| AMRI Obesity Surgery Clinic |
If you are obese and suffering from many of its associated problems there is finally a solution at hand. For the first time in East India, AMRI hospitals have established an obesity surgery clinic that provides all the well established surgeries for permanent cure of obesity. These surgeries are being performed by key-hole surgery (laparoscopy) and at fraction of cost in the west.
If you are severely overweight and have not had much success with dieting, exercise, or behavior modification, surgery may be an option. |
| WHY SURGERY? |
| We all know the best way to lose weight: Dieting and exercise! While many people are successful at using dieting and exercise to lose weight temporarily, often people have difficulty keeping this weight off. For those who are seriously overweight, weight loss is not just cosmetic |
| An Obese Person Is......... |
| 6 times more likely to develop gallbladder disease |
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| 5.6 times more likely to develop high blood pressure |
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| 3.8 times more likely to develop diabetes |
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| 2 times more likely to develop osteoarthritis |
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| Higher rates of cancer have also been linked to obesity including prostate, breast, cervix, and ovarian cancers. |
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| Losing weight will significantly reduce the many health risks that accompany obesity; |
| Co-Morbidity associated with obesity |
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| Respiratory disease |
10-20% |
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| Cancers-Esophageal, Prostate, Colon , Ovarian, Cervical, Uterine, Breast, etc |
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| Obesity Related Cancers |
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| Co-morbidities improved by Bariatric surgery : |
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| Idiopathic intracranial hypertension |
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| Urinary stress incontinence |
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| IS SURGERY FOR ME? |
If you are severely overweight (roughly 45 kg or more) and have been unsuccessful at dietary / behavioral approaches to weight loss, you may be a candidate for laparoscopic weight-loss surgery. Laparoscopic surgery is a minimally invasive procedure, performed through multiple small incisions (1/4" to ½" long) using specially designed surgical instruments and viewed through a laparoscope, or surgical telescope.
Surgery is NOT a "magic cure" for obesity. Surgery is a tool to help you lose weight. Even after a weight-loss operation, it is necessary to follow a special diet and exercise regularly. However, surgery has been shown to provide better and more permanent control of severe obesity than any other weight-loss method available today. |
| HOW DO I DETERMINE IF I ‘M A CANDIDATE? |
| In order to determine if you are a candidate for weight-loss surgery, it is helpful to know your Body Mass Index or BMI. It is equal to your weight (in kilograms) divided by the square of your height (in meters). |
| Body Mass Index—WHAT DOES IT MEAN? Click here to view |
A normal body mass index, or BMI, should be between 18 and 25.If your BMI is over 25, you are considered overweight. Above 30 are considered obese. You are considered to be a candidate for obesity surgery if you meet one of the following criteria :
BMI over 35—With a BMI over35, you are at risk for the numerous health problems that obese people face. It is unlikely you will be able to permanently lose a substantial amount of weight by dieting and exercise alone. Weight loss surgery may be valuable option.
BMI between 30 and 35with a significant health problem directly caused by your weight significant weight loss may help to improve hypertension, diabetes, sleep apnea, and many other obesity-related problems. If you suffer from one of those problems, you may stand to benefit from weight loss surgery.
Important : Remember that; while significant, your BMI is only factor in the decision to have weight loss surgery. Many other factors, such as your ability to tolerate an operation, must be carefully considered. |
| EVALUATION |
| Routine tests are done prior to surgery in all the patients to evaluate pre-operative co-morbidities and plan the surgery so as to avoid complications in the peri-operative period. The tests include : |
| Hemoglobin, total counts, differential counts |
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| Blood sugar (Fasting Post-prandial) |
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You will be further evaluated by a team of specialists at AMRI hospitals depending upon your co-morbidities.
