Table of contents
- What is weight loss surgery?
- Why should I consider surgery for weight loss?
- The options for Weight loss surgery in Bangalore
- Laparoscopic adjustable gastric banding (LAGB) – a) How it works b) Expected weight loss c) Things to consider
- Laparoscopic roux-en-Y-gastric bypass -a) How it works b) Expected weight loss c) Things to consider
- Laparoscopic sleeve gastrectomy -a) How it works b) Expected weight loss c) Things to consider
- Duodenal Switch -a) How it works b) Expected weight loss c) Things to consider
- Risk of undergoing bariatric surgery
- Longer term complications
- Making the right choice – a) what is the best operation for me b) Other things to consider c) What are my expectations?
- What about my health problems? a) How do my eating patterns affect my results after surgeryb) Smoking c) Alcohol d)Pregnancy
- Frequently asked questions
1) What is weight loss surgery?
Weight loss surgery is also known as obesity surgery or bariatric surgery. It refers to operations designed to help reduce your weight to improve your health and life expectancy. It should not be thought of as cosmetic surgery as its focus is on improving your health through weight loss, not on achieving a perfect body. The operations work in different ways to reduce your hunger and the amount of food your stomach can hold at any one time.
2) Why should I consider surgery for weight loss?
Bariatric surgery is proven to be one of the most effective methods to significantly improve weight elated health problems through weight loss. Making the decision to have weight loss surgery is a serious step and it is important that you fully understand all that is involved and the challenges ahead. From your first visit we will help you in making a long-term weight loss plan and continue to support you after your surgery. Please keep in mind there are risks associated with this type of surgery; however you can avoid complications by following certain basic guideline principles. Our guidelines are based on experience, with over 5,000 operations in the UK and up to 200, 000 per year in the United States we understand the factors that lead to both success and disappointment. The most successful weight reducers are able to commit to lifelong dietary, exercise and other lifestyle changes for Weight loss surgery in Bangalore. We agree this is not always easy to do but we will help you to recognise and make these changes. Weight loss surgery is a tool to help you lose weight and is not necessarily a solution for everyone.
3) The surgical options ?
The vast majority of operations are carried out laparoscopically, which is also known as keyhole surgery. This means that you’ll usually have five small incisions (cuts) in the abdomen instead of one large cut, thereby enabling a faster recovery. The types of operations for Weight loss surgery in Bangalore include:
- Laparoscopic Adjustable Gastric Banding (LAGB)
- Laparoscopic Roux-en-Y Gastric Bypass (RYBG)
- Laparoscopic Sleeve Gastrectomy (SG)
- Intragastric balloon (IGB) • Duodenal Switch (DS
4) Laparoscopic Adjustable Gastric Banding in Bangalore (LAGB)
How it works This operation limits the speed of eating which leads to a sense of fullness with smaller food portions. It does this by placing an adjustable band at the top of the stomach to form a small pouch and it also presses onto the surface of the stomach stimulating the nerves leading to the brain. This small pouch at the top of the stomach takes less food to feel full. When the band is adjusted to the right restriction, food passes slowly through the opening into the main part of the stomach. The food then continues into your intestine as normal. Please note this sensation is only achieved when firm textured food is eaten and the gastric band can not provide restriction for liquid or dissolvable foods such as ice cream, biscuits or crisps.
The band is attached by some tubing to a port which is placed under the skin of your abdomen. Fluid can be added to the band to increase or decrease the sense of satiety. The stomach and intestines are not cut, stapled or removed when placing the band. Therefore digestion and absorption are not affected. The band is not filled with fluid at the time of surgery. Your first band fill will usually be about four to six weeks after surgery. You may need to have your band tightened several times to provide you with the desired sense of fullness on eating. A member of the team will discuss the optimum amount with you, based on your food intake, eating habits and weight loss.
Should you require any other type of emergency or elective surgery in the future, the gastric band should not cause any problem. However, the surgeon performing the operation must be informed about your gastric banding prior to surgery. Expected weight loss You should lose weight steadily over two years following surgery. On average, people lose up to 50 per cent of their excess body weight. Often this doesn’t start to happen until three months after surgery.
