Procedure for Weight Loss Surgery

Weight Loss Surgery

• Bariatric surgery or weight loss surgery is performed to control and reduce obesity, especially when other weight loss treatment options are exhausted.
• When obesity is associated with other medical conditions such as diabetes, obstructive sleep apnoea, and certain other conditions bariatric surgery helps.

Preoperative Instructions

While before surgery a full preoperative assessment is required to see if one is an ideal candidate for bariatric surgery. The following steps need to be taken to ensure higher success rate:

1. If you are smoker
2. Control blood sugar.
3. Drink more water.
4. Restrict other drinks such as coffee, energy drinks, soda, alcohol etc.
5. Chalk out a good diet plan with your doctor.
6. Avoid over eating to comfort boredom, tiredness, stress.
7. Different weight loss surgery options are discussed to arrive at the best weight loss surgery for you.
8. Build up a strong mental and emotional connect with the changes you want to bring before and after the procedure.
9. Medications such as aspirin and herbal supplements to be avoided (one week prior to surgery).
10. Liquid diet before surgery (prior to 24 to 48 hours).

Hospital Stay

• It is usually for about 4-6 days during which period the patient is monitored for any postoperative complications.
• Monitoring of blood sugar, hydration level, signs of infection and blood clots postoperatively.

Obesity Surgery/Weight Loss Procedures

1. Gastric Bypass:

   • This procedure is done by Roux-en-Y technique which resembles the letter "Y".
   • The stomach is divided into two – smaller upper and lower larger portions.
   • The small intestine (duodenum) is connected to the upper smaller portion of the stomach.

2. Laparoscopic Gastric Banding (Adjustable):

   • A small band is tied around the upper portion of the stomach.
   • This limits the food intake.
   • With the adjustable band the doctor can adjust the rate of the band to alter the gastric emptying.
   • It is a reversible procedure.
   • This procedure has minimal complications since no part is removed.

3. Sleeve Gastrectomy:

   • Here a major part of the stomach is permanently removed leaving only a banana shaped passage for the food.
   • This is emerging as the most popular and safest weight loss surgerysince it has minimal long-term side effects.

4. Duodenal Switch With Biliopancreatic Diversion:

   • It’s a very complicated procedure where the major part of stomach is removed.
   • The last part of the intestine is connected to the remaining small part of the stomach.
   • Leads to rapid weight loss.
   • Rarely performed but still in practice.
   • Long term nutritional deficiencies and side effects are more pronounced.

Postoperative Care

Patient after discharge has to follow instructions given by the surgeon, which are:

• Liquid diet for about 2-3 weeks.
• You will have to work with your nutritionist to prepare a diet plan.
• Smaller meals.
• Avoid high fatty food.
• More fiber in food recommended.
• Chew properly and eat slowly.
• Do not overeat.
• Make sure all the nutrients are taken (may even take supplements).
• Scheduled lab work to know levels of vitamins, iron, calcium, copper and metabolic profile.
• Monitor your weight loss & maintain a chart.
• Monitoring of blood sugar levels and adjusting the medications by the doctor accordingly.
• Be physically active and exercise.
• No strenuous exercise or activity initially.
• Repeat sleep studies (in patients with obstructive sleep apnea).
• Long term complications may include stomach ulcers and gall bladder stones.
• Dumping syndrome (in gastric bypass) - Food and drinks pass quickly in the bowels leading to nausea, faintness and diarrhea. Discuss with your doctor and nutritionist.
• In gastric banding you may be require a repeat band adjustment.

Bariatric Surgery Cost in India

Cost of bariatric surgery in India ranges from USD 4000 to 9000 depending on the type of surgery.