You should first know the risks and benefits of sleeve gastrectomy, mini gastric bypass and Roux-en -y gastric bypass. For high-risk patients and super obese patients, we advise LSG as a first-stage procedure prior to gastric bypass. Ultimately, the decision regarding which procedure to perform is based on each patient’s operative risk, their expectations and goals for surgical weight-loss and is decided by a bariatric surgeon (Codsils – Dr. Amit Garg).

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Minimal hair loss, vitamin B12 and Iron deficiency anemia are the main side effects. However, they are rare and can be managed with medications. As sleeve only restricts the amount of food you can consume post-surgery, there are no long term complications either. Complications that can happen include a leak from the sleeve resulting in an infection or abscess, deep venous thrombosis or pulmonary embolism, narrowing of the sleeve (stricture). However, at our center, the total complication rate is less than 1% which is similar to other procedures, like a gall bladder or hernia surgery.

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We encourage you to walk 3 – 4 hours after the surgery, as being active and mobile reduces the risk of deep vein thrombosis. On third day, you are discharged from the hospital and you can return to work within a week.

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Yes you can if you are not careful with the intake of high calorie liquids or junk food as consumption of them could lead to increased caloric intake. Long term over eating can cause stretching/ dilatation of the sleeve which can lead to weight regain. Good healthy eating habits and regular exercise form the cornerstones of success after bariatric surgery.

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You will need to be on a liquid diet for first 15 days after the surgery. This is followed by 15 days of semi-solid foods and then you progress onto solids. Within 2 months you can have all kinds of foods though in limited quantities.

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Few of the patients have a habit of over eating and in such cases sleeve can dilate because of the repeated pushes with food from inside. In order to prevent sleeve dilatation, a non-adjustable band can be placed on the upper part of the sleeve. For the long term (> 10 years) success of sleeve gastrectomy, this can be a preferred.

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Sleeve Gastrectomy surgery cost varies from 2.5 lakhs to 4 lakhs based on the patients BMI, comorbid conditions, room category & hospital choice.

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Sleeve Gastrectomy Surgery is a restrictive procedure. In this, about 80 % of the stomach is removed so that it takes the shape of a sleeve or a banana. This greatly reduces the size of the stomach and limits the amount of food that can be eaten at one time.

Surgery for weight loss is caused by two mechanisms - First is restriction because of a smaller stomach size and secondly removing the part of the stomach that produces the “hunger hormone” (ghrelin) contributes to the weight loss by reducing the appetite.

Sleeve Gastrectomy Surgery also results in alteration of several gastro intestinal hormone levels in the body resulting in resetting of the set point of food storage to a lower level. These hormonal changes include reduced Ghrelin, increased GLP-1, Peptide YY and Amylin, resulting in reduced appetite and increased energy expenditure.

It is fairly a simple procedure that takes about 60-90 minutes to perform and requires 3 to 4 nights stay in the hospital.

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Experiencing weight gain following gastric sleeve surgery can be demoralizing. Despite taking a substantial leap toward attaining a healthier weight, it’s disheartening to witness the numbers on the scale inching upward again. We’ll delve into the multifaceted reasons behind this phenomenon, encompassing dietary patterns, lifestyle adjustments, and psychological factors. Whether you’re contemplating gastric sleeve surgery or have already undergone the procedure, our aim is to provide you with insights that empower you to sustain a healthy weight and embrace a healthier lifestyle.
Exploring the Factors Behind Weight Gain Following Gastric Sleeve Surgery
Gastric sleeve surgery, medically termed sleeve gastrectomy, involves surgically removing a significant portion of the stomach to form a smaller, sleeve-shaped organ. This alteration restricts food intake, aiding in calorie reduction and subsequent weight loss. Nonetheless, certain individuals may encounter weight gain post-surgery for several reasons:

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What is Gastric Plication?

Gastric plication involves in folding of your stomach along the greater curvature in 2 layers. Stitches are placed in the stomach to secure the folded stomach wall. This reduces the stomach volume by as much as 70 percent. As such, your stomach can no longer hold the volume of food it used to. You will feel fuller sooner, and this results in weight loss.

Most of patients lose 40 - 60 percent of their excess body weight during the first year after gastric plication surgery. As with other procedures that cause massive weight loss, there may also be improvements in many obesity-related conditions like diabetes, high blood pressure, sleep apnea and abnormal cholesterol levels.

Unlike other bariatric surgery procedures, there is no stapling involved with gastric plication. No part of the stomach or intestines is cut or removed either. They are just folded from within. Gastric plication can be reversed to normal anatomy or revised to any other procedure.

