8 cims bariatric (obesity) surgery · 6 3 how to measure obesity? obesity is determined by...
TRANSCRIPT
CIMS Bariatric (Obesity)
Surgery
Care Institute of Medical SciencesCIMS
At CIMS... we care
R
NABL
Ambulance & Emergency : +91-98244 50000,
97234 50000, 90990 11234
+91-+91-
CIMS Hospital : Nr. Shukan Mall, Off Science City Road, Sola,
Ahmedabad-380060. Ph.: +91-79-2771 2771-75 (5 lines)
For appointment call : +91-79-3010 1200, 3010 1008
Mobile : +91-98250 66661 or email on
email : web :
[email protected] www.cims.me
Green HospitalCare Institute of Medical SciencesCIMS
At CIMS... we care
R
Ambulance & Emergency : +91-98244 50000, 97234 50000, 90990 11234
18
Dr. Chirag Thakkar
Dr Jayant K Jhala
GI, Laparoscopic & Obesity SurgeonMS, MRCS Ed
Mobile : +91-84693 27634Email :
MS, FMAS, DLS, Fellowship-Hepatobiliary & Liver TransplantationConsultant Surgeon - Surgical Gastroenterology,
Hepatobiliary & LaparoscopyMobile : +91-97129 97096
Email :
72
What is Obesity?
Obesity is a life-long progressive, life threatening condition
marked by the excess accumulation of body fat, which can
significantly reduce life expectancy. When weight reaches
extreme levels, it is called MORBID OBESITY and is a chronic
condition with numerous medical, psychological and social
consequences.
Finding out if you are obese is simple; you calculate your
Body Mass Index or BMI. Obesity is also defined by waist size
- over 90 cm in males and over 80 cm in females.
How can Obesity affect you?
Obesity is rarely just a physiological problem . This disorder
has far reaching effects; physiological, psychological and
social. On the physical front, obesity can lead to several
complications that could be fatal or incapacitating if left
untreated.
Some of the most common diseases that are directly and
indirectly linked to obesity are:
u Type II Diabetes
u Heart Disease
u Hypertension
u Hypercholesterolemia
u Liver and kidney disorders
u Joint Pain/Osteoarthritis/Gout
u Respiratory disorders
u Gastro-esophageal reflux disease
u Infertility
u Certain cancers
u Depression and anxiety disorders
u Sleep Apnea
months after Bariatric
Surgery. However obese
female with infertility gets
significantly increased
c h a n c e s o f g e t t i n g
pregnant after weight loss
surgery.
Long-term follow-up
Over time, you will need
p e r i o d i c c h e c k s f o r
anaemia (low red blood cell count) and vitamin B12, folate
and iron levels. Follow-up tests will initially be conducted
every 3 to 6 months, or as needed and then every 1 to 2
years. Follow-up care is recommended for life.
Life Long Commitment:
To maintain weight loss after the surgery, you have to
continue to eat less, change your dietary habits and increase
physical activity. Weight reduction surgery helps you in
changing your food behaviour by giving early satiety after a
small meal and providing prolonged feeling of fullness so
that you can adhere to the dietary control. It also makes
adhering to the physical activity much easier. No body else
than an obese person can understand the different problems
of performing physical activity. Weight reduction with
surgery certainly helps in following the diet and exercise.
what it does not do is change the behaviour pattern , so it is
very important for patients to understand that life long
commitment from their side is the most important aspect of
the management of obesity.
36
How to measure Obesity?
Obesity is determined by calculating body mass index (BMI),
which is calculated by the weight in kilograms divided by
height in meters squared.
How to manage Obesity?
Obesity can be treated. But it involves more than just
swallowing a pill or sticking to a diet. It needs a multi-
disciplinary assessment involving a coordinated approach by
different specialists such as dietician, endocrinologist,
psychologist, internist, cardiologist, family doctor, bariatric
surgeon.
What is Bariatric (Obesity) Surgery?
