Bariatric Surgery

ABSTRACT: BARIATRIC SURGERY: OUR EXPERIENCE




      Ironically, while a significant number of individuals die of hunger in the world every year, surgery is required to be performed for another significant number for excess calorie intake. For the first time in history in the developed world, the number of overweight and underweight individuals is about the same. Even in India the problem in the metros and big cities is becoming alarming.

      40 patients (n=40) with obesity (BMI > 40 kg/m2 with or without co-morbidities and BMI > 35 kg/m with co-morbidities) underwent laparoscopic sleeve gastrectomy at our centre. Work-up included complete hematological workup, cardiology workup with minimum echocardiography, pulmonology workup to include PFT and sleep studies in cases of OSA and endocrinology workup to include HBA 1c, fasting insulin, cortisol and thyroid function tests. The Greeks were the first to recognize obesity as a medical disorder. Hippocrates wrote that "Corpulence is not only a disease itself, but the harbinger of others". Sushruta (6th century BC) related obesity to diabetes and heart disorders. He recommended physical work to help cure it and its side effects. Historically bariatric surgery has met with decades of skepticism and criticism, even within the surgical community itself. The term “morbid obesity” was coined by surgeon J. Howard Payne in the early 1960s to highlight that concept and convince insurance companies to reimburse the surgical treatment of obesity.

DEFINITIONS

In children, a healthy weight varies with age and sex. Obesity in children and adolescents is defined not as an absolute number, but in relation to a historical normal group, such that obesity is a BMI greater than the 95th percentile. In adults, the commonest and currently most reliable means of assessing obesity is by BMI. BMI is calculated by dividing the subject's weight in kgs by the square of his or her height in meter square.   It is given in the...