• Rukmani Birla Hospital,Gopalpura Bypass Road, Near Triveni Bridge,Gopalpura,Jaipur – 302018.

Category Archives: General and Minimal Invasive Surgery

How does bariatric surgery help you lose weight

A bariatric surgical procedure results in weight loss by making changes to an individual’s digestive system. Such a procedure restricts the amount of food held by the stomach, causing malabsorption of nutrients. Often, these surgeries also cause hormonal changes in the individual. Typically, this surgery is performed when diet and exercise have failed to yield results or when obesity poses serious health problems.

As opposed to dietary weight loss plans which can often lead to regaining weight, bariatric surgery affects hormone production such that long-term and sustainable weight loss is achieved.

What is bariatric surgery?           

Bariatric surgery is a term used to refer collectively to several types of weight loss surgeries that either limit the amount of food intake or reduce the body’s ability to absorb nutrients, or both.

This type of surgery is performed to help lose excess weight and reduce the risk of life-threatening conditions such as high blood pressure, heart disease, diabetes, etc. Typically, this surgery is done only after an individual has tried to lose weight through diet and exercise.

Generally, bariatric surgery is an option for obese individuals with a body mass index (BMI) of higher than 40 or those that have serious weight-related health problems. However, bariatric surgery isn’t meant for everyone who is overweight. You must meet certain medical guidelines to qualify for the surgery.  Additionally, you may be asked to participate in long-term follow-up programs that involve the monitoring of nutrition, lifestyle, and medical conditions.

Types of bariatric surgery

The following are some of the most common types of bariatric surgery –

  • Roux-en-Y Gastric Bypass: This is an irreversible surgery that works by decreasing the amount of food intake by the stomach and the absorption of nutrients in the body. In this procedure, the surgeon cuts a part from the top of the stomach, making a sealed off pouch that can hold just about an ounce of food. This pouch is then sewn directly into the small intestine. Food, once swallowed, passes from the small pouch to the small intestine, bypassing the rest of the stomach.
  • Sleeve Gastrectomy: In this procedure, multiple incisions are made on the upper stomach, thus effectively reducing 80% of the entire stomach. A long, tube-shaped pouch is left behind, which doesn’t hold much food. Additionally, hormonal changes are also induced that further aid weight loss by reducing appetite.
  • Biliopancreatic Diversion with Duodenal Switch: In this two-part and less common surgery, a procedure similar to a sleeve gastrectomy is performed first. Then, the end portion of the intestine is connected to the duodenum, bypassing the majority of the intestine. This procedure both limits food intake and reduces nutrient absorption. While it is very effective, it has greater risks such as malnutrition and vitamin deficiencies. Thus, it is typically recommended to individuals with a BMI of more than 50.

The best weight-loss surgery for you will depend on many factors – dietary habits, BMI, health issues, and the risks involved in each procedure.

How bariatric surgery results in weight loss

To put it simply, bariatric surgery causes weight loss in two primary ways –

  • Restriction – Physically limiting the amount of food the stomach can hold
  • Malabsorption – Bypassing or shortening part of the small intestine to reduce the body’s calorie and nutrient absorption

Combined with a comprehensive treatment plan, this procedure can be an excellent tool to facilitate long-term weight loss and boost the patient’s health. Moreover, bariatric surgery has been proven to help improve many obesity-related conditions such as type 2 diabetes, cardiovascular conditions, high blood pressure, etc.

Bariatric surgery works by changing the anatomy of the gastrointestinal tract – the stomach and digestive system – and/or causing different hormonal changes in the body. By changing the anatomy, bariatric procedures modify the production of some intestinal hormones such that and appetite is reduced and the patient experiences a feeling of “fullness” with less food intake.

When significant weight loss occurs, other changes in the body take effect, that further reduce defects in fat metabolism. The patient is likely to find themselves engaging in more physical activity, which improves the body’s ability to burn fat. Massive weight loss also reduces hormones such as insulin and cortisol, reducing the uptake and storage of fat in the body.

In addition to improvements in health, surgical weight-loss improves an individual’s quality of life by positively affecting self-esteem, mobility, social interactions, psychological conditions, and sexual functions. Thus, bariatric surgery can prove to be a useful tool to break the vicious cycle of weight gain and achieve long-term weight loss.

What to expect after bariatric surgery

After bariatric surgery, patients are typically not allowed to eat for a couple of days to allow the digestive system time to heal. After this, they are put on a specific (mostly liquid and puree) diet for some weeks. Patients must also get frequent medical checkups to monitor their health in the initial months.

