FAQ’S ABOUT BARIATRIC SURGERY

How Gastric Sleeve Surgery Works?
Sleeve gastrectomy is a restrictive procedure. In this, about 80 % of the stomach is removed so that it takes the shape of a sleeve or a banana. This greatly reduces the size of the stomach and limits the amount of food that can be eaten at one time.

Weight loss is caused by two mechanisms – First is restriction because of a smaller stomach size and secondly removing the part of the stomach that produces the “hunger hormone” (ghrelin) contributes to the weight loss by reducing the appetite.

Sleeve gastrectomy is a physiological operation that alters several hormone levels in the body resulting in resetting of the set point of food storage to a lower level. These hormonal changes include reduced Ghrelin, increased GLP 1, Peptide YY and Amylin, resulting in reduced appetite and increased energy expenditure.

How long is the surgery? Is it painful?
Laparoscopic Sleeve Gastrectomy is a fairly simple procedure that takes about 50 minutes to an hour to perform and requires only a night’s stay in the hospital. During the surgery you will be under general anesthesia and won’t feel any pain. But there is a minimal amount of discomfort for the first 3-4 days post the surgery which can be negated by taking painkillers.

How Much Weight-loss occurs after LSG?
The patient will lose 60 – 80 percent of their excess weight in the first two years after the procedure. In first 3-4 months, weight loss is the maximum, after which the rate of weight loss slows down. It further depends on initial BMI the patient and patient’s willingness to follow health lifestyle and eating habits.

Is LSG a Good Choice for Me?
You should first know the risks and benefits of sleeve gastrectomy, mini gastric bypass and Roux-en -y gastric bypass. For high-risk patients and super obese patients, we advise LSG as a first-stage procedure prior to gastric bypass. Ultimately, the decision regarding which procedure to perform is based on each patient’s operative risk and their expectations and goals for surgical weight-loss and is decided by a bariatric surgeon.

Do I need to take bed rest after the surgery?
We encourage you to walk 3-4 hours after the surgery as being active and mobile reduces the risk of deep vein thrombosis. On third day, you are discharged from the hospital and you can return to work within a week.

Will I regain weight after this surgery?
Yes you can if you are not careful with the intake of high calorie liquids or junk food as consumption of them could lead to increased caloric intake. Good healthy eating habits and regular exercise form the cornerstones of success after bariatric surgery.

What will be my diet after the surgery?
You will need to be on a liquid diet for first 15 days after the surgery. This is followed by 15 days of semi-solid foods and then you progress onto solids. Within 2 to 3 months you can have all kinds of foods though in limited quantities.

How long will it take before I can see results after MGB?
The patient will lose 60 – 80% of their excess weight in the first two years after the procedure. In first 3-4 months, weight loss is the maximum, after which the rate of weight loss slows down. It further depends on initial BMI of the patient and patient’s willingness to follow health lifestyle and eating habits.

What precaution do I need to take after the surgery?
After Mini gastric bypass, you will be able to eat much more than a bypass or a sleeve. You have to eat diet rich in proteins, calcium and iron. Eating sweets, high carbohydrate diet, eating too much and drinking water after food can cause ‘dumping syndrome’. It occurs as a result of food passing too quickly into the intestine. The symptoms of dumping syndrome are:

Nausea, diarrhea, weakness, vomiting, palpitations, sweating and a sense of fullness accompanied by discomfort. The best treatment is to keep a note of problem foods and avoid their intake. Dumping syndrome often improves on its own without medical treatment or after adjusting your diet.

Avoid smoking as it can cause marginal ulcers.

What are the Risks of Mini Gastric bypass?
Complications that can happen include bleeding, infection, internal herniation, malnutrition and a leak from the site of anastomosis i.e. gastrojejunostomy resulting in an infection or abscess, deep venous thrombosis or pulmonary embolism. However, at our center, the total complication rate is less than 1% which is similar to other procedures, like a gall bladder or hernia surgery.

