-operative goals. The success of surgery depends to quite an extent on this. Some important pre-operative steps steps have been mentioned below:

    Medicines

    Obese patients are often victims of conditions like diabetes, hypertension, metabolic syndrome, heart diseases. They may be on medicines for the same. The surgeon who is operating upon the patient will review the medicines properly. Their dose may be altered as the surgeon sees fit. Some medications might be stopped as well.

    Lifestyle Changes
    Patients should not rely on the surgery and give up on their attempts to lose weight. They should increase their efforts and lose as much weight as they can. Enrollment in a gymnasium for an weight loss program under supervision of fitness trainers is advised to patients. Other forms of exercise like walk, yoga, aerobics might be helpful in some cases. Patients who are regular consumers of alcohol and tobacco will benefit a lot if they abstain from these habits.

    Food Habits
    Quite a few restrictions are imposed on the patient since a month before surgery. Junk food, sugar rich food, food high on calorie content is strictly prohibited. Salads, fruits, natural food items free from preservatives are encouraged to be consumed.

    Investigations

    Candidates of bariatric surgery are required to undergo a battery of blood tests and other investigative tests before the surgery. Blood tests to determine sugar levels, cholesterol levels, thyroid, kidney and liver function are performed. If they are not within normal limits, they have to be normalized prior to surgery.

    White blood cell count is done just before surgery to ensure there is no underlying infection. Surgery cannot be performed in case of active infection.

    Most of the bariatric surgeries involve reshaping and realigning the digestive tract, hence prior to the surgery a sonography is performed to assess the intestinal tract. Gallstones might be diagnosed as they develop commonly in overweight and obese people.

    ECG is done to determine cardiac functions. X-Ray of the chest helps to visualize the shape and size of heart and lungs. Lung function tests might be additionally performed. A treadmill test (stress test) may be done sometimes in patients who are able to perform physical activities like running.

    Physical Examination and Patient Evaluation

    Prior to the surgery, a complete physical examination is done. Pulse, blood pressure, body temperature and breathing rate (vitals) are measured. The patient’s height is measured. Weight has to be measured recurrently to map the changes in B.M.I. As the weight changes, the B.M.I changes correspondingly.

    Examination of the cardiovascular system is done to detect signs of abnormal cardiac functions. A dietician will evaluate the patient’s nutritional status and past attempts to follow diet. Certain health conditions are a deterring factor for proceeding with bariatric surgery. These include kidney stone, gall stone, bleeding disorders. If they are detected, they have to be treated prior to the surgery.

    A psychological evaluation may be advised in cases where some underlying mental disorder is suspected. Conditions like depression , anxiety, eating disorders could contribute to development of obesity. In such cases, psychological counseling will be needed along with other treatment methods.

    Method of Surgery
    Bariatric surgery is not one single surgery, but several operative methods which help in stimulating weight loss. Each case of obesity is different and may require any of these methods. Depending on the examination findings, results of the investigations, general health and age of the patient, the method of surgery is chosen.

    Day before Surgery
    It is generally advisable to get admitted to the hospital a day prior to surgery. A thorough physical examination is done again after the patient is admitted. Vitals are monitored at set time interval. The patient’s weight is checked once before surgery.

    Bariatric surgery involves restructuring the position and shape of stomach or small intestine. Therefore it is necessary for the patient to keep an empty stomach since one night before the surgery. It is difficult to operate upon a full stomach or intestine. Surgery is performed under general anesthesia. This also requires the patient to have an empty digestive tract. Antacids and laxatives might be prescribed for the same. Patient is advised to relax physically and to avoid mental stress.

    Procedure Day

    On the day of surgery, well before the decided time of the procedure, the patient is taken to the operation theater. All the surgical equipment and clothing which will be used are treated before hand to get rid of all microorganisms. A clean surgical gown is worn by the patient during surgery. A pre-opertive dose of heparin (anti-blood clotting agent) may be administered.

    After monitoring the blood pressure once again, anesthesia is administered to the patient. It can be done in the form of an injection given into a vein in the arm or in the form of respiratory fumes. The skin over abdomen is shaved off any hair and cleaned with an antiseptic solution. Only when the anesthetist confirms that the patient is completely under effect of anesthetic agent, surgery can be started.

    Methods/Techniques of Bariatric Surgery
    Bariatric surgery methods involve operating up on the digestive tract. Some of the most commonly employed techniques have been mentioned below:

    Gastric Banding
    As the name suggests, a band is tied around the stomach. The procedure can be done laparoscopically. Multiple small incisions are given over the abdominal skin over the stomach. Surgical equipment is introduced into the abdomen through these incisions. Underlying abdominal muscles, fascia and fat are dissected. Care is taken to avoid injury to adjoining healthy organs. An adjustable band is tired around the stomach between the upper and lower part. This will narrow stomach.

