Bariatric & Metabolic Surgery
70 years research says obesity is not simply due to poor self -control or a lack of will power. Obesity is a chronic, non-communicable progressive disease stated by World Health Organization (WHO)along with national and International medical and scientific societies.
Excess weight may increase the risk for many health problems including, Type 2 diabetes, Hyper tension & Cardiovascular diseases, Sleep apnea / Respiratory problems, Osteoarthritis, Infertility, Certain types of Cancer, GERD/Heart burn, Fatty liver/ NASH, Kidney Disease, Psychological issues, Pregnancy problems, such as high blood glucose (sugar) during pregnancy, high blood pressure, and increased risk of caesarean delivery (C-section).
Diet, exercise, life style modifications are the first line treatment of obesity. People who have tried and failed in traditional weight loss methods are automatically eligible to undergo bariatric surgery , the best method for weight loss.
Bariatric surgery or weight loss surgery or obesity surgery involves bypassing or stapling of a portion of the stomach to reduce a person’s appetite. Bariatric surgery is otherwise called as obesity surgery, weight loss surgery, metabolic surgery as well. In India, sleeve gastrectomy, Gastric bypass (ROUX-en-Y gastric bypass), Minigastric bypass, gastric banding are commonly performed.
Measurement of Obesity
Body Mass Index (BMI), Waist Circumference (WC) and Waist Hip Ratio (WHR) are the practical and affordable measurements of obesity.
- Body Mass Index (BMI)is measured using one’s weight in kilograms divided by height in meters squared.
- Waist Circumference (WC) a common measure used to check for fat held around the stomach. Men – 90cm (35.5 inches) Women – 80cm (31.5 inches)
- Waist Hip Ratio (WHR)– The ratio of the circumference of the waist to that of the hip. This is calculated as waist measurement divided by hip measurement. Men – 0.90 Women – 0.80
| BMI Classification |
International
(WHO) |
Indian
(APG) |
Disease Risk
WC <90cm men &
< 80 women) |
Disease Risk
WC >90 cm men & >80 women) |
| Extremely Obese |
≥40 |
≥30 |
Severe |
Very severe |
| Obese |
≥30 |
25-29.9 |
Moderate |
Severe |
| Overweight |
25-29.9 |
23-24.9 |
Increased |
Moderate |
| Normal Weight |
18.5-24.9 |
18.5-22.9 |
Average |
Increased |
| Under Weight |
≤18.5 |
≤18.5 |
Low(other diseases ?) |
Average |
| Children |
Overweight above 90th & Obese above 95th percentile of standard weight |
Requirements for Bariatric Surgery
- People with BMI greater than 35kg/ m²with or without co-morbidities like type 2 diabetes, hyper tension, sleep apnea, fatty liver, joint pain, infertility
- People with BMI greater than 30kg/m² with T2DM or metabolic syndrome along with uncontrolled lifestyle alterations or medical treatment
- People with BMI greater than 27.5 kg/m² for inadequately controlled T2DM or metabolic syndrome
- People with age greater than 18 or less than 80 years old
- People who have tried and failed with medical therapy and life style modification
- People without any serious underlying psychiatric disorders, substance abuse or narcotic dependency
Truths & Benefits about Bariatric Surgery
- Done laproscopically i.e. through a keyhole or a small incision (1/4 to1/2 inch),almost scar less
- 60-80% of excess body weight loss occurs after surgery
- Less or no pain as it is done laproscopically
- Procedure times varies between 60-90 minutes
- Not much blood loss, so there is no need of blood transfusion
- Hospital stay would be 2-3 days only
- Go back to routine activities within a week time (5-7 days)
- Resolution of type 2 diabetes, hyper tension, sleep apnea and other obesity related co-morbidities added benefit
Principles of bariatric surgery
- Restricts food intake thereby increases energy expenditure and gives significant weight loss
- Decreases absorption of nutrients in the stomach and intestines and decreases fat deposition
- Suppresses hunger, reduces appetite and enhances satiety by favourable changes in gut hormones
Benefits of Bariatric Surgery
- Weight loss
- Improves obesity related conditions such as type 2 diabetes, hyper tension, sleep apnea etc Increases Longevity
- Improves Quality of Life
- Cost-effective
Types of Bariatric Surgery
Restrictive – Stomach is smaller to reduce food intake and feel full with little food
Malabsorptive – Bypass part of the digestive system and only less calories are absorbed from food
Combination – Involves both restriction and malabsorption and therefore has a two way weight reduction effect
- Adjustable Gastric Band – Restrictive
- Sleeve Gastrectomy , Banded Sleeve Gastrectomy – Restrictive
- Gastric Bypass, Banded Gastric Bypass – Combined
- Minigastric Bypass – Combined
Special About Bariatric Surgery at PSG Super Speciality Hospitals
- 1st hospital in INDIA to do Bariatric Surgery in 2005
- 1st Medical college and Hospital in INDIA to Start a Dedicated Bariatric Unit
- 1st 2000 Bedded multispecialty medical college and Hospital in INDIA to Give holistic approach for Overweight/Obese individuals
Special about PSG Super Speciality Hospitals
- Centrally located in Coimbatore
- Easily reachable by any means of transport (5kms from airport, 6kms from railway station, 4 kms from Singanallur bus stand & 8 kms from Gandhipuram bus stand)
- First and Only 2000 bedded Super Speciality Hospital for multi specialities with NABH Accreditation in South India
- Well designed infrastructure and operating theatre tables and equipment specially designed to accommodate morbidly obese individuals at ease
- International standard set up
- State of the art 3D operation theatre
Special About Bariatric & Metabolic Surgery Department
- Bariatric surgeon is expertise to perform bariatric procedures including gastric band, gastric bypass, min gastric bypass, sleeve gastrectomy, gastric bypass, min gastric bypass and metabolic surgeries in routine
- Experienced team of anaesthetist who regularly perform various bariatric procedures
- Multidisciplinary approach with long term follow up care facilities including rehabilitation facilities, psychiatric care, nutritional counselling and support groups
Vision
Maintaining a holistic approach towards treatment of obesity and wellbeing of individuals creating a healthier society by offering service excellence deploying state-of-the-art facilities.
- Psychological support
- Life style management
- Lifelong support group
Mission
- To improve the quality of life in the obese community
- To show the right path for holistic approach on obesity
- To reduce to mortality and morbidity due to obesity
- To give awareness to general public who are obese and what are they capable of and the power within them in this world
Professional Team
- Bariatric Surgeon – Dr.S.Balamurugan MS (Gen Surg)., FMAS., FALS (Bariatric )., FBMS.,
-
Bariatric Anaesthetist –Dr.M.S.Prasanth Kumar MBBS, DA, DNB(Anaes) MNAMS
-
Bariatric Anaesthetist –Dr.R. Arun Kumar ,MBBS, DA, DNB(Anaes)
Live & Love Yourself AGAIN with Bariatric Surgery……
Since 1974 – PSG Hospitals & Since 2005 – Proud to Fight Obesity
Departments
