In September 2001, the first ever bariatric surgery was performed in Mumbai by a team of enthusiastic and anxious team of surgeons at the Inlaks Hospital, Chembur. Besides Dr Ramen Goel, primary surgeon, the only other bariatric surgeon in the country Dr Shrihari Dhorepatil and 2 associate surgeons were part of this pathbreaking event. Extensive preparation including check lists of equipment and surgical do’s and dont’s preceded the actual event. Though first surgery had its set of hiccups, overall outcome was satisfactory.
Thus for the first time obesity, a so called medical disease could be managed surgically too. Best obesity doctors in Mumbai, in a subsequent conference, hailed the event and accepted the role of surgery in morbidly obese individuals. Within 2 years, the premier national healthcare institution Bombay Hospital, Mumbai started first ever obesity department in a private hospital under Dr Ramen Goel. Soon enough it was regarded as the best obesity hospital in Mumbai.
With continued knowledge sharing by pioneer bariatric surgeons, more surgeons took upon challenge and started bariatric programs at other hospitals like Breach Candy, Saifee Hospital etc. In the first decade, few patients opted for bariatric surgeries due to apprehensions about safety and outcome efficacy. Eight surgeons across the country founded an association of bariatric surgeons called ‘Obesity Surgery Society of India’, which laid foundation of academic growth of specialty.
Preferred surgical procedures continued to change over years. Vertical banded gastrectomy which were mostly done through open route went out of favour with the advent of minimally access or keyhole bariatric approach. Surgeons started performing more gastric bands, sleeve gastrectomy, roux-n-y gastric bypass and mini gastric bypass surgeries because of lowered risk and better acceptance.
Similarly surgical indications changed overtime due to better understanding of diseases and related complications. From a purely weight loss reason in over 40 BMI patients, the cut-offs were reduced to 35 BMI for Indian patients even in absence of any associated diseases. While for uncontrolled diabetes surgery can now be offered even at 27.5 BMI.
Various healthcare accreditation and rating agencies started evaluating performance of bariatric surgeons and institutions. Top obesity surgeons in Mumbai and specialty wise hospitals were identified and honoured by media outlets.
Recognising the efficacy and societal need, bariatric surgery became the only obesity treatment modality which is insurance covered, reimbursed by corporates and offered free to government employees and their dependants.
Additionally creation of a national bariatric registry, university and OSSI fellowship program, creation of specialty courses through National Board of Examinations and launch of an international bariatric journal – all together it has been a dream journey in just 20 years.