The team consists of associated specialists from :
Endocrinology, Psychology, Nutrition, Gastro-enterology, Pulmonology, Cardiology. |
| SURGERY FOR OBESITY |
ADJUSTABLE GASTRIC LAP-BAND : The lap band system is a device used to help you loss weight. The lap band helps you eat less by limiting the amount of the food that can be eaten at one time and it increases the time it takes for food to be digested.
The lap band system consists of a hollow silicon band tubing and a across reservoir. The band is placed around the upper part of stomach, creating a small pouch that can hold only a small amount of food. The narrowed opening between the stomach pouch and the rest of the stomach controls how quickly food passes from the pouch to the lower part of the stomach. Connected to the band is tubing which is attached to a port, this part is placed under the skin in a muscle in the chest wall. Once the band is in place it can adjusted. Your consultant makes adjustments to the band by adding saline by injecting into the port. This allows for the inflation of an inner band.
By inflating the band it makes the opening to the stomach smaller causing food to pass through slowly. The band can be tightened or loosened to meet your needs; depending on your weight procedure you do not need an anesthetic for this. |
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| LAP-BAND |
GASTRIC BYPASS |
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| LAPAROSCOPIC ROUX-EN-Y GASTRIC BYPASS : Gastric bypass involves creating a small pouch by dividing the stomach. The small intestine is divided and brought up to join the new stomach pouch. This allows food to go straight from the stomach pouch into the small intestine, which causes it to bypass the lower stomach and the duodenum (the first segment of the small intestine). This reduces the amount of calories that the body absorbs. |
| THE MAIN DIFFERENCES BETWEEN ADJUSTABLE GASTRIC BAND AND THE GASTRIC BYPASS |
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LAP-BAND |
GASTRIC BYPASS |
| Complexity |
Simple |
Moderate |
| Reversibility |
Easier in general |
Reversible but moderately difficult |
| Laparoscopic |
Yes |
Yes |
| Relative early risk |
Lower |
Moderate |
| Expected hospital stay |
1 night |
3-4 nights |
| Mortality |
0.1% |
0.4% |
Statistical average
Weight loss (2 years) |
50-60% of excess weight |
70-75% of excess weight |
| Possible late term risks |
Band slippage, port complications, erosions, lap-band infection, esophageal dilatation |
Ulcers, anemia, stricture, vitamin/calcium/iron deficiencies, intestinal obstruction |
| Risk of malnutrition |
minimal |
low |
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| RESULTS OF BARIATRIC SURGERY |
The effectiveness of the Bariatric surgery depends on the success of the surgical procedure and the ability of the patient to change his/her diet and eating behavior. Patients choosing Bariatric surgery have to be committed to long term lifestyle changes, including dietary and behavioral modifications.
Patients can expect gradual weight loss up to 2 years. Patients may lose 50-60% of their excess weight within 18 months after surgery. Studies with a follow-up of over 5-years confirm that weight loss is long term. Majority of weight loss occurs in the first year. Much depends on the degree of post-operative complications and patient compliance with dietary guidelines. Weight loss is more, rapid and is sustained in the gastric bypass procedure compared to lap band which in itself is very powerful modality for sustained and significant weight loss in comparison to supervised dietary regimens. |
| Department of Laparoscopy And Bariatric Surgery |
| CONSULTANTS |
POST-DOCTROL FELLOW |
MEDICAL OFFICER |
DR. V K BHARTIA,
Chief Bariatric Surgeon
Director, Institute of Minimally Invasive Surgery
AMRI Hospitals, Kolkata
Contact: vkbhartia@vsnl.com, 0091-(0)33-24610270
DR. PUNEET GUPTA,
Surgical Gastroenterologist and Laparoscopic Surgeon,
AMRI Hospitals, Kolkata
Contact: drpgmas@yahoo.co.in |
DR. JOTINDER KHANNA
Contact: jotinderkhanna@rediffmail.com
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DR.H V SINGH
Contact: drharshvs@yahoo.co.in |
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| Click here for Minimally Invasive Surgery |
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