Gastric Bypass , Gastric Sleeve and Lap Band Surgery: Answers to Morbid Obesity

Obesity occurs over time when you eat more calories than you use. The balance between calories-in and calories-out differs for each person. Factors that might tip the balance include your genetic makeup, overeating, eating high-fat foods and not being physically active. It is an accumulation of excess body fat, to an extent that may impair health. It is different from being overweight, which means weighing too much. The weight may come from muscle, bone, fat and/or body water. Both terms mean that a person's weight is greater than what's considered healthy for his or her height.

Being obese increases your risk of diabetes, heart disease, stroke, arthritis and some cancers. A crude population measure of excess fat is the body mass index (BMI), a person’s weight (in kilograms) divided by the square of his or her height (in metres). WHO defines overweight as a BMI of 25 or more, and obesity as a BMI of 30 or more. There is also evidence that the risk of chronic disease increases progressively as average BMI increases above 21.

Morbid weight problems are on an increase and despite diet control and exercise regimes; increase in weight has become a health hazard. Severe obesity damages the body by its mechanical, metabolic and physiological adverse effects on normal body functions. These "co-morbidities" affect nearly every organ in the body in some way, and produce serious secondary illnesses, which may also be life threatening.

The risk of developing these medical problems is proportional to the degree of obesity. Obesity comes with its bag and baggage of threats:

Years of life lost: People who are obese do not live as long as those who are not obese and the earlier a person becomes obese; the more years of life are lost.
Dysmetabolic Syndrome X: This syndrome involving abdominal obesity, abnormal blood fat levels, changes in insulin sensitivity and inflammation of the arteries is associated with a markedly increased risk of heart and blood vessel disease: a precursor to the onset of diabetes in adults.
Heart Disease: Severely obese persons are approximately 6 times as likely to develop heart disease as those who are normal-weighted.
High Blood Pressure: Essential hypertension, the progressive elevation of blood pressure, is more common in obese persons leading to development of heart disease, and damage to the blood vessels, causing susceptibility to strokes, kidney damage, and hardening of the arteries.
High Blood Cholesterol: Cholesterol levels are commonly elevated in the severely obese - another factor predisposing to development of heart and blood vessel disease.
Diabetes Mellitus: Overweight persons are 40 times as likely to develop Type-2, Adult-Onset diabetes. Elevation of the blood sugar, the essential feature of diabetes, leads to damage to tissues throughout the body: Diabetes is the leading cause of adult-onset blindness, a major cause of kidney failure and the cause of over one half of all amputations.
Sleep Apnea Syndrome: The stoppage of breathing during sleep is commonly caused in the obese, by compression of the neck, closing the air passage to the lungs.
Obesity Hypoventilation Syndrome: It is characterized by episodes of drowsiness, or narcosis and is caused by abnormalities of breathing and accumulation of toxic levels of carbon dioxide in the blood.
Respiratory Insufficiency: Obese persons find that exercise causes them to be out of breath very quickly, even during ordinary activities. This condition prevents normal physical activities and exercise, often interfering with usual daily activities.
Heartburn: The real problem is not with digestion, but with the burning of the esophagus by the powerful stomach acid, getting to where it doesn't belong.
Asthma and Bronchitis: Obesity is associated with a higher rate of asthma, about 3 times normal.
Gallbladder Disease: Gallbladder disease occurs several times as frequently in the obese, leading to stones in the gallbladder and abdominal pain and hence removal of gallbladder.

Besides, there are other health problems like Stress Urinary Incontinence, Degenerative Disease of Lumbo-Sacral Spine, Degenerative Arthritis of Weight-Bearing Joints, Venous Stasis Disease, Embolism - a serious or even fatal event
and a host of social and psychological effects.

We’ve all heard of fitness centers, dieticians and nutritionists doing big. Losing even 5 to 10 percent of your weight can delay or prevent some of these diseases. But sometimes things just don’t work the way we want them to. There’s no fret anymore as now we have help at hand and it works like magic. It’s tried and tested and has no side effects whatsoever. Wockhardt Hospital India offers exclusive obesity treatments by a team of expert consultant physicians, dieticians, endocronologists, physiotherapists, anesthetists, allied specialists and surgeons.

At Wockhardt Obesity Surgery Centre, medical professionals endeavour to treat your medical condition and safeguard your well-being .Wockhardt has for you, a team of experts who combine their skills and experience to help solve patient's health problems.
Bariatric Surgery is an effective alternative to treat severe obesity. Only people who suffer from morbid obesity (body mass index higher than 40) can have bariatric procedures.

PROCEDURES FOR OBESITY SURGERY

Different types of surgery for treating Obesity or Surgical Operations for Morbid Obesity

The Laproscopic Adjustable Gastric Banding

The band is placed laparoscopicaly “key hole surgery”.The band can be adjusted by injecting fluid into it as an outpatient.Reversible Hospital stay 2-3 days
In this procedure a band made of silastic material is placed around the stomach near its upper end creating a small pouch and narrow passage into the larger remainder of the stomach.

The surgery involves forming a small pouch in the upper part of the stomach that effectively becomes a new baby stomach. The sialistic band is wraped around the upper portion of stomach all around to form a "baby stomach." The narrow opening or stoma is formed by the bands two ends joining together. This band has a balloon on it which can be inflated or deflated in later stages so as to increase or decrease the size of stoma. This step makes the SAGB a stoma adjustable operation. This can be done anytime after the operation with the help of port kept under the skin at the time of operation, Now the food still goes down the normal way and is digested in the bowel normally. The big difference is that the pouch will only allow a very small amount to be fitted in at one time and when this happens satisfaction is achieved and hunger will subside until the pouch eventually empties into the duodenum. So you feel full after eating a small amount of solid food and your intake of food can be kept to two or three tiny meals a day with no desire to eat between meals.

GASTRIC BYPASS
Gastric pouch 30 ml. Part of small intestine is bypassed. Greater weight loss. Hospital stay 5-7 days Vitamin mineral supplementation required.
In this procedure a small stomach pouch is created by stapling the stomach. This causes restriction of the food intake. Next a “Y” shaped section of the small intestine is attached to the pouch to allow food to by-pass the first part of small intestine. This causes reduced calorie and nutrient absorption.
Advantages of Laproscopic Gastric Bypass RNY
• After gastric bypass surgery, weight loss is more predictable and usually maintained. Average excess weight loss is usually higher than with purely restrictive procedures.
• One year after surgery, weight loss can average 65% to 70% of excess body weight. After 10 to 14 years, some patients have maintained 50-60% of excess body weight loss.
• 96% of certain associated health conditions (back pain, sleep apnea, high blood pressure, diabetes and depression) were improved or resolved according to a 2000 study of 500 patients. It also helps in leg swelling, high cholesterol, urinary incontinence etc.

Sleeve Gastrectomy

With this procedure, the surgeon removes approximately 60 per cent of the stomach laparoscopically so that the stomach takes the shape of a tube or "Sleeve".
Technically most of these procedures are reversible but it is not advisable to contemplate reversal as person can regain the loss weight. Band slippage incidence has reduced with the modified band placement technique, improved band design and standardization of band adjustment protocol.
Bariatric surgery continues to benefit people struggling with morbid obesity, most importantly it saves lives. But finally it is you who has to remember that "health is the thing that makes you feel that now is the thing that makes you feel that now is the best time of the year!!"