MEET YOUR DOCTOR - THINGS TO KNOW BEFORE A BARIATRIC SURGERY
Published: Wed 5 Aug 2020, 7:39 AM
Last updated: Thu 3 Sep 2020, 11:00 AM
Did you know that bariatric surgeries can also help address sleep apnea, diabetic issues and high cholesterol levels in individuals? Deciding on and choosing the right type of procedures is essential. Here are some key aspects of a bariatric surgery you may want to know. Take a quick read on the below frequently answered questions by Specialist General Surgeons Dr. Uday Shankar in Zulekha Hospital Dubai and Dr. Parag Rane in Zulekha Hospital Sharjah.
When must one consider a weight loss surgery?
Going by International guidelines or criteria any person between the ages of 18 to 55 years can be considered for this surgery. Individuals with a Body Mass Index above 40 with / without co morbid diseases like type 2 diabetes, hypertension, hyperlipidemia or BMI above 35 with any co morbid disease can also be considered for surgery. All patients who are considered for surgery have to be given a trial of diet and exercise for at least six months for weight loss before the surgery.
What is the difference between gastric band or gastric sleeve or a balloon surgery?
Gastric Band: is where a silicon gastric band is placed at upper end of stomach dividing it in upper small pouch from rest of stomach using a laparoscopic technique. It is reversible surgery, requires band inflation or deflation as per weight gain or loss. It can help with 25-30% of excess weight loss for an individual. It has high complication rates with possible band slippage, erosion through gastric wall with infection.
Gastric Balloon: It is an endoscopic procedure for overweight patients and those who are not willing for surgery. It is reversible and helps in losing 15-20% of excess weight. Some individuals cannot adapt to a balloon and experience abdominal colicky pain and nausea vomiting. In such cases, the balloon can be removed immediately.
Gastric Sleeve: is the most commonly performed Bariatric procedure at present. It is a restrictive type of surgery. This surgery is performed laparoscopicaly resulting in 70-75% of excess weight loss.
What surgery is best for me? How can I decide this?
While choosing the procedure, let your Bariatric surgeon do all the work up and give you options. You can then choose from the given options by considering merits and demerits of each procedure.Mostly gastric balloon is chosen by overweight individuals, gastric sleeve surgery is chosen for weight loss without comorbid diseases, and gastric bypass is considered by obese patients with comorbid diseases and those having acid reflux diseases. Your surgeon will be giving you the final best advice after studying your health condition thoroughly.
What are some factors I must keep in mind while choosing my doctor or hospital for the bariatric surgery?
Before choosing a doctor or hospital for your Bariatric surgery one must look for best bariatric surgery unit available in a fully equipped hospital. Alongside an experienced Bariatric surgeon a best supporting medical team consisting of physician, gastroenterologist, dietician, pulmonologist, cardiologist, anesthetists and physiotherapist are also important. A Bariatric surgery is a team work and keeping safety in mind, one must select only those centers with high volume of surgeries performed and with an experienced team.
Do I need to be worried about scars and wounds after a bariatric surgery?
As a Bariatric or weight loss surgery is performed with laparoscopy or a key-hole approach that requires skin incision from 0.5 cm to 1 cm only, you need worry about scars and wounds. All these skin incisions are sutured from beneath, so in most cases there are no visible external stiches. Individuals are even allowed to take a shower two days after the surgery.
Does one need a skin tightening surgery or other procedures after a bariatric surgery?
This depends upon the BMI of the individual. If the patient has decided to undergo surgery while he/she has a very high BMI or eccentric fat deposition is one area, than a skin tightening procedure may be required. But most individuals who undergo this surgery from 35 BMI to 50 BMI range don't require any skin tightening procedure. A lot depends upon the individual's expectation as well. All patients are encouraged to start mild to moderate exercise soon after the surgery & should enroll into some kind of fitness program to prevent skin sagging and preserve muscle mass.
When will one be able to return to work, how long can a surgery and hospital stay last?
As these surgeries are done laparoscopically, the usual hospital stay is 1-2 days only. Most of patients are made to walk after 3-4 hours of completion of surgery. Ability to return to work varies, but most people are able to return to work within seven days to one month depending upon the nature of their job.
Can weight loss surgery help me manage or overcome other health conditions such as diabetes, high blood pressure, high cholesterol, heart disease, joint problems, or sleep apnea?
A Bariatric surgery is also known as a metabolic surgery, as this surgery is highly effective in Adipose-Based Chronic Disease (ABCD). After a Bariatric surgery, 88-92% of patient would have completed treatment of diabetes and there won't be any need of medication thereafter. Sleep apnea gets resolved within a week of surgery in most cases. In last few years more and more people are opting for this surgery because of awareness that Bariatric surgery is very effective tool against high blood pressure, cholesterol, PCOD, obesity related infertility and joint pain.