Bariatric surgery

1
What Is Obesity?

• Obesity is a medical condition in which
  excess body fat  has accumulated to the extent
  that it may have an adverse effect on health,
  leading to reduced life expectancy  and/or
  increased health problems

2
What Is Morbid Obesity?

• Morbid obesity is a medical term describing
  people who have a Body Mass Index (BMI) of 40, or
  of 35 to 40 with significant medical problems
  caused by or made worse by their weight. 

3
Obesity and Mortality Risk
2.5
VeryHigh
4
Medical Co-Morbidities Resolved after
Bariatric Surgery
5
Why Surgery?

• Diet and exercise are not effective long term in
  the morbidly obese
• Surgery is an accepted and effective approach
• Medical co-morbidities are improved/resolved
• Surgical risk is acceptable vs. risk of long-term
  obesity

6
Roux-en-Y Gastric Bypass

• Combination
• Most frequently performed bariatric procedure in
  the US
• First done in 1967
• Laparoscopically since 1993
• 60-70 EBW 14yr follow-up

7
How Does the Roux-en-Y Work?

• Surgery factors
• restriction of meal size
• dumping syndrome
• some malabsorption
• decreased appetite
• Patient factors
• calorie intake
• calorie expenditure

8
Results of Gastric Bypass

• Longest and most thorough follow-up
• Significant and durable weight loss
• Control of adult onset diabetes mellitus
• Control of hypertension
• Long term improvement in health and physical
  functioning

9
Laparoscopic Adjustable Gastric Banding

• Restrictive
• Good results in Europe and Australia
• Inamed Lap Band FDA approved 6/01

10
How does the Band work?

• Surgery Factors
• Restriction of meal size
• Decreased appetite
• Patient Factors
• Decreased calorie intake
• Increased calorie expenditure

11
Advantages of Laparoscopy

• Fewer wound complications/infection
• Decreased rate of incisional hernias
• Less pain and faster recovery
• Surgeon has better view of the anatomy
• Quicker return to work/activities
• Shorter hospitalization

12
Hospital Course

• Laparoscopic Bypass 2-3 days
• Open Bypass 4-7 days
• Gastric Band overnight stay

13
Results of Bariatric Surgery

• Weight loss
• Reduction or improvement in co-morbidities
• Increased longevity
• Improved Quality of Life
• health
• social
• personal
• work

14

• Presented By
• Dr.Saurabh Mishra.
• http//lapsurg.in
• Consultant Minimal Acess and Bariatric
  Surgeon Department of General and GI
  surgery Apollo Hospitals
  154/11, bannerghatta Road,
  Bangalore-560 076 
  e-maildrsaurabhmisra_at_yahoo.co.in
• Phone[phone]

15

• Thank You.