Bariatric (Obesity) surgery, or weight loss surgery, includes a
variety of procedures performed on people who are obese.
Weight loss is achieved by reducing the size of the stomach
through removal of a portion of the stomach (sleeve
gastrectomy) or by resecting and re-routing the small
18.5 - 24.9
Body Mass Index (BMI)
Normal Overweight Obese Severe Obesity
25 - 29.9 30 - 34.9 35 - 39.9
Weight in kilograms2BMI = (kg/m )
2Height in meters
MorbidObesity
> 40
Obesity Management at CIMS
CIMS provides a comprehensive, multidisciplinary
approach to care for the evaluation and treatment of
Obesity. We offer a unique, integrated Patient-
Focused Team Approach that meets patients' needs
through every step of the process.
At CIMS the highly skilled and committed team gives
you the best and the latest options for Bariatric
surgery so you can get back to your normal life with
more self-confidence.
LIFE AFTER SURGERY
Diet
The modifications made to your gastrointestinal tract will
require permanent changes in your eating habits that must
be adhered to for successful weight loss. Most important is
that you strictly follow your surgeon's recommended
guidelines.
Birth control and pregnancy
It is strongly advised that women of childbearing age use the
most effective forms of birth control during the first 16 to 24
54
intestines to a small stomach pouch (gastric bypass surgery).
Why should I consider Weight Loss Surgery ?
Because it works! Surgical treatment for obesity is the ONLY
treatment that reliably produces significant and sustained
weight loss. People with clinically severe obesity are at great
risk for developing many associated medical conditions.
Research has shown that surgical treatment results in
significant weight loss and improvement in most problems
associated with obesity. Surgical treatment for clinically
severe obesity has been endorsed by the National Institutes
of Health, the World Health Organization, the American
Heart Association, the American Dietetic Association, and
the American Obesity Association.
Does my weight alone justify such extreme measures?
Yes. Morbid obesity is an independent risk factor for
premature death, with the risk rising as the BMI increases.
People with a BMI of 30 have a relative risk of dying early that
is 1.3 times greater than normal weight individuals. By the
time the BMI is 40, the risk is close to 3 times as great.
INTRAGASTRIC AIR BALOON
An air balloon is implanted through
the endoscopic route in only around
30 minutes without the need to
hospitalize the patient. This
procedure of implanting is non
surgical and minimally invasive thus
reducing post implantation nausea,
vomiting and the feeling of pain.
How it works to help you lose weight?
Intragastric Air Balloon is filled inside the stomach to create
short term and rapid weight loss. It promotes a sensation of
having eaten too much
after a little meal and
thus loses weight at a
fast rate. This balloon
is temporary and has
to be extracted after
six months.
The Vertical Sleeve Gastrectomy (VSG) generates weight loss
solely through gastric restriction (reduced stomach volume).
In VSG approximately 2/3rd of the stomach is stapled off
along its greater curvature, leaving behind 1/3rd stomach
along lesser curvature, which is roughly the size and shape of
a Banana or Sleeve.
This operation does not involve any “rerouting” or
reconnecting of the intestines. Hence it is technically a
simpler operation than the gastric bypass.
How it works to help you lose weight?
Food absorption is normal, with no malabsorption. It is
known to reduce hunger because Ghrelin (hunger
stimulating hormone) producing part of stomach is
removed. Provides satiety with small amount of food and
unlike gastric band & gastric bypass, patients feels full with
liquids as well.
Under this procedure, a small stomach pouch is created and
section of the small intestine is directly attached to the
pouch. By creating a smaller stomach pouch, a Gastric
Bypass limits the amount of food that can be eaten at one
time, so you feel full sooner and stay full longer. It also causes
your body to absorb fewer calories.
How it works to help you lose weight?
As you eat less food and absorb fewer calories, your body will
stop storing excess calories and start using its fat supply for
energy.
SLEEVE GASTRECTOMY
GASTRIC BYPASS