Apollo introduces structured bariatric & metabolic surgery
Obesity is recognised as a disease nowadays. It is not only because of overeating. The cause of obesity is multifactorial.
Obesity is measured by the Body Mass Index (BMI) . BMI = Weight in Kg / Height in meter2 i.e, if someone is 80 Kg and height is 1.7 meters the BMI is 27.68. Normal BMI is 18.5-23.5.
Obesity is the causes of early onset of diabetes, hypertension, ischemic heart disease, sleep apnea, non-alcoholic fatty steatosis (fatty liver), osteoarthrosis if both knees, increased chance of developing cancer, infertility, poor lifestyle and so on.
This is how, obesity is a disease and causes many life threatening complications resulting in early death by 15-20 years.
Obesity needs structured treatment. It is not only medication or the surgery. It requires a complete team of physician, endocrinologist, dietitian, psychologist and of course surgeons and anaesthesiologists.
Initially these patients are counseled about the problem and dietitian gives them proper diet. They are followed up monthly for 6 months. If they can decrease their weight reasonably and maintain it, they are directed to continue that. The indication for surgical treatment is BMI 33.5 with one low morbid diseases e.g. diabetes or BMI 30.5.
Roux-En-Y Gastric Bypass Surgery is the gold standard for these patients.
The procedure has two parts.
Part one: Making a small pouch in the stomach — the surgeon divides the stomach into a large portion and a much smaller one. Then, in a process sometimes called "stomach stapling," the small part of the stomach is sewn or stapled together to make a pouch, which can hold only a cup or so of food.
With such a small stomach, people feel full quickly and eat less. This strategy is also called "restrictive," because the new stomach size restricts how much food it can hold.
Part two: Bypass — the surgeon disconnects the new, small stomach pouch from the majority of the stomach and first part of the small intestine (the duodenum), and then connects it to a part of the small intestine slightly farther down (the jejunum).
After a Roux-en-Y, food passes directly from the stomach into the jejunum, bypassing the duodenum. This curbs your absorption of calories and nutrients.
Stomach stapling and Roux-en-Y are typically done during the same surgery and together are called a "Roux-en-Y gastric bypass."
Laparoscopy is used to do this operation. It is nearly peerless operation and patient starts to drink from the next morning and can walk. Patient is discharged within 72 hours from the time of operation, although this operation has standard risk as other operations.
After operation, these patients lose weight gradually and over 1 and 1.5 years, they lose 60 to 70% of their excess weight. They are given instructions to maintain a disciplined life, good food habit and regular exercise.
Apollo Hospitals Dhaka has recently opened a Comprehensive Structured Metabolic Surgery Unit where patients get all the services in one point. In abroad, the cost of this surgery is about 50 thousand dollars, where as its only 10 thousand dollars at Apollo Hospitals Dhaka.
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