Archive for June 2014

A Newer Bariatric Surgery – Simpler, Safer and more Effective

Bariatric surgery – a weight loss surgery- is becoming an increasingly popular option for patients who are obese and diabetic. It not only helps to reduce weight and resolve diabetes, it also helps patients with arthritis, snoring, infertility substantially. The dramatic results and benefits it produces is the major reason for its popularity. The method in which it achieves this outcome is based on the fact that it reduces the capacity of the stomach and hence eating less can satisfy the patients. The consequent calorie deficit drives the body fat to melt to supply calories. This fat meltdown translates into remarkable weight loss.


So far, the more popular bariatric procedures utilized this principle of food restriction that worked well with many patients.  Be it a Lap-band, Sleeve Gastrectomy or a Gastric Bypass, all worked mostly on this principle. The procedure like Lap- Band are simpler but less effective whereas a Bypass is more effective but technically more difficult.  A procedure with advantages of both would be the optimum surgery.


Recently, a procedure that is effective and simple has been developed that utilizes the principle of malabsorption (causes only part of the food to be absorbed). This has joined the armamentarium of bariatric surgery. It is called the Mini Gastric Bypass.


The Mini Gastric Bypass was developed by an American Surgeon, Dr. R Rutledge and has significant advantages. It is simpler to do, takes less time- less than an hour mostly and involves a single day hospital stay.


It is claimed that this surgery works even after a few years when most of other procedures have stopped their restrictive potential significantly. This is important especially in India, where patients cannot think of a second surgery because of the costs and risks involved.


Additionally, if patients wanted the procedure to be reversed for any reason, it is possible.


Since the procedure works on the principle of malabsorption and relies less on restriction, the patients can eat and drink more- an effect that may be more than welcome to many food-loving patients. Since we Indians have primarily a cereal-based diet, this may come real handy.


The surgery has been accepted widely by thousands of patients in the last fifteen years and has become the procedure of choice for many.

Watch video of Bariatric Surgery on YouTube.

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Surgery for Hiatus Hernia


What is a Hiatus hernia ?

In a hiatus hernia, a part of the stomach that should normally be in the abdomen protrudes through the diaphragm into the chest (See picture). This hernia allows food and acid abnormally to travel upwards and may produce symptoms.


What are the symptoms in Hiatus hernia ?

These individuals experience heartburn when acid produced in stomach enters the chest. They also experience the distressful symptom of regurgitation (feeling of food coming up in the throat) when food travels into the chest due to this wide defect. Some hiatus hernias can lead to dysphagia (difficulty in swallowing) too.


What causes a Hiatus Hernia ?

Most of the time, the cause is not known. A person may be born with a larger hiatal opening. Increased pressure in the abdomen such as from pregnancy, coughing, or straining during bowel movements may also play a role. Being overweight and obese is a definite risk factor for hiatus hernia.


How is a Hiatus Hernia Diagnosed ?

A hiatal hernia can be diagnosed with a specialized X-ray (using a barium swallow or with endoscopy.


What is the treatment of Hiatus Hernia ?

Most heartburns can be controlled by dietary changes and medicines. Surgery is required if these measures fail.


When Is Hiatus Hernia Surgery Necessary ?

Hiatus hernia surgery (laparoscopic fundoplication) is needed if symptoms of GERD and regurgitation cannot be controlled effectively by medicines or when there is complication of hernia.

Hiatal hernia surgery is performed as a laparoscopic procedure. It involves minimal pain and scars and one day hospital stay. The patient is spared the misery of life long treatment and therefore is the treatment of choice for many patients.

Watch video on YouTube on Laparoscopic Hernia Surgery.

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