Only surgery has proven effective over the long term for most patients with clinically severe obesity.” - NIH Consensus Conference Statement, 1991 Surgery for the treatment of clinically severe obesity is endorsed by: The National Institutes of Health The American Medical Association The National Institute of Diabetes and Digestive and Kidney Diseases American Association of Family Practitioners

1. ROLE OF BARIATRIC SURGERY IN
TREATMENT OF MORBIDLY OBESE
PATIENTS
• Dr. Ashish AhujaDr. Ashish Ahuja
• M.S (Surgery), Fellowship Bariatric Surgery, (Australia)M.S (Surgery), Fellowship Bariatric Surgery, (Australia)
• Consultant Surgeon & Asst. Prof. of Surgery,Consultant Surgeon & Asst. Prof. of Surgery,
• Dayanand Medical College & Hospital, LudhianaDayanand Medical College & Hospital, Ludhiana

2. • BARIATRIC SURGERY IS NOT
LIPOSUCTION
• BARIATRIC SURGERY IS A SAFE SURGERY
• DOES NOT CAUSE ANY SIDE EFFECTS
• RISKS OF UNDERGOING BARIATRIC
SURGERY ARE FAR LESS THAN RISKS OF
OBESITY

3. What is Bariatric Surgery?
• Comes from Greek words
–Baros: - Weight
–Iatreia: - Medical Treatment

4. Obese patients who
undergo weight loss
surgery live longer, studies
suggest
The Associated Press
Published: September 7, 2006 The
Associated Press
Published: September 7, 2006
SYDNEY, Australia — Stomach stapling and
other surgical procedures to help overweight
people eat less may be radical, but they also
could be safer than staying obese, new
research suggests. ……………………..

7. Obesity ‘harms sexual health’Obesity ‘harms sexual health’

9. Why Surgery for the Treatment of theWhy Surgery for the Treatment of the
Clinically Severe Obese?Clinically Severe Obese?
“Only surgery has proven effective over the long term
for most patients with clinically severe obesity.”
- NIH Consensus Conference Statement, 1991
Surgery for the treatment of clinically severe obesity
is endorsed by:
The National Institutes of Health
The American Medical Association
The National Institute of Diabetes and Digestive
and Kidney Diseases
American Association of Family Practitioners

10. • Bariatric Surgical and Procedural
Interventions
• in the Treatment of Obese Patients
• with Type 2 Diabetes
• A position statement from the
• International Diabetes Federation Taskforce
• on Epidemiology and Prevention

11. Complication of ObesityComplication of Obesity

12. B.M.I.

13. Diet
Exercise
How To Lose Weight?How To Lose Weight?

14. When diets and
exercise don’t
work?

16. Types of bariatric procedures
1. Sweedish adjustable gastric band
2. Gastric sleeve resection
3. Roux-en-y gastric bypass
4. Bilio-pancreatic diversion with duodenal
switch

19. Adjustable Silastic Gastric BandingAdjustable Silastic Gastric Banding
(ASGB): LapBand(ASGB): LapBand
– Inflatable balloon within the
band orifice can be
adjusted via a reservoir
under the skin
Average Weight loss
– 50% of excess weight

20. Gastric sleeve resection
• Restrictive procedure
• No complication rates
• Weight loss around 50-60%

22. Roux-en-Y Gastric BypassRoux-en-Y Gastric Bypass
(RYGBP)(RYGBP)
General Features
– Pouch size: 15-20 cc
– Pouch opening: 0.5 in
– Roux-en-Y limb
– Standard: 2 ft
Average Weight Loss
– 70 % of excess weight
“The Pouch-Tool”

31. Procedure
Swedish
adjustable
Gastric band
Gastric
sleeve
resection
Roux-en-y
Gastric
bypass
Laparoscopic √ √ √
Hospital Stay X √ √
Abdominal drain X √ √
Operative time
(<1 hour)
√ X X
Post operative
supplements
X X √
Post operative
adjustments
√ X X
Weight loss √ √ √√
Comparison of different procedures

32. Contra indications for obesityContra indications for obesity
surgerysurgery
• Only be offered to patients suffering from morbid
obesity who are willing, motivated and high level of
intelligence.
• Patient unfit for general anesthesia, advanced
cancer disease.
• Patients having underlined endocrine disorders and
major psychiatric illness .

33. Patients
Before And After
Bariatric Surgery

34. 170 kgs with BMI-72, HTN, TYPE-2 DM, OSA,170 kgs with BMI-72, HTN, TYPE-2 DM, OSA,
AFTER 1 year 2 months 110 kgsAFTER 1 year 2 months 110 kgs

36. 145 kgs with BMI, HTN, TYPE-2 DM,145 kgs with BMI, HTN, TYPE-2 DM,
AFTER 10 MONTHS 90 kgsAFTER 10 MONTHS 90 kgs

37. 128 kgs128 kgs HTN & THYROID DISEASEHTN & THYROID DISEASE
after 9 months present weight 74 kgsafter 9 months present weight 74 kgs

38. 130 kgs with HTN ,after 1 year 4130 kgs with HTN ,after 1 year 4
months present weight 70 kgsmonths present weight 70 kgs

39. Morbid obesity with Blood Pressure,Morbid obesity with Blood Pressure,
SugarSugar
BeforeBefore AfterAfter

40. World Anti Obesity Day

41. Before 106 kgs After 65 kgs

42. After surgery Today 60
Before surgery 100

43. 117 kgs with HTN117 kgs with HTN AFTER 12 MONTHSAFTER 12 MONTHS
65 kgs and resolved HTN,D.M type 265 kgs and resolved HTN,D.M type 2

44. 105 kgs, HTN,105 kgs, HTN,
AFTER 5 MONTHS 70 kgs resolved HTNAFTER 5 MONTHS 70 kgs resolved HTN

45. 102 kgs sugar + blood pressure Now 48
kgs

46. DM Type-2 with HTN,DM Type-2 with HTN,
Before 127 kgs – Present 70 kgsBefore 127 kgs – Present 70 kgs

47. 110 kgs with HTN110 kgs with HTN AFTER 9 MONTHS 78 kgsAFTER 9 MONTHS 78 kgs

48. 102 kgs, Unmarried,
Polycystic Ovarian
Disease
BEFORE SURGERY

49. AFTER 8 MONTHS 55
KGS

50. Dental Surgeon from Delhi
115 kgs, HTN (Before Surgery)

52. A 32 year old male, 170 kg weight
Gastric bypass done

54. When we choose to live withWhen we choose to live with
ObesityObesity
• Frequent hospitalization
• High cost of medicine
• Frequent visit to specialist doctors
• Dependability on others,
– e.g. wearing socks, changing clothes, domestic
works.
• Various diseases
• Laughing stock

55. Option is yours……
Or
Famous bollywood singer
Before
After surgery