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Safe Bariatric Surgery – A Reality

Bariatric surgery remains the most effective and durable tool for weight loss or obesity-care even with an enhanced understanding of disease, nutrition, medicines and healthy living. Weight loss bariatric surgery not only helps in losing 70%-100% of extra weight, treat most associated. Co-morbidities but also helps in maintaining them for long duration unlike lifestyle interventions.

Most patients considering a bariatric surgery option look for the best weight loss surgeon in their respective city while others look for best bariatric surgeon in India because the main concern amongst patient and their family members is safety of the surgery.

Bariatric surgery has become increasingly safe over decades and years to an extent that now it is considered safer than even a lap gall bladder surgery. This has become possible due to multiple factors including technological changes, better understanding of disease, surgical mechanism, improved post op care and of course experience of the surgeon.

It is an accepted fact that surgeons performing over 100 bariatric surgeries/year and center of bariatric excellence have better outcomes. This can be explained by surgeon’s experience or availability of a support team.

Surgery has become safer due to technological advancements including availability of safer staplers(3 row staples versus 2 row), optical trocars to avoid major surgical injuries, dedicated tables for optimal patient positioning during surgery, availability of better anaesthesia drugs(desflurane etc) with faster recovery and video laryngoscopes for safer intubation.

Now most established bariatric program in the country have dedicated support teams including psychologists, physicians and nutritionists. Multi-disciplinary team is considered a major determinant of improved long term outcomes post bariatric surgery.

From 2% severe complication rates barely 2 decades back, now serious adverse events have reduced to 0.05% in the hands of experienced bariatric surgeons across the country. As more new surgeons join the bariatric specialty, a patient should try to locate a surgeon with safe outcomes either by searching for top bariatric surgeon or in their own city like best bariatric surgeon in Mumbai.

It is necessary that outcomes of a surgeon are assessed before finalising the surgeon/surgery. This should override the considerations of proximity of a surgeon and cost. The questions to be asked should include number of bariatric surgeries performed annually, number of serious adverse events and bariatric related mortality, if any. It is always preferable that a prospective patient should speak to 2-3 operated patients for feedback.

Responsibility for safe outcomes does not end with the surgeon alone but a patient equally contributes through compliance of post-operative requirements like quality and quantity of food, eating speed and appreciating cues of fullness. Safe outcomes are not only desirable but essential for patient, family and for bariatric programs as well.

Realising the safety and efficacy, all insurance companies, most corporates and even central government now provide cashless treatment benefit to their policyholders or employees for bariatric surgeries.

It is indeed gratifying to realise that in just last 2 decades of my personal bariatric experience, it has grown into a mainstream intervention for obesity.

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