Bariatric surgeon in Delhi NCR INDIA

Dr ARUN PRASAD
Senior Consultant, Indraprastha Apollo Hospitals

Dr MANISH BAIJAL
Director - Max Institute of Minimal Access, Metabolic & Bariatric Surgery

Dr. NITIN JHA
Senior Consultant, Fortis hospital

Dr MANISH JOSHI
Advanced Laparoscopic Surgeon, Bangalore

Dr A P PREM
General Surgeon, Apollo hospitals Chennai
Overview – What is Bariatric Surgery second opinion in delhi, India ?
Bariatric surgery involves making surgical changes to your digestive system in order to facilitate in metabolism which in turn helps in reducing your weight. It is also known as weight loss surgery.
Bariatric surgery are helpful in treating other co morbidity conditions like type diabetes, sleep apnea, high cholesterol and high blood pressure among many other diseases.
Why it is recommended by doctors?
To reduce the heavy weight which isn’t budging even after a healthy diet and physical exercises. Also to reduce the discomfort caused by obese related conditions
- heart attack or cardiovascular disease,
- high blood pressure,
- joint pains
- infertility issues
- and several other conditions
    Who qualifies for the surgery?
- A person with Body Mass Index (BMI) 40 or above 40 which counts in extreme obesity.
- if you have other severe conditions like type 2 diabetes, high blood pressure, high cholesterol or severe sleep apnea along with obesity.
     These are just an option if you fit above condition, you still will have to go through a screening to
     see if you can handle the surgery. The doctor will explain you every procedure related to surgery,
     the costs involved and the level of commitment it will require.
Types of surgery
1. Second opinion in Sleeve gastrectomy
     This surgery is performed to reduce the stomach size to 20%, rest of the part is removed. Hence,
     stomach remained is in shaped of a banana or a sleeve from which this procedure draws its
     name.
Procedure
- The stomach is reduced by surgically removing a large chunk of it.
- Surgical stapler is used to attach the remaining stomach.
     The procedure permanently reduces the size of the stomach. This procedure is irreversible.
How it works
     The new stomach occupies less food, you feel full and the calories intake drops making an impact on metabolism. Soon the body adapts to it and maintain healthy blood sugar control.
Pros
- simple surgery, short surgery time, fast recovery.
- can undertake surgeries with other serious medical conditions
- helps in overcoming severe obesity.
- effective in weight loss and eliminates other comorbidity related to obesity.
Cons
- Non reversible nature of surgery
- risks are involved, no weight loss in some cases
- less effective than bypass surgeries

2. Second opinion in Gastric Bypass
     The Roux-en-Y gastric bypass commonly denoted as gastric bypass is the most techniques for weight loss and widely recommended by the surgeon. It is also refined over the years and is very effective in obesity and related conditions. “Roux-en-Y” is french terminology meaning “in the shape of Y”.
Procedure
The stomach is divided into two parts, one small part (like a small pouch) and a large part. The intestine are them divided and connected to the small part bypassing the large portion of the stomach. Meaning, the food will pass through the smaller portion of the stomach directly to the intestine bypassing the bigger portion of the stomach.
How it works?
Like the sleeve surgery here to the size of the stomach which is in use is reduced and hence lesser calories are ingested in the digestive system. The new structure in the digestive system reduces hunger and the weights comes under control.
The improved hormones and metabolism process helps in improving diabetes. It also improves the heart related problems and the symptoms disappears even quicker than the weight loss.
Pros
- Reliable, trusted procedure, tested and improved over time and has long lasting effect.
- Effective on other conditions like diabetes, blood pressure, cholesterol and other obesity induced problems.
Cons
- Technically complex when compared to other bariatric surgical procedures
- deficiencies of vitamins and mineral post surgery, more than other surgeries.
- risk of developing ulcer on use of tobacco or any other complications
- can cause “dumping syndrome” a condition where one feels exhausted after eating especially sweets.

3. Second opinion in Adjustable Gastric Band (AGB)
     As the name suggest it uses a band made of silicone that is implanted on the top part of the
     stomach to restrict the intake of nutrients from the food we eat. This surgery is performed using
     laparoscopic techniques and is considered the most safe surgical procedure out of all the
     bariatric surgery with mortality rate as low as 0.05%.
     But it also has less impact on the weight loss and other related conditions compared to other
     surgeries. Therefore, the use AGB has been declining rapidly.
Procedure
     The silicone band is tied at the top of the stomach which creates a pouch like structure at the
     top of the stomach.
     Once the band is implanted your doctor can adjust the band tightness. This does not require any
     surgical technique. It is adjusted based on your symptom.
How it works?
     The band restricts the food in the pouch for a longer time. With food in your stomach you feel
     full for long.
     Afterwards, the food comes to lower stomach where it gets digested just like before. The size of
     opening of the band is controlled by the surgeon. If the size is big then it will not be effective
     else it may affect your health. But with time the surgeon gets a hang of the optimal size of the
     opening. It is not effective against Type 2 diabetes.
Pros
- Lowest risk of any complication post surgery.
- No surgically removing of the stomach or intestine.
- Small and fast surgery with patient returning home the same day of surgery.
- Band is removable.
Cons
- Numerous doctor visits during the first few months for adjusting the band.
- Slower and less effective compared to other surgeries
- risk of band getting displaced or developing swallowing issue.
- Foreign entity sits inside the body for long period of time.

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Risks involved
Every surgery major or minor comes with short term or long term risks. Short term risks associated with bariatric surgery are as follows:
- Internal bleeding
- infection or reaction to anesthesia
- Blood clotting
- excessive vomiting
- other health related problems like breathing problems
Long term risks may include
- worsening of bowel movement
- formation of gallstones
- developing conditions like hernias
- experiencing diarrhea, vomiting, nausea or dizziness
- weakness or fatigue
- ulcers or infection in digestive system
- need for another or second surgery.
Preparation before surgery
The surgeon will help you in preparing by giving you instruction to carry out specific lab test and examination. Prescription will be provided to you to follow before the surgery and avoid certain types of eatables.
You’ll have to give up tobacco, smoking and drinking. You’ll also have to plan out your action before and after surgery.
The surgery will be under the influence of general anesthesia and could take several hours. Accordingly, arrange for assistance at home.
Although, it will be laparoscopic surgery which needs small incision in the abdomen. Hence, the recovery is fast. But it is not recommended to everybody some may need to have open surgery which increases operation time as well recovery time.
Note: If you do not follow the recommended changes by the surgeon to your lifestyle then you may gain the weight again despite the successful surgery.
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01. Organization !
We are a group of surgeons from different surgical specialities and not a intermediate/ middleman medical website company just in the business of giving second opinion.

02. Our principles !
We want to re-establish the dwindling lack of trust between the doctors and patients with our honest second opinion.

03. No financial expectation bias !
For your second opinion, We choose surgeons who practice in a city away from your place, so they won’t have any expectation that you would be coming to them for surgery – so no bias of financial expectation

04. We are not a Hospital !
Lot of Hospitals give second opinion. Their opinion cannot be unbiased as they would definitely be benefited if they advise surgery and they would expect you to be coming to them as patients. Whereas we are not a hospital.

05. Surgeons preferred by other doctors !
We choose the surgical panel team very carefully –after taking suggestion from other fellow doctors as to whom they would prefer if someone of their own family requires a surgery.
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