There is, however, a large variation in results and weight loss is not guaranteed. Adherence to dietary advice and regular exercise is necessary to achieve these results. The dietitians will discuss with you what changes you would need to make to your eating patterns to have the best weight loss results for Weight loss surgery in Bangalore
Things to consider
- The operation works by limiting the speed of eating and helps to create early fullness providing the right foods are chosen. It is extremely important that you eat healthily.
- It may take several visits to get the band to the right level of restriction for you.
- You can lose on average 50 per cent of your excess weight.
- The surgery does not involve cutting, stapling or removing any part of the stomach and intestines so food is digested and absorbed as normal.
- The surgery can be reversed if necessary (although it is very likely you will regain the weight).
- Weight loss may be slow and there is large variability in weight loss amongst patients.
- Weight loss may not start until many months after surgery when optimum balance through fills is achieved.Weight loss surgery in Bangalore
- The access port may twist and therefore be inaccessible for band fills—you may require another operation to correct the problem.
- The port or band may leak and deflate, which may require another operation to correct the problem.
- The band may move out of place or you may need to have all the fluid removed from your band for a period of time, or need another operation to remove or replace it.
- The band may erode into the stomach wall and need another operation to remove or replace it.Weight loss surgery in Bangalore
- The band or port may become infected and need to be removed
- You may suffer from worsening gastrooesophageal reflux (heart burn), ulceration, gastritis, bloating, difficulty swallowing and dehydration.
- Nausea and vomiting may occur, particularly in the first few days after surgery—vomiting is also common if you eat too quickly or eat too much or do not chew your food well enough.Weight loss surgery in Bangalore
- The gastric band is not generally recommended for people who struggle with comfort or binge eating episodes. Continued overeating and vomiting can lead to the complications described above.
5) Laparoscopic Roux-en-Y Gastric Bypass in Bangalore
How it works ?
This operation creates a new small stomach pouch where a new opening is formed by making a Y loop from the intestine. This means food bypasses most of the stomach and about a third of the small intestine. This reduces hunger and creates fullness quickly so the amount you can eat is less. This together with changes to your diet and activity levels results in weight loss. A consequence of the surgery is that fewer vitamins and minerals are absorbed as food passes through the intestine. To avoid developing a complication following surgery such as nausea and vomiting or a nutrient deficiency it is essential that you follow the dietary advice recommended. You also need to take vitamin and mineral supplements prescribed everyday for life. Regular blood tests are needed to ensure you do not develop any nutritional deficiencies.
Expected weight loss ?
Most people lose weight quite quickly following this operation. You will generally reach your target weight after 18 months. On average, people lose 65 per cent of their excess body weight. There is variation in the amount of weight that people lose following surgery. Adherence to dietary advice and regular exercise will result in greater weight loss. The team will discuss the changes you need to make to your eating habits for the best weight loss result for Weight loss surgery in Bangalore
Things to consider
The amount of food you can eat is reduced. It is therefore important to eat well for good health. • You can lose on average 65 per cent of your excess weight. • It is unusual for a patient not to lose the expected amount of weight. • The gastric bypass procedure is particularly effective at reducing your medication requirements and improving blood sugar control for patients affected by Type 2 Diabetes. • Nausea and vomiting may occur, particularly in the first few days after surgery; vomiting is common if you eat too quickly, eat too much or don’t chew properly. You will have better results if you follow dietary guidelines. • You will need to take multivitamin and mineral supplements daily for life to avoid nutritional deficiencies. • It is important to eat a healthy, balanced and varied diet. • Some people experience hair thinning; this is temporary and associated with the weight loss in the first few months. • 30 per cent of patients experience dumping syndrome, a condition which occurs if you eat too much sugar, fat or alcohol, or large amounts of food. It is not considered a health risk, but can be very unpleasant with symptoms including nausea, vomiting, diarrhoea, sweating, faintness, weakness and increased heart rate (dumping syndrome varies from person to person but tends to wear off one year or so after surgery).
