“Aster Bariatrics - we will make you slim” is an exclusive super specialty division which deals with the problem of morbid obesity at Aster CMI Hospital, Bangalore. The centre is well established having the most experienced bariatric and other specialists of international repute.
Obesity is a non-communicable disease reaching epidemic proportions worldwide, due to various causes like genetic, environmental and behavioural. Childhood and adolescent obesity is an offshoot of modern day life style of less exerciser and more intake of junk food or high calorie food. There is an urgent need to educate the public on importance of healthy life style and the havoc created by fast food and junk food.
The human body is structured to bear certain amount of weight and if the weight remains excessive for years together, it damages many organs in the body. The organs like pancreas, blood vessels, heart, lung, knee joint, back etc. have to bear the brunt of excess body weight and gradually they fail causing various diseases. The morbid obesity is associated with more than 30 diseases and the most common of them is diabetes mellitus. Some of the other diseases caused by obesity are hypertension, high cholesterol, hear problem, sleep disturbances (sleep apnoea), excessive snoring, leg problems, irregular menses, poly cystic ovarian disease, infertility, depression etc. In addition to this there are many social adjustment problem, marriage and divorce issues. No wonder that the obese person in his later part of life has to spend time visiting many specialists. It is a medically established fact that the life span of an obese person is less than that of a normal healthy person.
Weight reduction is not for cosmetic purpose; it is for the healthy, useful and productive living of an individual. By treating obesity we can control or cure almost all the diseases associated with this problem at one go. Controlling hunger and able to feel satisfied with less and healthy food is most crucial for weight loss. Unfortunately there is no injection or tablet which can control hunger and reduce substantial body weight. Diet and exercises when continued lifelong can keep the weight under control. Persons who are very obese cannot do effective exercises and hence you don't see them in a gym or park! Yoga and naturopathy are again lifestyle and behavioural changers. The problem is that no one can continue dieting and starve for their life!
Bariatric surgery or weight loss surgery is the most scientific way of losing weight in a healthy way. In this treatment modality certain alterations are made to the stomach and intestine which reduces hunger and makes one feel satisfied with eating less food. The weight loss is gradual and sustained so that in about 6 to 8 months' time one will show substantial weight loss. To be effective, as soon as the weight loss process begins, one should start daily exercises and follow a diet regimen prescribed by the nutritionist.
Bariatric surgery is being performed worldwide for more than 30 to 40 years. The recent awareness and popularity is because of the technological innovations. Now it can be performed by keyhole or laparoscopic methods without the need for any large opening or incision in the tummy. There is no big scar and hence not much of pain.
The obesity patients at Aster CMI Hospital are evaluated by a multidisciplinary team, following which, appropriate managementdecision is taken in consultation with the patient and family. Detailed counselling is done at various levels. Patients and family members are encouraged to ask questions and clarify their doubtsand apprehensions. They are also given all the reading materials pertaining to bariatric surgery. They can also interact with the patients who have undergone bariatric surgery earlier. The team also consists of: cardiologist,pulmonologist, endocrinologist, anesthetists, pain specialist, nutritionist & physiotherapist.
All surgeries are performed laparascopically (keyhole method). The patient is admitted on the night prior to surgery and given low molecular weight heparin to prevent any deep vein thrombosis. The surgery is done under general anaesthesia. The procedures performed are laparoscopic roux-en Y gastric bypass or sleeve gastrectomy or mini gastric bypass as decided and discusses with the patient and relatives during counselling. Re-do or revision bariatric surgeries and banded sleeve or bypasses are also performed when needed. At the end of the surgery the patients are given ultrasound guided nerve blocks so that there is no pain afterthe surgery. After 3 hours of observation in recovery room in operation theatre the patients are shifted to the wards. The patients are encouraged to walk after 3 to 4 hours. There will not be any drains or tubes. Patients will start taking liquids by mouth from the next day onwards and discharged in 48 hours after surgery. There are no sutures over the key holes and water proof dressings are put over the holes and hence patients can take bath daily. After a week later the dressings are removed.
Due to sustained improvements in techniques, staplers, laparoscopic equipment, surgeons experience etc. the bariatric surgery is as safe as any other laparoscopic surgery. The occasional problems of staple line leak, bleeding, infection etc. are managed appropriately
The best thing about surgery at Aster CMI Hospital is that patient are not bed bound and we encourage them to get back to their work as early possible- within a week or so. They can bathe daily, do their routine work and come back after a week to remove the dressings and get diet counselling. Then onwards they have to take multivitamins,calcium and other nutrients. It is very important to consume a high protein diet and daily exercise for 45 minutes. The weight loss occurs over the weeks gradually in a healthy way and in about 6 to 8 months the target weight loss is achieved. The patients are checked for any nutritional deficiency once in 4 months. Most of the patients can stop many of their diabetes and cholesterol medications and stop using CPAP machines for sleep apnoea.
It is our patients who encourage us to popularize this surgery at Aster CMI Hospital and they spread the news around and motivate and counsel others who are suffering from this crippling disease. Truly this is a life changing surgery bringing transformation in one's life.