1. Frequently asked questions (FAQs)

2. Frequently asked questions (FAQs) Dr. AparnaGovilBhasker Is the pre-operative high protein liquid diet necessary? Yes, it is essential to follow a high protein liquid diet prior to surgery. This helps to reduce the swelling on your liver. This makes the surgery easier for the surgeon and safer for the patient.

4. Laparoscopic Sleeve Gastrectomy: Laparoscopic sleeve gastrectomy is one of the commonest bariatric procedures performed across the world. In this procedure, a long and narrow tube of the stomach is created over a calibration tube. Almost two-thirds of the outer half of the stomach is removed. This procedure leads to restriction of food intake, early satiety, decreased hunger and increased gastric emptying. It leads to a weight loss of about 65 to 75% excess weight over a period of 18 to 24 months and significant improvement in obesity associated co-morbidities. 2. Laparoscopic Roux-en Y Gastric Bypass: Laparoscopic Roux-en Y Gastric Bypass is one of the oldest and time tested bariatric procedures. It is also known as the gold standard bariatric procedure. In this procedure a 30 to 50 cc pouch of stomach is created and the small intestine is re-routed to join the stomach pouch. Most of the stomach, duodenum and first part of jejunum is bypassed. The food enters the stomach pouch and then directly into the attached jejunum. This surgery leads to restriction of food intake, early satiety, decreased hunger, soHow many days before the surgery should I do my tests and investigations? Tests must be carried out atleast 2 weeks prior to surgery. In case any abnormalities come up during this period, it gives the doctor some time to correct them. Also, in case you need fitness from other specialists such as a cardiologist, chest physician, endocrinologist etc, it gives us enough time. Does someone have to accompany me during my hospital stay? Yes, one attendant, preferably a family member must accompany you during your stay in the hospital. Do I have to be on bed rest after bariatric surgery? No, infact we encourage you to start walking after 4 to 6 hours of your surgery. You can go to the washroom yourself. Even after getting discharged from the hospital, being active is recommended. There is usually no need for bed rest after this surgery. For how long does one need to be on liquid diet after bariatric surgery? One needs to be on liquid diet for about 15 days post bariatric surgery. Can I drink alcohol or smoke after bariatric surgery? Drinking alcohol, smoking or any other kind of substance abuse is to be strictly avoided after bariatric surgery. If you feel that you will not be able to stop smoking or drinking after the surgery, it is advisable to not undergo this surgery. There can be grave consequences later on. When can I go back to work after bariatric surgery? Most patients get back to work in a week’s time. Every patient is different and some may get back to work earlier and some may take a bit longer as well. Will there be hair fall after bariatric surgery? Some degree of hair fall is expected with any kind of weight loss be it due to dieting, exercise or bariatric surgery. This hair fall is transient and once the weight loss stabilises, hair growth increases. At times, excess hair fall may happen due to protein or iron deficiency. Proper nutritional supplementation can help in limiting hair fall. me degree of mal-absorption, early release of gastro-intestinal hormones like PYY and GLP-1 and bile acid alterations. It leads to a weight loss of about 70 to 80% over 18 to 24 months and significant improvement in obesity associated co-morbidities.

6. Will I get depressed after surgery? Most often we observe an improvement in the confidence levels of most patients. Weight loss and improved body image lead to positive changes in patient attitude. Yes, you will need to get used to smaller portions of food, but after the surgery your hunger and cravings will decrease considerably and your body will support you in your journey towards weight loss. It has been seen that patients who are on antidepressant medication before surgery, do not need to take those medicines after surgery. Very rarely do patients get depressed after surgery and in those cases, the in house psychologist will help you. Will I look very old and lose the charm on my face after surgery? Most patients experience rapid weight loss in the first year after surgery. Weight loss not only improves patient confidence but also increases the charm. Most patients find a renewed vigour to live life and enjoy their new life. Some degree of skin sagging does happen due to weight loss but it can be curtailed with regular exercise and weight training. Can I develop six pack abs after bariatric surgery? There is no limitation to what the human mind and body can achieve. Everything is possible; however, it depends on your age, clinical profile and the effort put in. I have undergone a liver or kidney transplant. Is bariatric/metabolic surgery advisable for me? Patients who have undergone liver and kidney transplant tend to put on weight due to corticosteroids and immunosuppressant drugs. Weight gain after transplant can have ill effects on the new liver as well and can lead to liver disease over a period of time. There are a few reports about bariatric surgery having been done on post- transplant patients but the reports are equivocal. In such cases every patient needs to be evaluated on an individual basis and the treatment has to be tailormade pertaining to the clinical condition of the particular patient.

7. I suffer from cirrhosis of liver. Is bariatric/metabolic surgery advisable for me? Liver disease is commonly associated with obesity. Fatty liver and NASH (non-alcoholic steato-hepatitis) are seen often in obese individuals. If they do not lose weight, a significant percentage of these patients may progress to cirrhosis of liver. Bariatric surgery in such patients is decided based on their Child-Pugh score. Patients with Child’s A cirrhosis may benefit with bariatric surgery but the decision has to be taken after consultation with the hepatologist. However, each patient is different and treatment must be tailormade as per the individual case. Patients with higher degree of cirrhosis are not recommended to undergo bariatric surgery. I am on regular dialysis for kidney failure. Is bariatric/metabolic surgery advisable for me? Dialysis per say is not a contra-indication for bariatric surgery. The decision for surgery is taken after consultation with the concerned nephrologist. Pros and cons of bariatric surgery need to be weighed before recommending it to such patients. However, the outcomes of a kidney transplant are said to be better if the patient has lost significant amount of weight prior to the transplant. Is bariatric surgery advisable for children and adolescents? Bariatric surgery can be advised for morbidly obese adolescents if they have completed their growth. This is assessed by certain tests. Surgery must be advised only in extreme cases and must be done after consultation with an endocrinologist. Bariatric surgery must strictly be avoided in young children and toddlers. Is there a risk of developing gall bladder stones after bariatric/metabolic surgery? Obesity is a pre-disposing condition for formation of gall bladder stones. Rapid weight loss can also predispose one to develop gall bladder stones. 8 to 10% patients tend to develop stones in the gall bladder after bariatric surgery. However, post-operative administration of urso-deoxycholic acid can reduce the incidence of stone formation. Will I need a plastic surgery for removal of sagging skin after bariatric surgery? Massive amount of weight loss can lead to sagging of skin in some patients. At the end of 2 years after bariatric surgery, it can be assessed whether the patient needs to undergo plastic surgery. A plastic surgery consult is scheduled at 2 years and the patient along with the surgeon can then take a decision regarding the same. If you are suffering from obesity and, you are looking for a weight loss surgery in Mumbai. Dr. AparnaGovilBhasker is best bariatric surgeon in Mumbai.