6) Laparoscopic Sleeve Gastrectomy in Bangalore
How it works ?
This operation makes the stomach smaller. This is done by removing the majority of the stomach and forming the remainder into a thin narrow tube. It helps achieve weight loss by reducing hunger and creating fullness quickly so the amount of food you can eat is less. This together with changes to your diet and activity levels results in weight loss. The sleeve gastrectomy is sometimes used as the first part of a two stage operation. This may be because the risks of a long surgical procedure or the technical difficulties are considered too high for some patients. The second stage such as the bypass or duodenal switch is then carried out some months later at a lower body weight. This operation has now also been shown to give good weight loss results in its own right for Weight loss surgery in Bangalore.
Expected weight loss ?
Much of the weight is lost over the first year after surgery. On average people lose about 50 – 60 per cent of their excess weight for Weight loss surgery in Bangalore. There is variation in the amount of weight that people lose following surgery. Adherence to dietary advice and regular exercise will result in greater weight loss and better weight maintenance. The team will discuss the changes you need to make to your eating patterns for the best weight loss results.
Things to consider
- The amount of food you can eat is reduced. It is therefore important to eat well for good health. • You can lose on average 50 – 60 per cent of your excess weight. • Your intestines remain intact so food is digested and absorbed as normal, unlike with the gastric bypass. However, you may need to take a vitamin and mineral supplement during the weight loss phase. • Nausea and vomiting may occur, particularly in the first few days after surgery; vomiting is common if you eat too quickly, eat too much or don’t chew properly. You will have better results if you follow dietary guidelines. • It is important to eat a healthy balanced and varied diet. • Some people experience hair thinning, this is temporary and associated with the weight loss in the first few months.
7) The Duodenal Switch in Bangalore
The Duodenal Switch (DS) is a technically demanding bariatric procedure that often takes longer to perform than other weight loss surgeries. Statistically it is proven as the most effective bariatric option in terms of weight loss, it also performs well improving metabolic health problems such as diabetes, cholesterol or blood pressure. The DS may be chosen as an initial procedure or is done where other options, such as the sleeve gastrectomy or gastric band have failed to achieve weight loss or resolve medical problems. The DS is often performed as a single stage or two stage operation. Please note: The DS is the most demanding operation from a diet and lifestyle perspective. Please read through the following information to ensure you understand the necessary commitments and considerations before deciding to undergo a DS procedure. If you are unsure about any of these factors, this may not be the right procedure for you. Feel free to contact your consultant, dietitian or bariatric nurse to discuss your concerns.
How it works The Duodenal Switch works mainly by malabsorption of calories. There is also a moderate reduction in the size of the stomach which will reduce how much you can eat at any one time. Depending on the choice of food and texture you should feel full with smaller portion than before the operation. You may also notice a reduction of appetite between meals. The mal-absorption effect achieves weight loss by re routing the intestine into two pathways or channels. One channel is known as the alimentary limb and carries only your food to where it meets the other channel (biliopancreatic limb) which carries the digestive juices. Where the two eventually meet and mix is it called the common limb and is where digestion and absorption finally takes place. By taking separate pathways to the common limb there is less time for food and digestive juices to mix. Because the common limb is quite short your body has less chance to absorb the full energy value of the meal. With the DS absorption of fat, carbohydrate and protein is impaired. It is thought that only 20% of fats are absorbed, 50% protein and 60% complex carbohydrates. Please note that 100% of sugars and alcohol will still be absorbed. As you can see, mal-absorption is quite significant; however this poses potential risks for those undergoing the DS. Protein is arguably the most important nutrient in our diets. Protein is vital to our health and its absorption is impaired by the DS. For this reason eating a high protein balanced diet after the DS is critical for long term health.
Another consequence of the shortened pathway is that some vitamins and minerals are not well absorbed and need to be supplemented to the diet. Supplementation is not optional; it is an absolute necessity and is required for life. If you feel you cannot maintain this obligation, then the DS may not be for you. Expected weight loss Most people can expect to lose about 70 to 80 per cent of their excess body weight.
