Bariatric surgery also known as weight loss surgery includes various procedures performed on people who are having extra fat. Weight loss is achieved by reducing the size of the stomach with a gastric band or through removal of a portion of the stomach (sleeve gastrectomy or biliopancreatic diversion with duodenal switch) or by resecting and re-routing the small intestines to a small stomach pouch

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
Very
High

4. Medical Co-Morbidities Resolved
Bariatric Surgery
after
Type 2 Diabetes
95%
Cholesterol
97%
Hypertension
92%
GERD
98%
Cardiac Function
Improvement
95%
Stress Incontinence
87%
Osteoarthritis
82%
Sleep Apnea
75%

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 longterm 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
Open Bypass
Gastric Band
2-3 days
4-7 days
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-mail:drsaurabhmisra@yahoo.co.in
Phone:+91 997 2200 999

15. Thank You.