Frequently asked questions
Gastric Bypass Surgery is the most common surgical procedure for weight loss which can reduce the excess body weight by about 70%. Surgeons have developed many variants of this procedure, however the most popular one is known as Roux-en-Y bypass(RYGB). The stomach is divided into a small upper pouch and a larger bottom pouch during the procedure. The small upper pouch is then connected to a part of the small intestine thus effectively bypassing a major part of the digestive system. The advantages of this procedure are lesser intake of food and lesser absorption of calories into the system. Gastric bypass surgery is an effective treatment method for severe obesity and comorbid conditions like hypertension, sleep apnea, Type 2 diabetes and high cholesterol.
You will be administered general anaesthesia before the surgery to ensure that surgery will be painless.
The procedure is done in 2 steps and the whole process usually takes around 4-5 hours.
In Step 1, the surgeon will use staples to divide the stomach into a smaller upper section (the pouch) and a larger bottom section of the stomach. This makes the stomach smaller in size by more than 90%. The small pouch can hold only about an ounce (30 millilitre) of food which makes you feel full with a very small amount of food intake.
During Step 2, the surgeon connects a part of the small intestine (jejunum) to this pouch thus bypassing the major portion of the intestine. The food will now pass directly through this path to the intestine. This will reduce absorption of calories in the body thus aiding weight loss.
Gastric bypass surgery cost in India is typically between 6,000-8,000 USD. The cost depends on the hospital, type of room (shared or private), experience of the doctor and the length of stay in the hospital. The overall hospitalisation period would typically be 3-4 days including the date of surgery. The patient is expected to be in India 1-2 days before the surgery and then for 7-10 days after the surgery for follow-up consultations with the doctor.
The cost mentioned above would include the following
· Room charges (for the specified period in hospital)
· Consultation charges
· Initial evaluation tests - radiological and labs
· Operation Theatre charges
· Surgery Fees including anaesthesia charges
· Routine Medicines & Investigations
· Food and Beverages for patient and 1 companion ( for the specified period in hospital)
Any items not mentioned above, like stay outside hospital, will have additional charges. As mentioned above, the overall stay period outside the hospital would be between 8-10 days. The cost of stay would range from 20 USD per day(for a decent 2-star accommodation) to around 150 USD per day(for a 5 star accommodation). Thus, the total cost of Gastric bypass surgery in India including surgery, accommodation and other daily expenses will be between 6,300 to 10,000 USD. This cost is still significantly lower when compared to the gastric bypass surgery costs in UK (11,000 to 20,000 USD), US (23,000 USD) and Australia (12,000 -14,000 USD).
About 20% of population in India is considered overweight with more than 5% in the obese category. This has led to a large number of people seeking bariatric surgeries like Gastric bypass in India. Recent studies show that there are more than 100 bariatric surgeries conducted every day in India with hospitals in New Delhi region accounting to 15% of the surgeries. Major advancements in surgical techniques, expertise of doctors and their high level of experience have all made gastric bypass surgery in India as safe as it is anywhere else in the world. Gastric bypass surgery has an overall survival rate of 99.8% and complications arising out of surgery are less than 10%. Another point to note is that obesity related health issues are far more riskier than bariatric surgery.
It is always advisable to have a discussion with the doctor in India to understand more about survival rates and safety issues before travelling for the surgery.
Gastric bypass surgery is a very safe procedure with a very high survival rate. However as with any other major surgical procedure, there are few risks or side effects associated with it. These risks could be short term (during or immediately after the surgery ) or long term. Short term risks can include complications due to blood loss during surgery, blood clots, breathing problems, infection and adverse reaction to anaesthesia. Long term complications can include:
· Bowel obstruction also called as internal hernia which causes pain and swelling in the abdomen and/or vomiting
· Dumping syndrome causing nausea, vomiting, diarrhoea and in some cases also Hypoglycaemia (Low blood sugar)
· Bowel function changes like diarrhoea, constipation
· Kidney stones
It is normal to have body aches, dry skin, mood changes etc. during the first couple of months. This would go away as the body gets used to the new weight.
Most of these side effects can be effectively managed with a proper diet plan and rehabilitation routines like mild exercises. Do make it a point to discuss your medical history with the bariatric surgeon before the procedure.
You are a candidate for gastric bypass surgery (weight loss surgery) if you are either
· morbidly obese with a BMI* over 40
· or if you are severely obese with a BMI over 35 and have comorbid conditions like hypertension, sleep apnea, Type 2 diabetes and high cholesterol
You should be thinking of bariatric/weight loss surgeries only if you satisfy the conditions above. There are also few other key factors that you should be considering before proceeding such as:
1. Finances for the procedure: Insurance may or may not cover bariatric surgery, so it is best to check with insurance company about this.
2. Commitment to change to a regulated diet and a healthier lifestyle
3. Understanding that you may be required to take vitamin supplements for the rest of the life.
4. Meet certain medical guidelines as specified by the surgeon. Pre-surgery tests may include blood tests, ECG, ultrasound scans of the gallbladder and nutritional tests. These tests help the surgeon to determine if the patient is fit to undergo surgery.
5. Your age: Ideally the age of the patient should be between 20 and 50. If you are over 50, the doctor would most likely require a cardiac evaluation.
You should also discuss with the surgeon in detail to understand whether you a good candidate for the surgery. Do ensure that doctor is aware of all your medical problems (if there are any) and your family medical history.
*BMI or Body Mass Index is a universally accepted measure to find out a person’s relative weight index. In metric system, this is calculated using a simple formula which is kg/m2 (weight in Kilograms/square of height in metres). In Imperial system when pounds (for weight) and inches(for height) are used, a conversion factor of 703 must be applied to get the BMI which then becomes (lb/in2)*703.
In general, Gastric bypass surgery usually reduces the excess weight in the body by around 70%. However, individual person conditions would greatly determine the amount of weight loss in each case.
Studies show that 1 year weight loss is around 65% of the excess weight. Many people will regain some of these lost weight after 1 or 2 years. In spite of that, 5 year weight loss after bariatric surgery is still at more than 50% of the excess weight. The most important factor though is the complete resolution of many obesity related health conditions like hypertension and sleep apnea. Care should be taken to ensure that you follow a strict diet and don’t go back to the old food habits again.
Gastric bypass surgery could be done either as an open surgery or as a minimally invasive laparoscopic surgery. In the open surgery, a big cut is made in the abdomen area to reach the stomach. In the laparoscopic surgery, surgeons will make 4-5 small incisions around the stomach area. Surgical camera (laparoscope) and surgical instruments are inserted through these incisions. Laparoscopic surgeries have a much faster recovery time and lesser hospitalization time. All of the best bariatric surgeons in India have extensive experience in laparoscopic bariatric surgery as well as open surgery. Doctor would decide on the type of surgery after evaluating the patient.
Yes, you can have solid food after 4-6 weeks of gastric bypass surgery. You will be on liquid diet with only clear liquids as food for the first few days after the surgery. Thicker drinks like broth, milk and Smooth foods (without any chunks) will be part of the diet during the second week. After 2 weeks, soft and pureed(mashed) foods like cottage cheese, soft scrambled eggs, cooked vegetables and fruits can be added to the diet. Solid foods can be tested from week 4-6 as specified in your diet plan.
Following a proper diet is very critical after a bariatric surgery to avoid complications and achieve the optimal benefits. Your doctor and/or the dietician will prescribe the right diet for you after the surgery and also explain the quantity and frequency of food intake.