New Year Resolutions and Weight Loss Surgery

As the year 2009 rolls to a close with a high pitched crescendo, it is that part of the year that most people dread, which is: making resolutions, and most importantly sticking to it. If you are teetering on the edge of making a decision whether or not to undergo weight loss surgery for health or cosmetic reasons, then the New Year is the right time to make the best decisions.

Your mind may be choc-a-bloc teeming with a million questions. Should I undergo surgery or not? The following FAQs are a sampler to help you clear the muddle.

Q: What if I undergo sleeve gastrectomy or laparoscopic gastric bypass surgery and STILL don’t lose weight?

A: Most gastrectomy and bypass patients lose a projected 50 to 70 percent of their weight. The surgeries are safe and reliable, and Springfield Wellness Centre has the technical know how and the expertise to perform these procedures.

Q: What if I regain all of my weight after surgery?

A: While there’s no guarantee that you won’t gain back some or all of your weight after surgery, our team of specialists can help you prepare for the lifestyle changes required to ensure your surgery is a long-term success. If you’re committed to improvements in your health and well-being, you’ll experience success.

Q: Aren’t gastric bypass and sleeve gastrectomy invasive?

A: It’s true that bypass and sleeve surgery are more invasive than banding procedures, but they may be the best fit for your health situation. When conducted by the knowledgeable and experienced Dr. Maran, the benefits of weight loss surgery far outweigh the risks of obesity-related health problems.

Let the coming Year shower you with health and happiness.

For all other details, feel free to go through our website: www.killobesity.com

Total laparoscopic liver resection in 78 patients

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AIM: To summarize the clinical experience of laparoscopic hepatectomy at a single center. METHODS: Between November 2003 and March 2009, 78 patients with hepatocellular carcinoma (n = 39), metastatic liver carcinoma (n = 10), and benign liver neoplasms (n = 29) underwent laparoscopic hepatectomy in our unit. A retrospective analysis was done on the clinical outcomes of the 78 patients. RESULTS: The lesions were located in segments I (n = 3), II (n = 16), III (n = 24), IV (n = 11), V (n = 11), VI (n = 9), and VIII (n = 4). The lesion sizes ranged from 0.8 to 15 cm. The number of lesions was three (n = 4), two (n = 8) and one (n = 66) in the study cohort. The surgical procedures included left hemi-hepatectomy (n = 7), left lateral lobectomy (n = 14), segmentectomy (n = 11), local resection (n = 39), and resection of metastatic liver lesions during laparoscopic surgery for rectal cancer (n = 7). Laparoscopic liver resection was successful in all patients, with no conversion to open procedures. Only four patients received blood transfusion (400-800 mL). There were no perioperative complications, such as bleeding and biliary leakage. The liver function of all patients recovered within 1 wk, and no liver failure occurred. CONCLUSION: Laparoscopic hepatectomy is a safe and feasible operation with minimal surgical trauma. It should be performed by a surgeon with sufficient experience in open hepatic resection and who is proficient in laparoscopy.

SILS: Single Incision Laparoscopic Surgery

10-09-09 will be a memorable day for me and Springfield Institute! Reason? It was the day when I successfully completed a Single Port Laparoscopic procedure for a major surgery wherein one third of the stomach and the uterus was removed via a single key-hole on the umbilicus (navel). I am of the firm conviction that it is India’s and possibly Asia's first procedure involving SILS and a partial gastrectomy and a hysterectomy The patient, a 46 yr old lady, presented to me with severe anemia (low hemoglobin in the blood) and a history of excessive menstrual bleed. Her BMI was 39 and further investigations showed that she had a bleeding polyp in her stomach and considering the best interests of the patient, she required a surgery that involved removing at least 2/3rd of her stomach (which would also be a bariatric procedure to reduce weight) and also a complete removal of the uterus.

Why is this relevant?

The surgical specialty field is an evolving continuum. The attitude towards surgery, the surgical approach as well as the instrument and gadgets of surgery aren’t the same in a time span of even a few months! Up to about 10 years back surgery means knives and scissors and traditionally abdominal surgeries were very much 'invasive', meaning it was done via a big incision down the middle of the stomach which lead to a lot of bleeding, wound infection, extended hospital stay and a longer recuperation time but with the advent of second generation surgical techniques like laparoscopy all that changed for the good!

What is laparoscopy (key-hole surgery)?

In a conventional laparoscopic technique, the surgeon gains access to the intra-abdominal organs by means of at least 3 (and up to 6) one centimeter key-holes. Through one, a camera is inserted and the remaining 2 have a pair of scissors and dissector which help the surgeon do the needful.

3rd generation surgery?

We are surely and steadily on the verge of another paradigm shift. A third generation surgical procedure known as SILS-Single Incision Laparoscopic Surgery is done using only one small key-hole of just 1 and a half cms done exactly on the navel and all the required instruments are passed through it. While this new procedure may seem a bit unorthodox, the safety and care of the patient is in the forefront as this technology is fully patient friendly!

Transfer of Technology!

Earlier it took at least 4-5 years to know/learn new surgical skills from the affluent West and only a few privileged persons could gain the knowledge. But SILS happened in 3-4 months of it being introduced in the West. Now SILS is the standard procedure for removal of the gall bladder and the appendix, but even major surgeries like removing a portion of the stomach can be done and in India.

Advantages of this ‘Belly button’ surgery:

a) Blood loss is minimal

b) Patient tolerance and discomfort is reduced

c) Hospital stay is reduced as patient can be ambulant and take oral feeds on the very same day!

d) Newer technology doesn’t necessarily mean higher cost! In fact the treatment costs are reduced by at least a third.

f) Though this is the first of a kind here in India, this emerging technique doesn’t require a corporate hospital set up and can be done at your neighbourhood hospitals.

g) Hitherto, one had to travel abroad for sophisticated surgery, but with the advent of rapid technology transfer along with globalization we can have it done conveniently at home reducing on the travel cost and hassles of traveling.

e) Last but not the least, cosmetically there is absolutely no scar!

Namaste World!

Feels nice to have a blog of your own! Watch out for regular updates on laparoscopy and bariatrics. Thank you very much!