Obesity

Obesity is a major health problem of an approaching epidemic proportions. An NIH consensus conference on surgical treatment of obesity has recommended consideration of surgery in patients with a BMI over 40 kg/m2 without medical complications or a BMI over 35 kg/m2, if severe concomitant diseases were present. Obesity accelerates the progression of coronary atherosclerosis in young men (aged 15-34 years). Obesity increases the risk of developing

Hypertension,

Hyperlipidemia,

Type 2 diabetes,

Coronary heart disease,

Cerebrovascular diseases,

Osteoarthritis,

Sleep apnea,

The endometrium, breast, prostate and colon cancer.

Severe obesity is a chronic disease that is difficult to treat through diet and exercise. Gastrointestinal Surgery, obesity, and bariatric surgery is an option for people who are very overweight and can not be removed by traditional means or suffer the health from serious problems related to obesity.

Obesity Surgery />
Bariatric is from the Greek word bar, the weight means. Obesity surgery creates an anatomic barrier to prevent over-consumption and the accumulation of excess calories or limiting the gastric reservoir or induce malabsorption. Bariatric surgery alters the digestive and is divided into two categories:
Restrictive />
Malabsorptive.

Almost all patients with morbid obesity, with satisfactory postoperative weight loss, improvement in the quality of the experience of their lives. Currently, Roux-en-Y gastric bypass (RYGB), the operation, the only bariatric weight loss sustained over the longer term to an acceptable level of risk.

Directions:

Mass Index (BMI) greater than 40
severe obesity comorbidity (eg hypertension, diabetes, sleep apnea, Pickwickian syndrome, debilitating arthritis)
Obesity-related physical problems that interfere with employment, walking, or family functioning may be a candidate.

Procedures for obesity surgery:

Procedures 1.Restrictive

Promote weight loss by closing parts of the stomach to make it smaller, reducing the amount of food the stomach can hold. restrictive procedures do not interfere with normal digestion.

After this operation, most people lose the ability to eat large amounts of food at once. Eat after the operation, the person usually only ¾ to 1 cup of food without discomfort or nausea. In addition, food must be chewed well.
Restrictive measures against obesity:

Adjustable gastric />
Vertical banded gastroplasty />
Both methods are used to create a small stomach pouch.

2. Malabsorptive procedures />
The most common stomach surgery to lose weight, combine gastric restriction with a partial bypass of the small intestine. A direct connection between the stomach and the lower segment of the small intestine is created to include bypassing portions of the digestive tract, the calories and nutrients.

biliopancreatic diversion (BPD):

In this more complicated malabsorptive part of the stomach are removed. The small pouch that remains connected directly to the last segment of the small intestine, completely bypassing the duodenum and jejunum. Although this procedure successfully promotes weight loss is less frequent than other types of operations because of the high risk of malnutrition used. A variation of BPD includes a “duodenal switch” that a larger part of the stomach intact, including the pyloric valve that the release of stomach contents into the small intestine regulates leaves. He also holds a small portion of the duodenum in the digestive tract.

Roux-en-Y gastric bypass

Roux-en-Y gastric bypass (RGB) is an established operation for the control of body weight in morbidly obese patients. This operation is the most common and successful malabsorptive surgery. First, a small stomach pouch is created to restrict food intake. Next, a Y-shaped section of the small intestine is attached to the pouch so that food to bypass the lower stomach, duodenum, and the first part of the jejunum. This bypass reduces the amount of calories and nutrients the body absorbs

Review article:

Very obese patients under general anesthesia to tolerate remarkably well. However, intubation may be difficult.
Patients can be taken to the intensive care unit after surgery.
Patients with sleep apnea, heart failure and severe asthmatic bronchitis were to spend a night or two in the intensive care unit for close monitoring of cardiovascular status

Complications of obesity surgery:

The risk of gallstone formation.

Inflammatory hepatitis.

Occult cirrhosis

Dumping syndrome (stomach contents move too quickly into the small intestine by nausea, weakness, sweating, faintness and sometimes diarrhea after eating)



Vitamin B12 deficiency />
Deficiencies

Anemia (due to reduced absorption of iron in the stomach)

Metabolic bone disease (due to less calcium absorption in the small intestine)

Abdominal pain />
Vomiting

Disembowelment /> /
Bleeding (including splenic injury)

Gastrointestinal leakage (unintentional injuries in the gastrointestinal tract)

Tread wear and breakdown of the baseline.

can occur in very less post-operative infection complications or death.

Operations Review

Early technical complications and poor weight loss, known consequences of this process required re-operation. The incidence of major postoperative complications following revision surgery bariatric procedures is substantially higher compared with primary surgery.

Patients who have gastric bypass may need revision, either because of inadequate weight loss or complications. The incidence of major postoperative complications after revision bariatric procedures is substantially higher compared with primary surgery. Early morbidity varies from 15% to 50%. The mortality rate after revision surgery reported as high as 10% is sufficient, balanced bariatric operation without conversion to another weight reduction procedure is always quick with the patient lost weight again finds.

Indications for reoperation include

Dilated intestinal anastomosis />
insufficient weight loss without any detectable expansion of the anastomosis

Staple line cutting />
Anastomotic obstruction />
Anastomotic

Large proximal gastric pouch.

Reoperation were:

Completely redo first RGB />
Restoring the anastomosis only

Staple line revision />
intraoperative dilatation of the anastomosis

.
Intractable marginal ulcer />
Major postoperative complications are:

RGB / fail>
RGB to begin the technical review

failure
insufficient weight loss is associated with a high incidence of major complications

Subsequently, significant weight loss.
Intractable marginal ulcer.

Severe metabolic complications

Therefore, technical failure or complications RGB repair is not recommended.
Gastric bypass patients with anatomically intact operations and weight loss are probably unsatisfactory “outeaten” operation.Gastric bypass patients with weight loss effects are best changed in malabsorption converted Roux-en-Y gastric bypass, or in some case the biliopancreatic diversion. Unfortunately, some patients suffer, leading to a malabsorptive process converts heavy metabolic complications.

The larger the bypass, the greater the risk of complications and nutritional deficiencies. People with a large bypass the normal process of digestion requires close monitoring and lifetime use of specific foods, dietary supplements and drugs

Why gastric bypass surgery in India

The revision gastric bypass surgery in India has witnessed a phenomenal growth in recent years. Most patients from countries like USA and UK to India for treatment.

Some reasons:
India offers a wide range of price options, the cheapest treatment.

While planning is the treatment in India is no need to wait in queues of patients, or registering for a waiting list.

In addition, doctors and medical institutions in India comparable to the best in the world.

Another main reason for choosing India for a gastric bypass is the comfort of the revision of the communication was not a problem that most people speak English.

Above all, India still offers a great holiday, the restoration of health can help quickly. Another important reason why people are increasingly considering India from abroad for the consideration of health promotion and medical and technical superiority of the medical profession in India. Therefore, India is the ideal destination for medical tourism.


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