Is the duodenal switch suitable for me? Weight loss surgery in Bangalore
- The DS is an effective operation for weight loss, however there is an increased risk of complications compared to the other bariatric options. Attending follow up is essential. • This operation relies on you being able to eat a high protein diet (about 100g per day). You will be given advice on how to do this but if you think you would struggle to achieve this then this is not the right operation for you. For this reason it is not recommended for vegetarians or vegans. • This operation is not suitable for you if you have had previous surgery involving your colon, if you suffer with severe reflux or if you suffer with an inflammatory condition of the bowel such as IBD or Crohn’s disease. • Diarrhoea is common after this procedure. This is often foul smelling and associated with gas. You can expect loose bowel motions on a daily basis; the frequency of bowel motion varies between individuals and depends on the quality of your diet. • This operation reduces the amount of fat your body is able to absorb. It does not limit the amount of sugar or simple carbohydrates your body can absorb so if you have excess calories coming from these foods, your weight loss won’t be as good. • It is possible to have a ‘normal’ diet following the DS but a high protein intake and compliance with a range of vitamin and mineral supplements on a daily basis is essential to prevent complications. Commonly prescribed supplements include two multivitamin and minerals daily, two calcium with Vitamin D, two iron/folate tablet as well as fat-soluble vitamins A, E and K. • You would require lifelong annual blood tests to check for vitamin and mineral deficiencies. Without proper follow up tests and lifetime commitment to the supplements DS patients can become ill. Follow-up care is not optional and must continue lifelong. • The long-term risks of DS include the brittle bone disease known as osteoporosis. This is due to mal-absorption of calcium and vitamin D, which are needed to maintain bone strength. Your follow up may therefore include routine bone scans to check the health of your bones. Weight loss surgery in Bangalore
8) Risks of undergoing Weight loss surgery in Bangalore
Although surgery is very safe, like any gastrointestinal operation there are some risks which do occur. Although these complications do occur, it should be emphasised that these are rare events but can include:
- General anaesthesia –People who are obese are at greater risk of surgical anaesthetic complications.
- Leaks – Leaks from the gastrointestinal tract can occur in two to three per cent of cases where the bowel or stomach are cut or sown. If a complete seal does not form, bowel contents can leak into the abdomen causing a serious infec
- Deep vein thrombosis and pulmonary embolism -Any surgical operation which involves a period of immobility can result in the formation of a blood clot in the leg. These clots can break off and travel to the lungs. To help prevent this, you will be put on blood thinning medication (heparin) and given compression stockings while in hospital. You will also be encouraged to get out of bed and walk as soon as possible after surgery. Tion
- Infection Following surgery, you will be more susceptible to a number of infections including lung, wound and urinary infections. Overall the incidences of these infections are low and are normally successfully treated with antibiotics.Weight loss surgery in Bangalore
- Bleeding This can occur in 1 per cent of cases and is usually resolved by stopping the blood thinning medication (heparin) which prevents blood clotting and pulmonary embolism. Occasionally surgery and/or endoscopy may be needed to stop the bleeding
- Conversion to an open operation Although over 95 per cent of operations can be performed through keyhole surgery, some operations cannot be successfully completed by a keyhole approach and require a larger cut. The most common reason for this is the presence of bleeding or the presence of dense scar tissue during surgery.
- Bowel and other injuries During the insertion of the camera, there is small risk of damaging the bowel or blood vessels. These are usually noticed at the time of operation and dealt with then. In addition, the stomach is close to the spleen and very rarely injuries can occur during surgery. In some cases you may have to have your spleen removed.
- Overall when all the risks are added up there is a very small risk of death associated with surgery (less than one in 200). The exact figure varies according to your medical status and the type of operation performed and your particular risk of complications will be discussed with your doctor prior to surgery.
