Bariatric Surgery

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Bariatric surgery also known as weight loss surgery includes various procedures performed on people who are having extra fat. Weight loss is achieved by reducing the size of the stomach with a gastric band or through removal of a portion of the stomach (sleeve gastrectomy or biliopancreatic diversion with duodenal switch) or by resecting and re-routing the small intestines to a small stomach pouch

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  • Sources: Bariatric Surgery: A Summary of the Literature, 1990 to 2001
  • The operation produced significant and durable weight loss with an average maximum weight loss of 70% of excess weight at about 2 years after surgery. At 5 years the loss was 58%, 10 years it was 55% and after 14 years it was 49%.
    More striking is the control of diabetes. Pre-op 27% had NIDDM and 27% had impaired glucose tolerance. Within 10 days of surgery most patients had no further evidence of diabetes. Long term 91% were restored to euglycemic.
    Pre-op 58% had hypertension. Post-op this was reduced to 14%. Additionally these patients noted marked improvement in cardiorespiratory function, arthritis problems and improvement in fertility.
  • Bariatric Surgery

    1. 1. What Is Obesity? Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health problems
    2. 2. What Is Morbid Obesity? Morbid obesity is a medical term describing people who have a Body Mass Index (BMI) of 40, or of 35 to 40 with significant medical problems caused by or made worse by their weight.
    3. 3. Obesity and Mortality Risk 2.5 Very High
    4. 4. Medical Co-Morbidities Resolved Bariatric Surgery after Type 2 Diabetes 95% Cholesterol 97% Hypertension 92% GERD 98% Cardiac Function Improvement 95% Stress Incontinence 87% Osteoarthritis 82% Sleep Apnea 75%
    5. 5. Why Surgery? Diet and exercise are not effective long term in the morbidly obese Surgery is an accepted and effective approach Medical co-morbidities are improved/resolved Surgical risk is acceptable vs. risk of longterm obesity
    6. 6. Roux-en-Y Gastric Bypass Combination Most frequently performed bariatric procedure in the US First done in 1967 Laparoscopically since 1993 60-70% EBW 14yr follow-up
    7. 7. How Does the Roux-en-Y Work? Surgery factors:  restriction of meal size  “dumping syndrome”  some malabsorption  decreased appetite Patient factors:  calorie intake  calorie expenditure
    8. 8. Results of Gastric Bypass* Longest and most thorough follow-up Significant and durable weight loss Control of adult onset diabetes mellitus Control of hypertension Long term improvement in health and physical functioning
    9. 9. Laparoscopic Adjustable Gastric Banding Restrictive Good results in Europe and Australia Inamed Lap Band™ FDA approved 6/01
    10. 10. How does the Band work? Surgery Factors: Restriction of meal size Decreased appetite Patient Factors: Decreased calorie intake Increased calorie expenditure
    11. 11. Advantages of Laparoscopy Fewer wound complications/infection Decreased rate of incisional hernias Less pain and faster recovery Surgeon has better view of the anatomy Quicker return to work/activities Shorter hospitalization
    12. 12. Hospital Course Laparoscopic Bypass Open Bypass Gastric Band 2-3 days 4-7 days overnight stay
    13. 13. Results of Bariatric Surgery Weight loss Reduction or improvement in co- morbidities Increased longevity Improved Quality of Life     health social personal work
    14. 14. Presented By: Dr.Saurabh Mishra. http://lapsurg.in Consultant Minimal Acess and Bariatric Surgeon Department of General and GI surgery Apollo Hospitals 154/11, bannerghatta Road, Bangalore-560 076 e-mail:drsaurabhmisra@yahoo.co.in Phone:+91 997 2200 999
    15. 15. Thank You.

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