    The long term effect of this surgery is that the quantity of food consumed at a time reduces, thus stimulating weight loss. The abdominal muscle which were dissected are replaced to their former position. Surgical incisions are closed with a medically designed thread.

    gastric banding
    The band tied around stomach is made of silicone. A tube connects the silicone band to a device placed under the skin. Through this tube, saline can be injected into or removed from the band to adjust its tightness.

    A variant of this surgery is vertical banding gastroplasty. After a band is placed around the stomach, the surgeon will make a small pouch of the stomach and staple it. This further reduces food intake. But the surgery does not promote as much weight loss as other surgeries and also has more complications. Hence it is utilized less commonly.

    Sleeve Gastrectomy

    Gastrectomy means removal of stomach. Sleeve gastrectomy involves removal of a part of the stomach from one side. The surgery is done by laparoscopic method. Through multiple small incisions on the abdominal skin, surgical instruments are inserted inside the abdominal cavity. A video camera (laparoscope) is introduced to record and visualize the internal organs. This gives more precision while performing the surgery.

    Sleeve Gastrectomy

    The left side of stomach is surgically cut and removed in this process. This leaves behind a vertical tube like structure. It is is sealed together with staples. Because the size of stomach reduces drastically after this surgery, intake of food is restricted which promotes weight loss.

    Gastric Bypass
    The term bypass means avoiding one path and finding an alternate route to proceed. In gastric bypass surgery, the food is allowed to remain in the stomach for a very little time and directly pass into the intestine. The procedure can be done laparoscopically or with open method. Through incision, surgical tools are passed inside the abdominal cavity.

    If laparoscopic method is being used, multiple small surgical incisions are made on the abdominal skin. If open surgery is being done, a single larger incision will be made. Laparoscopy involves using a video camera atatched to a long flexible tube being introduced inside the abdominal cavity. This helps to get an idea about the structure of the internal organs.

    Gastric Bypass
    The further procedure is same for both methods. The stomach is divided and the upper part is tied up like a pouch. The remaining lower part of the stomach, which is the larger portion is then either surgically removed, or bypassed. The initial part of the lower intestine is directly connected to the upper small pouch of the stomach. Due to the reduced volume of stomach cavity, very little food can be consumed at a time. The food passes almost immediately to the intestines, thus reducing the digesting time. This leads to lesser absorption of calories and unwanted fats. Thus weight loss can be achieved faster.

    Duodenal Switch

    The surgery can be done with open or laparoscopic method. In open method, a single large surgical cut is made over the abdominal skin. For laparoscopic method, multiple smaller incisions are made. Through one of the multiple incisions, a laparoscope is inserted. This is a camera which records and allows the operating surgeon to see the internal organs. This facilitates the surgeon to have a clear field of vision during surgery. Rest of the steps are same for both the approaches.

    A large part of the stomach is removed. The lower opening of the stomach known as pylorus, is directly connected to the lower portion of small intestines. This way, food does not pass through the intermediate portion of small intestine. Digestion time of the food is reduced and there is reduced absorption of calories and fats. This will accelerate weight loss and help in reducing excess body fat.

    Duodenal Switch
    The portion of the intestines which is bypassed continues to receive bile and liver enzymes needed for digestion. They are passed on the the lower part of the intestine. A segment of small intestine serves as a common pathway for both these paths, i.e., the one which receives bile and the one where pylorus is connected to the small intestine. In this common pathway food and bile mix and further digestion takes place. It is a complicated procedure.

    Any one of these surgeries or a combination of them may be performed in an obese patient. A lot of post-operative care and restrictions are associated with bariatric surgery. The long term success of bariatric surgery depends a lot on how well these restrictions are followed.

    Post Procedure
    Immediately after the surgery patient is taken to the recovery room. Consciousness is regained soon after the effects of anesthetic agent reduce. The patient is examined thoroughly. Vitals are continued to be monitored. Hospital stay for about 2-3 days is necessary during which the patient is kept under observation. They may be discharged sooner or after this duration depending upon their recovery. Complete recovery form surgery takes about 3-4 weeks. After bariatric surgery, efforts have to be put in by the patient as well as doctor to achieve the desired weight loss and to maintain it. Some useful information for post-operative care are mentioned below:

    Weight Loss

    A general misconception is that the patient will have lost a lot of weight immediately after surgery. This is not true. Bariatric surgery does not remove any excess fat or weight from the person’s body, it merely paves the way to stimulate weight loss. A regular exercise regimen is advised to the patient which has to be followed strictly. If adequate weight loss is not done properly, the surgery will not produce much benefit. Weight loss can be achieved by exercise like brisk walk, yoga. Once the person loses some weight and gets more mobility, they can proceed to aerobics, jogging, going to the gym. Massage therapy also helps in weight loss. Once the desired weight is achieved, exercise has to be continued to maintain it.

