Bariatrict Surgery Team
Obesity is a chronic disorder with multiple serious health complications. Previously it used to be a concern only for developed countries but now it is becoming a problem of developing countries as well. There is a global epidemic of obesity with prevalence as high as 30 to 40% in some regions. In India approximately 139 million people are obese (INDIAB study).
Obesity impairs quality of life and reduces life expectancy. All the effects and complications of obesity appear at lower body weight and at a younger age in Indians as compared to white population.
EXPECTATIONS FROM PATIENT
- Agree to complete the weight management program as plan
- Agree to comply with the recommendations
- Agree for investigations, questionnaires
- Agree to realistic goals and expectations
- If interested to take part in research activities in the department
- Funding approval
THE WEIGHT MANAGEMENT TEAM UNDERTAKES….
- To discuss about management plan
- To discuss realistic expectations and goals
- To discuss about benefits of weight loss
- To support the patient through the whole journey of weight loss
ROLES
Physician
- Medical assessments for causes of obesity
- Identifying co morbidities, complications of obesity
- Formulatng a treatment plan
- Assessing suitability for bariatric surgery
Intensivist
- Diagnosing and managing sleep apnea
- Accessing fitness for surgery
- Immediate post-operative care
Nutritionist
- Individualized meal plan
- Specialist diets
- Diet plan for surgery
- Assessing eating habits
- Pre and post operative support
Clinical psychologist
- Motivation assessment
- Motivational technique
- Screening for psychological issues
Fitness instructor
- Assessing levels of fitness
- Individualized exercise plan
Surgeon
- Full surgical assessment
- Explaining types of surgical operations
- Explaining the risks and benefits
- Expertise in all surgical operations
POSSIBLE SURGERIES
1.Roux-en-Y Gastric Bypass
A new small stomach pouch is created and the intestine is divided and joined to new stomach pouch, thereby bypassing part of the intestine
Positives
Faster weight loss, dumping (specifically if you eat high sugar meal), requires less outpatient follow up than the band, better effect on diabetes.
Negatives
Increased risk – clots (deep venous thrombosis and pulmonary embolism). Risk of leakage of internal joins where cuts have been made. Longer surgery than the band, longer hospital stay, longer off work, more pain, more vomiting for some (although some have little or no vomiting at all). Not everyone gets dumping. Procedure is more risky than the band. Patient needs more monitoring about vitamins and diet. Shouldn’t eat and drink at the same time. More chance of weight regain than with the band.
2.Sleeve Gastrectomy
A new sausage shaped stomach is made, smaller than the original, but with no intestinal bypass. One of the newest operations. It can be done as the first part of another operation for larger people, or those with other high risk factors
Positives
Quicker, easier and less time in hospital
Negatives
Less convincing longer term weight loss and no help in maintaining weight loss