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

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. 

Obesity and Mortality Risk2.5

VeryHigh

Medical Co-Morbidities Resolved after Bariatric Surgery

Type 2 Diabetes 95%

Hypertension 92%

Osteoarthritis 82%

Cardiac Function Improvement

95%

Stress Incontinence 87%

GERD 98%

Cholesterol 97%

Sleep Apnea 75%

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

Roux-en-Y Gastric Bypass

CombinationMost frequently

performed bariatric procedure in the US

First done in 1967Laparoscopically

since 199360-70% EBW 14yr

follow-up

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

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

Laparoscopic Adjustable Gastric Banding

RestrictiveGood results in

Europe and Australia

Inamed Lap Band™ FDA approved 6/01

How does the Band work?

Surgery Factors:Restriction of meal sizeDecreased appetite

Patient Factors:Decreased calorie intakeIncreased calorie expenditure

Advantages of Laparoscopy

Fewer wound complications/infectionDecreased rate of incisional herniasLess pain and faster recoverySurgeon has better view of the anatomy Quicker return to work/activitiesShorter hospitalization

Hospital Course

Laparoscopic Bypass 2-3 daysOpen Bypass 4-7 daysGastric Band overnight stay

Results of Bariatric Surgery

Weight lossReduction or improvement in co-

morbiditiesIncreased longevityImproved Quality of Life

health social personal work

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

Thank You.