    Diet

    Immediately after surgery, patient is not allowed to consumed food for 1-2 days. The nutritional requirements are maintained via intravenous route. For the next 3-4 months, a special diet is advised by the nutritionist. It includes soft, light food which is easy to digest. Food intake reduces drastically after bariatric surgery. This is because the area of stomach available for accumulating food is very less. Patients observe a change in their appetite. They cannot eat large quantities of food at a time. It is advisable to eat small meals at regular intervals for such patients. The surgery can lead to malnutrition as absorption of essential nutrients is affected. Hence, it is advised to have balanced meals to fulfill as much of the nutritional requirements as possible. Consumption of adequate water is advised to patients to maintain hydration levels.

    Lifestyle Changes

    After surgery, the patient may have to follow certain restrictions for life long to achieve and maintain the desired weight loss. One of these is to ration the quantity of food consumed at each meal. Regular physical activity is also essential to avoid gaining weight again. Both these have been explained above in detail. Smoking and alcohol consumption are to be avoided as much as possible for life long. They may cause undesirable weight changes.

    Follow-up

    Regular follow ups with the bariatric surgeon are advised to the patient. These may be done once or twice in a month. During follow up the patient’s weight and B.M.I are checked. This will give the doctor and patient both, an idea about the progress being made. During follow up, the patient’s medicines can also be reviewed and necessary changes can be made. If the patient has had any health conditions associated with obesity prior to surgery, medicines for the same are continued after surgery. Once weight loss begins, these conditions may resolve and dose of medicine can be altered accordingly. Diabetes, high cholesterol levels, high blood pressure, may be some of these conditions.

    Psychological Counseling

    As mentioned earlier in this article, psychological stress, depression, anxiety are some of the causes of obesity. In such patients, psychological counseling plays as important a role as bariatric surgery. Discussion and therapy sessions with a psychologist at regular intervals will benefit the patient greatly. In some cases, where the cause is too deep rooted, psychiatric medication may be needed.

    Restrictions related to diet and exercise have to be followed for life long after surgery. The patient will be evaluated periodically. The frequency of evaluations reduces as times passes. There are some drawbacks associated with weight loss surgery. These could occur during the surgery, during recovery period or later.

    Risks and Complications

    Bleeding and Blood Clot Formation
    Bleeding is more likely to occur during open surgery than laparoscopy. Blood obstructs the field of vision during surgery and needs to be drained. If blood clots are formed, they have to removed mechanically. Smaller clots may however enter some vein and could cause health complications if they block the vein. Blood thinning medicines will be administered in such cases.

    Infection

    Infection can occur at the site of surgical incision or in some cases internally, upon the parts which were operated. It may be presented in the form of swelling, redness and pain a the site of incision. If internal infection is present, fever and abdominal pain may be present. Antibiotics help to control the infection.

    Digestive Troubles

    After bariatric surgery there is a lot of change in the normal digestion. Food does not pass through the normal route through intestines. The time of digestive process is also altered. This could lead to affected absorption of essential nutrients. Problems like malnutrition, constipation, nausea vomiting could arise. Altering the diet, quantity of food consumed at a time and time interval between two consecutive meals may help to curb these complaints. Gallstones are known to occur in people who lose a lot of weight in a relatively short time span. If they are diagnosed in a patient after bariatric surgery, appropriate treatment in the form of medicines or corrective surgery is provided separately for them.

    Bariatric surgery can give a very good outcome if all the instructions are followed carefully. Life long care is needed for patients after this surgery. Before undergoing the procedure it is advisable for patients to get complete information about the pre-surgical requirements, surgical methods and post-operative care. The outcome may not be exactly the same for each patient undergoing bariatric surgery, but the end result is that the patient ends up loosing quite a lot of their unhealthy weight.

    More Information related to Bariatric Surgery
    Gastric Bypass Procedure
    Sleeve Gastrectomy Procedure
    Cost of Bariatric surgery in India and top cities
    List of best Gastro surgeons in India and top cities
    List of best Laparoscopic surgeons in India and top cities
    List of best Bariatric surgeons in India and top cities
    List of best Gastroenterology Hospitals in India and top cities

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