The prevalence of morbid obesity in the Indian population, particularly in Kerala obesity is rising, bringing with it increased levels of cardiovascular disease, diabetes, arthritis and early mortality. A sample survey conducted among school children in Kochi, Kerala has shown alarming results with more than a third of children are overweight and half of them are obese. So, finding a treatment or solution is a necessary thing.
Morbid obesity is associated with twice the mortality compared with the general population and with other conditions such as hypertension and type II diabetes, as well as increased levels of psychiatric illness. Many of the co-morbidities listed in the box result from the metabolic effects of obesity. The so‐called “metabolic syndrome” becomes more common with rising BMI, and carries a threefold increase in cardiovascular morbidity. Further, non‐alcoholic fatty liver disease is present in 90% of liver biopsy specimens taken during bariatric surgery.
All these facts and figures urge for a safe and reliable solution like a keyhole sleeve gastrectomy provided at Astra Medcity Kochi Kerala.
A number of weight loss operations have been devised over the last 40-50 years. The three main treatment options for morbid obesity are a lifestyle change, pharmacotherapy and surgery. Lifestyle change should involve restriction of calorie intake with an increase in exercise so that moderate weight loss can occur in the short term. However, the effects of these weight loss measures are not sustainable in the long term with 66%-90% of them regain weight after cessation of treatment. Best is going through a keyhole sleeve gastrectomy or laparoscopic surgery to bring the increased BMI index to normal condition.
Bariatric surgery indicates a set of surgical procedures on the gastrointestinal tract originally designed to reduce intake and/or absorption of nutrients by reducing the stomach’s size or bypassing a part of the small intestine, or by a combination of the above. Bariatric surgery offers the only means of delivering sustained weight loss. Comorbidity resolution after bariatric surgery occurs in 75–90% of cases, particularly for insulin resistance, hypertension and respiratory disorders. The number of bariatric procedures performed worldwide has increased considerably over the past few years for weight loss.
Laparoscopic or keyhole sleeve gastrectomy is the simplest form of surgery for overweight or morbidly obese patients. In this keyhole surgery, the stomach size is restricted to reduce food intake. Sleeve gastrectomy has no or minimal long term nutritional consequences. Weight loss following sleeve gastrectomy is maximum in the first 3 months and continues up to 1-year post laparoscopic sleeve gastrectomy. This surgery can be done by single incision bariatric surgery method as well. About 60 5 excess body weight is lost following this bariatric surgery- laparoscopic sleeve gastrectomy.
The Roux‐en‐Y gastric bypass (RYGBP) is another most common bariatric surgery done for morbidly obese patients after the keyhole sleeve gastrectomy. This effectively reduces the size of the meal that the patient is able to ingest. Additionally, the bypass causes some degree of malabsorption. Gastric bypass achieves excellent initial weight reduction, with a mean EWL of nearly 70% at 1 year. Gastric bypass is also effective in the treatment of “super” obese patients with a BMI of ⩾60 kg/m.
Laparoscopic Minigastric bypass is a new development is the laparoscopic mini‐gastric bypass procedure, a modification of the older loop gastrojejunostomy. Mini gastric bypass a technically simpler modification of Roux Y Gastric bypass. Laparoscopic mini‐gastric bypass procedure has been shown to achieve EWL of >70% at 2 years, equivalent to RYGBP but long‐term data are not yet available. It is a simpler and easier laparoscopic procedure to perform than RYGBP; however, long‐term data are still needed to determine whether it can match RYGBP in terms of sustained weight reduction, and also whether there is an increased incidence of long‐term complications such as biliary reflux, marginal ulceration and reflux oesophagitis.
Bariatric surgery can effectively contrast such physiologic, compensatory changes and therefore results in greater and more durable weight loss than any other weight reduction therapy. All these surgeries for weight loss are being done at our hospital at Kochi Kerala under the guidance of veteran laparoscopic surgeon Dr. K Prakash. Ask for Laparoscopic weight loss surgery or the keyhole sleeve gastrectomy from us, it’s now affordable and sage.
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