DO YOU SUFFER FROM PILES – KNOW ABOUT THE LASER SURGERY TREATMENT

Piles, also known as haemorrhoids are a compilation of inflamed and swollen tissues and veins in the anal canal that have blood vessels, support tissue, muscle, as well as elastic fibres. Piles are caused due to extreme constipation, excessive diarrhoea, straining while passing stool or lifting heavy items. It can also be caused due to pregnancy or in people who are obese. Moreover, piles can also occur due to family history or genes. Piles can vary in size and could be located inside or outside the anal canal. In most cases, piles do not cause any symptoms and resolve on their own, whereas there can be cases where piles cause extreme discomfort and pain, which might require medical intervention either in the form of medicines or surgery.

Some common symptoms of piles are:

  • Hard, painful lump around the anus
  • Feeling full even after passing stool
  • Blood after a bowel movement
  • Red, itchy and swollen area around the anus
  • Pain while passing a stool

Conditions, where piles reach an intense level, will show symptoms such as:

  • Uncontrollable bleeding from the anal
  • Infection
  • Loss of control on bowel movements
  • Formation of a new channel between the skin near the anus and inside the anus
  • Blood clot or infection due to loss of blood supply to the haemorrhoid

Piles can be classified into four categories depending on the severity, namely:

  • Grade 1: These are invisible, minor inflammations inside the lining of the anus.
  • Grade 2: These are larger than Grade 1 piles and are found inside of the anus. These can come out during the passing of stool but will return easily.
  • Grade 3: These are painful and are seen hanging from outside the anus. These can be re-inserted easily.
  • Grade 4: These are extremely painful, sore small lumps that remain outside the anus and cannot be pushed back in without treatment.

That said, there are multiple treatment options to cure the problem of piles depending on the grade of the problem and resultant symptoms. The most definitive form of treatment that has been used over the years is a surgery that involves removing the affected areas by cutting them. This is a painful, long and often time risk procedure that will also need you to get multiple dressings and revisit the doctor time and again. Moreover, despite the surgery, the chances of recurrence of piles still remain. However, with new advancements in medical technology, the problem of piles can be treated by laser surgery which is less invasive, has shorter recovery time, low chances of complications or infections, and significantly less painful. Laser surgery treatment uses a high-energy light to safely cut, shrink or burn the piles. Some of the most effective laser treatments applied today by doctors include:

Haemorrhoidal LASER Procedure (HeLP): Haemorrhoidal LASER procedure is a pain-free outpatient form of treatment that is performed without anaesthesia to effectively cure piles of grade 1, 2 and 3. The technique involves identifying terminal branches of the upper rectal artery by using a Doppler transducer, which is placed on a proctoscope. Post identification of the terminal branches, heat from electric current is directed by diode fibre LASER – to destroy the abnormal tissue and cause interruption of blood flow to the haemorrhoidal. The technique is repeated circumferentially per clockwise positions. This technique is simple, less time consuming, safe and easy to perform. It has been very effective in minimising complications and symptoms for people suffering from piles up to grade 3.

Laser Haemorrhoidoplasty (LHP): Laser Haemorrhoidplasty is used to treat advanced piles by placing patients under anaesthesia and then using the laser energy centrally in the haemorrhoidal node to shrink the piles. This technique uses controlled laser energy that obliterates the nodes internally while safeguarding the mucosa and sphincter structure. The procedure closes the arteries evading the haemorrhoidal cushion, reduces the tissues in the haemorrhoidal node, ensures maximum preservation of the muscle, anal lining, and mucosa, as well as restores the natural anatomical structure. Additionally, fibrotic reconstruction helps in the generation of new tissue to keep the mucosa in the underlying tissue, preventing relapse or recurrence of piles. The procedure involves no use of foreign materials such as clamps and does not cause any wounds in the area. The healing process is fast since there are no incisions, stitches or wounds. Moreover, the pain post the treatment is bearable and the recovery time is fast; most patients resume normal activities within a few days.

Laser Hemorrhoidectomy: In this technique, the doctor passes a laser fibre through the opening in the anal and then directs controlled laser energy to the haemorrhoidal mass. The laser energy reaches the submucosa area, causing shrinkage of the haemorrhoidal mass. The controlled use of laser energy protects the surrounding tissues and ensures minimal bleeding along with quick recovery time. The procedure is followed by a fibrosis reconstruction that helps in the generation of new tissues.

FILAC technique: This procedure involves the treatment of advanced piles by placing the patient under anaesthesia and then centrally directing the energy of the laser radially 360° into the haemorrhoidal node; the technique applies laser energy as per the size of the haemorrhoid to avoid damaging the anoderm or mucosa.

Most laser surgeries are minimally-invasive, non-complicated and easy procedures that help cure the problem of piles, while ensuring minimum after effects, low risk, lesser pain, shorter recovery time and low relapse probability.

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