Is Mini Gastric Bypass a Good Choice for Me?
You should first know the risks and benefits of all common bariatric procedures. For high-risk patients and super obese patients, we advise mini gastric bypass procedure. Ultimately, the decision regarding which procedure to perform is based on each patient’s operative risk and their expectations and goals for surgical weight-loss and is decided by a bariatric surgeon.

Who can undergo this procedure?
If you are morbidly obese and are suffering from co-morbidities such as long standing type 2 diabetes or metabolic syndrome.

If you are suffering from severe acid reflux and hiatus hernia along with obesity.

How long will it take before I can see results?
The patient will lose 60 – 80 percent of their excess weight in the first two years after the procedure. In first 3-4 months, weight loss is the maximum, after which the rate of weight loss slows down. It further depends on initial BMI the patient and patient’s willingness to follow health lifestyle and eating habits.

What are the Risks of LRYGB?
Complications that can happen include a leak from the site of anastomosis i.e. gastrojejunostomy and jejunojeunostomy resulting in an infection or abscess, deep venous thrombosis or pulmonary embolism. Internal herniation can happen because of the mesenteric defects created even though both the defects are closed during surgery. However, at our center, the total complication rate is less than 1% which is similar to other procedures, like a gall bladder or hernia surgery.

Is Gastric Bypass a Good Choice for Me?
You should first know the risks and benefits of all common bariatric procedures. For high-risk patients and super obese patients, we advise LSG as a first-stage procedure prior to gastric bypass. Ultimately, the decision regarding which procedure to perform is based on each patient’s operative risk and their expectations and goals for surgical weight-loss and is decided by a bariatric surgeon.

FREQUENTLY ASKED QUESTIONS

IS LAPAROSCOPIC SLEEVE GASTRECTOMY SURGERY A GOOD CHOICE FOR ME?
You should first know the risks and benefits of sleeve gastrectomy, mini gastric bypass and Roux-en -y gastric bypass. For high-risk patients and super obese patients, we advise LSG as a first-stage procedure prior to gastric bypass. Ultimately, the decision regarding which procedure to perform is based on each patient’s operative risk, their expectations and goals for surgical weight-loss and is decided by a bariatric surgeon.

WHAT ARE THE RISKS OF SLEEVE GASTRECTOMY?
Minimal hair loss, vitamin B12 and Iron deficiency anemia are the main side effects. However, they are rare and can be managed with medications. As sleeve only restricts the amount of food you can consume post-surgery, there are no long term complications either. Complications that can happen include a leak from the sleeve resulting in an infection or abscess, deep venous thrombosis or pulmonary embolism, narrowing of the sleeve (stricture). However, at our center, the total complication rate is less than 1% which is similar to other procedures, like a gall bladder or hernia surgery.

DO I NEED TO TAKE BED REST AFTER THE BARIATRIC SURGERY?
We encourage you to walk 3 – 4 hours after the surgery, as being active and mobile reduces the risk of deep vein thrombosis. On third day, you are discharged from the hospital and you can return to work within a week.

WILL I EVER REGAIN WEIGHT AFTER BARIATRIC SURGERY?
Yes you can if you are not careful with the intake of high calorie liquids or junk food as consumption of them could lead to increased caloric intake. Long term over eating can cause stretching/ dilatation of the sleeve which can lead to weight regain. Good healthy eating habits and regular exercise form the cornerstones of success after bariatric surgery.

WHAT WILL BE MY DIET AFTER THE BARIATRIC SURGERY?
You will need to be on a liquid diet for first 15 days after the surgery. This is followed by 15 days of semi-solid foods and then you progress onto solids. Within 2 months you can have all kinds of foods though in limited quantities.

WHAT IS BANDED SLEEVE GASTRECTOMY?
Few of the patients have a habit of over eating and in such cases sleeve can dilate because of the repeated pushes with food from inside. In order to prevent sleeve dilatation, a non-adjustable band can be placed on the upper part of the sleeve. For the long term (> 10 years) success of sleeve gastrectomy, this can be a preferred.

WHAT IS THE COST OF BARIATRIC SURGERY?
Bariatric Surgery cost varies from 2.5 lakhs to 4 lakhs based on the patients BMI, comorbid conditions, room category & hospital choice