Gastric Bypass Surgery/Bariatric Surgery Cost in India

Types of gastric surgery

1. Purely Restrictive

• Gastric Balloons 

• Vertical-banded gastroplasty/sleeve gastrectomy 

• Gastric adjustable banding
 

2. Restrictive is more than Malabsorptive

• Short-limb/Roux-en-Y gastric bypass 

• Long-limb/distal Roux-en-Y gastric bypass
 

3. Malabsorptive is more than Restrictive

• Biliopancreatic diversion (BPD)

• BPD with duodenal switch

• Very long limb Roux-en-Y gastric bypass
 

4. Purely Malabsorptive

• Jejunoilieal bypass 

• Jejunocolonic bypass
 

Most common Gastric Bypass Surgery

ROUX-EN-Y GASTRIC BYPASS:

The most common gastric bypass surgery is the Roux-en-Y. This surgery can be done Laparoscopically (keyhole surgery) or through a larger open incision. Your surgeon will decide which option is best suited for you.

In this surgery, a small stomach pouch is created by stapling along the upper part of the stomach and a new opening is created as well. The small intestine is then cut into two parts. To the entry of the stomach pouch, the lower part of the intestine is attached and this structure is referred to as the "roux limb". The distal end of this roux limb is connected to the upper section of the small intestine which carries juices vital for digestion. This limb facilitates food to bypass the lower part of the stomach, duodenum, and a portion of the small intestine.
 

Gastric Bypass: Complications

Early:

• Acute gastric distention

• Roux-Y obstruction

• Staple line leak (probability 1-5%) 
 

Late:

• Stomal narrowing/vomiting (probability 15%)

• Marginal ulcer 13%

• Heartburn/inflammation of the esophagus

• Anaemia

• Folate deficiency

• Vitamin B12 deficiency 

• Iron deficiency

• Calcium deficiency / osteoporosis
 

Other gastric bypass surgeries are explained below 

Laparoscopic Gastric Bypass

The stomach reduced to a size of a walnut and then attached to the middle of the small intestine, bypassing a section of the small intestine (duodenum and jejunum) and limiting the absorption of calories. Risks include allergic reactions to medicines, blood clots in the legs, blood loss, breathing problems, heart attack or stroke during or after surgery and infection.

Laparoscopic Adjustable Gastric Band

 Adjustable silicone band filled with saline wrapped around the upper part of the stomach, creating a small pouch that restricts food intake.

 Risks include the gastric band eroding through the stomach, the gastric band slipping partly out of place, gastritis, heartburn, stomach ulcers, infection in the port, injury to the stomach, intestines, or other organs during surgery, poor nutrition, and scarring inside the belly.

Sleeve Gastrectomy

Stomach divided and stapled vertically, removing more than 85%, creating a tube or banana-shaped pouch restricting the amount of food that can be consumed and absorbed by the body.

Risks include gastritis, heartburn, stomach ulcers, injury to the stomach, intestines, or other organs during surgery, leakage from the line where parts of the stomach have been stapled together; poor nutrition, scarring inside the belly that could lead to a future blockage in the bowel; and vomiting.
 

Advantages of Gastric Bypass Surgery 

• Quick and visible weight loss.

• Continued weight loss for up to 2 years post-surgery.

• Improved health and prognosis of diseases associated with severe obesity such as cardiovascular disorders e.g. heart problems.  Diabetes, hypertension improves.

• Improved mobility because of decreased obesity and quality index of life improves.
 

 Disadvantages of Gastric Bypass Surgery include:

• Major surgery with serious risks.

• Malnourishment and blood disorders such as anaemia may occur and the patient may require vitamins and mineral supplementation for the whole life.

• Requires modifications in the patient’s diet and lifestyle permanently.

• Patients are at increased risk of gall bladder stones due to rapid weight loss. 

• A syndrome known as Dumping syndrome can occur after ingesting high sugary foods. Features of dumping syndrome include nausea, reflux, and diarrhea.

• Patients usually are at risk of hair loss.