9) Longer term complications
- Bariatric surgery is a lifelong commitment and as such there are some complications which can occur both immediately after surgery and many years following surgery. Although these are rare they include:
- Bowel obstruction Blockage of the bowel following bariatric surgery may be caused by a number of factors including scar tissue in the abdomen, kinking of the bowel, or the development of an internal hernia. These complications can occur in the immediate period following surgery as well as many years following your operation and may require a further operation. Weight loss surgery in Bangalore
- Stomach ulcers and strictures These can occur at the junction between the stomach pouch and the intestine in gastric bypass patients. These can usually occur in the first n to correct it. year following surgery and may be treated with medication however in some cases this leads to partial or total blockage of the stomach. Smoking after surgery significantly increases the risk of ulcer formation.Weight loss surgery in Bangalore
- Gallstones Over time you may develop gallstones due to rapid weight loss. It may be necessary to undergo a further operation to remove yIncisional hernia This refers to a weakness in the abdominal wall following surgery, typically resulting in a bulge over an old wound site. This occurs more frequently with open surgery techniques and is rarer when using laparoscopic ‘keyhole’ techniques. It usually requires an operation to repair the herniaour gallbladderfor Weight loss surgery in Bangalore.
10) Making the right choice – what is the best operation for me?
- There is no straightforward answer to this question. You may have an idea of the procedure you would prefer when you first attend the clinic. This may be based on your own research or from talking to other people who have had surgery.
- The assessment process with the surgeons, dietitians and sometimes the psychologist will help to identify the most appropriate procedure considering factors such your age, dietary habits, your previous medical and surgical history and expectations of weight loss for Weight loss surgery in Bangalore .
- After the assessments we will provide you with information to help you decide, it will be a joint decision between you, the surgeon and the rest of the team. We feel that it is important for patients to fully understand the changes that weight loss surgery will bring, together with the commitments and risks. The risks of the surgery have to be balanced against the risks of remaining overweight and long term implications of obesity on your health.
11) Other things to consider
What are my expectations?
- In making the right choice you need to consider why you are having this surgery? What is your main aim? What do you wish to achieve?
- Your reasons may be for health, mobility, and improved self esteem or simply to win the battle with your weight and stop the upward trend. Some people expect to feel happy after weight loss. They wish to avoid the negative thoughts or depression that often leads to unhelpful eating habits or poor food choice.
- For some, there is an expectation that the surgery will prevent them from overeating or binge eating. Some expect the surgery to do more than it can and that it will be the key to happiness and satisfaction in life. Unfortunately weight loss does not always improve our patient’s moods. For many this can be quite disappointing. Please be realistic in your expectations from the beginning.Weight loss surgery in Bangalore
- Some hope the surgery will ‘sort out’ their diet. It is true that surgery marks a new beginning; however keep in mind that weight management is a lifelong challenge, there are no easy solutions, and that you must be committed to the process of self monitoring and planning to avoid regaining the weight. Unfortunately not everyone keeps the weight off after bariatric surgery. Following a healthy eating plan and being as active as possible will help to ensure you sustain good weight loss.
- If you have doubts then please discuss your concerns with any of the team. It may be a good idea to write down your concerns and questions before your next appointment for Weight loss surgery in Bangalore
What about my health problems?
- Many health problems are directly linked to weight. Diabetes, high blood pressure, cholesterol or sleep apnoea all improve with significant weight loss.
- If you carry a number of medical problems the gastric bypass may be your best option. The bypass has a proven reputation for achieving a greater amount of weight loss with rapid improvement in health conditions such as diabetes. So much so, that the bypass is the procedure of choice in almost all cases for those with diabetes. Weight loss surgery in Bangalore
- Other factors may influence the choice of operation. If you have kidney problems, Crohn’s disease or require certain medicines to treat other issues, then a simple restrictive procedure such as the gastric band or sleeve gastrectomy may offer the best risk to benefits balance. The surgeons or endocrine physician will be able to advise you on this.
How will my eating patterns affect my weight loss and health after surgery?
