Rahul Misra (name changed), who was always on the heavier side, became excessively overweight because of his lockdown-infused sedentary lifestyle. When his day-to-day life activity started getting affected because of his poor health condition, he decided to shed the weight through excessive exercise. But, as a result, he developed spine and joint injuries. When he visited a doctor, he was suggested to undergo bariatric surgery or weight loss surgery. The delay in surgery led to prolonged recovery and unnecessary ICU admission.
Health experts across the globe recommend that one shouldn’t delay bariatric surgery once indications and needs have been established. Weight gain and worsening of related diseases while awaiting surgery leads to poor quality of life and also slow recovery rates. Our sedentary lifestyle has contributed to many health problems and obesity is one of them. It has been quite dismal to see how the remote working and staying at home during the pandemic and has led to a rise in obesity in children of Delhi by 51% as per a recent report. The situation is not grim only in the national capital; the National family health survey of India has shown an increase in obesity in all of the Indian states.
COVID AND BARIATRIC SURGERY
The surge in obesity cases could be mainly due to the lifestyle and a change in diet pattern as people are mostly consuming processed food, which is causing a disturbance in metabolism and insulin resistance in their bodies. As the government has now lifted the restrictions on elective surgeries, it’s just the apt moment to go for it. This surgery is done when diet and exercise haven’t worked or when somebody has serious health problems because of the weight. Robotic surgery and endoscopic bariatrics are examples of how new technology has given us more options. Also, the industry has come up with improved stapling and suturing devices. Even the hospitals are adhering to all the Covid safety guidelines with their healthcare staff vaccinated; patients should get their bariatric surgery done without any hesitation. It is advisable that people who had decided to undergo bariatric surgery before the start of the pandemic should consider having it done sooner rather than later to avoid any further adverse health outcomes.
PROCEDURES OF BARIATRIC SURGERY: ROBOTIC SURGERY IS THE WAY AHEAD
One can opt for bariatric surgery if he/she has a BMI of 32.5, with specific significant health problems like Type 2 diabetes, sleep apnea or high blood pressure. A BMI of 37.5 or higher also is a qualifying criterion for the surgery. Depending on the BMI and patient requirements, endoscopic/laparoscopic/robotic surgery is offered. Endoscopic is preferred when a small amount of weight loss is needed and robotic is the choice in extreme cases. In robotic bariatric surgery, the latest in the field, the surgeon operates the procedures through a master console and the robotic patient cart operates through tiny holes on the patient similar to laparoscopy with much ease and precision. This procedure has many definite advantages over conventional laparoscopic surgery due to its 3D vision and precise intuitive multi-range instruments that add more safety to the patients. It also helps in better suturing skills and reduces post-operative pain and recovery time after surgery. Post-bariatric surgery, nutritional deficiencies can be a problem. However, it can be prevented by staying in close touch with the hospital team and following the dietary guidelines as suggested by the dietician.
The writer is Senior Gastrointestinal & Bariatric Surgeon, Apollo Hospitals, New Delhi.