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Page 1: Bariatric Surgery

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

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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. 

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Obesity and Mortality Risk2.5

VeryHigh

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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%

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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

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Roux-en-Y Gastric Bypass

CombinationMost frequently

performed bariatric procedure in the US

First done in 1967Laparoscopically

since 199360-70% EBW 14yr

follow-up

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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

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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

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Laparoscopic Adjustable Gastric Banding

RestrictiveGood results in

Europe and Australia

Inamed Lap Band™ FDA approved 6/01

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How does the Band work?

Surgery Factors:Restriction of meal sizeDecreased appetite

Patient Factors:Decreased calorie intakeIncreased calorie expenditure

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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

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Hospital Course

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

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Results of Bariatric Surgery

Weight lossReduction or improvement in co-

morbiditiesIncreased longevityImproved Quality of Life

health social personal work

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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:[email protected]

Phone:+91 997 2200 999

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Thank You.