- All operations require diet and lifestyle changes. There are characteristics of each operation which suit different dietary profiles and the team will work with you to decide on the best procedure. The following is a brief summary of a few common dietary profiles. See if you can identify any of your own habits:
- I cannot resist sweets, chocolates, biscuits or cakes. Surgery cannot stop you eating these foods. It is important to eat a healthy balanced diet and significantly reduce the consumption of these foods for the best chance of good results. If you still rely on foods such as these, with little nutritional value, you are likely to feel tired and unwell. With the gastric bypass an unpleasant side effect known as dumping syndrome can occur after eating sugary or high fat foods on an empty stomach. This side effect can be helpful to reduce the quantity of these foods or avoid them altogether, however four out of ten will not experience this effect for Weight loss surgery in Bangalore
- I eat lots of fatty, fried foods and/ or I drink alcohol regularly. These foods are high in calories and are quite well tolerated after surgery. Obviously they will impair weight loss if eaten too often. You will find little to no restriction to alcohol. High fat foods are lubricated and will slide down comfortably. High fat foods are often less well tolerated after the bypass; however they are easily managed following a gastric band or sleeve gastrectomy and will influence your weight loss results.
- I eat irregularly and can go long periods between meals. A key factor for successful weight management is keeping a regular meal pattern to regulate metabolism and avoid building up a strong appetite. Research shows that missing meals slows the metabolism. It is well known that people lose more weight when following a regular meal pattern. If you allow yourself to become too hungry you may be more likely to eat too quickly, or not chew well enough causing pain and vomiting.Weight loss surgery in Bangalore
- I follow a special diet. If you are vegetarian, vegan, intolerant to various foods or are simply a fussy eater you should carefully consider the overall variety and balance of your diet. Those on restrictive diets such as the above have a greater risk of nutrient deficiencies after weight loss surgery. Protein becomes one of the most important food groups and should come from a variety of sources. Vitamin and mineral supplements are important for everyone undergoing weight loss surgery and possibly even more so if you are on a special diet.Weight loss surgery in Bangalore
- I don’t have any back teeth. After weight loss surgery, it is important that you chew your food well. Failure to do so can cause considerable discomfort or pain. It may be a good idea to see your dentist prior to getting a date for surgery. For some people soft easily managed food textures can be eaten in good quantities. A reliance on soft food may result in a poor weight loss outcome for Weight loss surgery in Bangalore.
- I am a comfort or binge eater. Surgery does little to address the factors in your life that lead to binge or emotional eating. Regular episodes of emotional eating may limit your weight loss or lead to other unhelpful or even dangerous ways of coping with pressure after surgery. While binge eating will not necessarily prevent you from having weight loss surgery, we do need to assess whether you need additional help beforehand. We can help you access.Weight loss surgery in Bangalore
- Smokers carry a far greater risk of complications such as leaks, strictures, perforations or stomach ulcers after this type of surgery. We insist that you quit before the surgery as the effects of smoking are far more detrimental to your health than being overweight. You should see your GP for help quitting, there are now effective treatments available to assist you with this aim. This is a good time to consider everything as a new beginning to change your diet and lifestyle habits.Weight loss surgery in Bangalore
- Alcohol can be enjoyed in moderation after weight loss surgery; though do keep in mind there is little restriction to fluids after any of the weight loss surgeries. Alcohol is high in calories and may reduce the amount of weight loss you achieve. Many find it possible to drink considerable quantities of alcohol after surgery, albeit at a slower rate. Studies show the risk of developing alcohol dependency after weight loss surgery is quite common. For some, alcohol can replace the use of food in difficult emotional circumstances. Those with a past history of alcohol excess are at the greatest risk of relaps for Weight loss surgery in Bangalore
- It is recommended to wait twelve months before trying for a baby. Weight loss surgery increases the chances of nutritional deficiencies and it is important that key nutrients are available from conception and throughout pregnancy., During the rapid weight loss phase it is difficult for your body to get the essential nutrients it needs for your baby to be healthy. Keep in mind that considerable weight loss can improve fertility. The gastric bypass can also reduce the effectiveness of the oral contraceptive pill. As a result there is a greater chance you may fall pregnant; take precautions, even if you have been told you cannot have children. If you do fall pregnant, please inform your GP and let us know so we can monitor you more closely.Weight loss surgery in Bangalore