Facts about Gastric Plication 

• Reversible
• No Stapling
• No Cutting

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The best and only way to determine which, if any, bariatric surgery is right for you is to schedule a consultation. We will take a thorough obesity history and discuss all of the alternatives, including gastric plication and adjustable gastric banded plication or sleeve gastrectomy.

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Gastric plication takes 2 hours to perform. Many people will stay in the hospital for up to two days after the procedure.

Your recovery begins almost immediately after the surgery as you gradually begin to get used to your new way of eating. This starts with a two-week liquid diet that likely will include water, milk, coconut water, fruit juice and lime juice. The next few weeks will involve thicker liquids such as soup with some vegetables, and eventually you can try yogurts and fruits. After this, you will be able to eat all foods in restricted amounts.

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• Physiological, less invasive and more conservative with reversible potency.
• Less chance of complications such as leakage, hemorrhage, infection or erosion
• No foreign body inside the body unlike gastric banding
• Cost effective
• Shorter hospital stay
• No/minimal requirement for supplementation of calcium and multivitamins after  adequate weight loss is achieved.

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Requires intensive behavioral and life style modification for the long term success of the procedure. Plication may get dilated over a period of time if one does not change his/her eating habits.

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When we discuss the risks of any bariatric surgery, they must be compared to the serious risks associated with obesity. Risks of gastric plication include bleeding, blood clots, infection, and injury to other organs.

Other gastric plication-specific risks may include:

• Stomach leakage from the fold
• Blockage of the stomach from swelling or a fold that is too tight
• Stomach expansion, which can cause damage to the sutures
• Fundal Herniation

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Yes, you can if you are not careful with the intake of high calorie liquids or junk food as consumption of them could lead to increased caloric intake. With any bariatric procedure, restriction is only for solid food but not for high calorie liquids or sweets. Good healthy eating habits and regular exercise form the cornerstones of success after bariatric surgery.

Read more

You will need to be on a liquid diet for first 15 days after the surgery. This is followed by 15 days of semi-solid foods and then you progress onto solids. Within 2 to 3 months you can have all kinds of foods though in limited quantities.

Read more

We encourage you to walk 3 – 4 hours after the surgery, as being active and mobile reduces the risk of deep vein thrombosis. On third day, you are discharged from the hospital and you can return to work within a week.

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The best and only way to determine which, if any, bariatric surgery is right for you is to schedule a consultation. We will take a thorough obesity history and discuss all of the alternatives, including sleeve Gastrectomy and gastric bypass surgery.

Read more

It takes 2-3 hours to perform. Many people will stay in the hospital for up to two days after the procedure.
Your recovery begins almost immediately after the surgery as you gradually begin to get used to your new way of eating. This starts with a two-week liquid diet that likely will include water, milk, coconut water, fruit juice and lime juice. The next few weeks will involve thicker liquids such as soup with some vegetables, and eventually you can try yogurts and fruits. After this, you will be able to eat all foods in restricted amounts. We start Band adjustments 3 months after the surgery.

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• Potentially Reversible
• Obviates the need for GI resection or anastomosis
• Obviates the need for intestinal bypass and future mal-absorption
• Provides a “bi-phasic” restrictive effect
• Combines benefits of adjustability of gastric band and quick weight loss of gastric plication
• Reduces the need of frequent band adjustments

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When we discuss the risks of any bariatric surgery, they must be compared to the serious risks associated with obesity. Risks of gastric plication include bleeding, blood clots, infection, and injury to other organs.
Other LAPAROSCOPIC GASTRIC PLICATION -specific risks may include:

• Stomach leakage from the fold
• Blockage of the stomach from swelling or a fold that is too tight
• Fundal herniation
• Band Slippage or infection

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We encourage you to walk 2-3 hours after the surgery as being active and mobile reduces the risk of deep vein thrombosis. On third day, you are discharged from the hospital and you can return to work within a week.

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Yes you can if you are not careful with the intake of high calorie liquids or junk food as consumption of them could lead to increased caloric intake. With any bariatric procedure, restriction is only for solid food but not for high calorie liquids or sweets. Good healthy eating habits and regular exercise form the cornerstones of success after bariatric surgery.

Read more

You will need to be on a liquid diet for first 15 days after the surgery. This is followed by 15 days of semi-solid foods and then you progress onto solids. Within 2 to 3 months you can have all kinds of foods though in limited quantities.

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Gastric plication surgery cost varies from 2.5 lakhs to 4 lakhs based on the patients BMI, comorbid conditions, room category & hospital choice.

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• Dual Restrictive
• Reversible
• No Stapling
• No Cutting

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You should first know the risks and benefits of all common bariatric procedures. For high-risk patients and super obese patients, we advise mini gastric bypass procedure. Ultimately, the decision regarding which procedure to perform is based on each patient’s operative risk and their expectations and goals for surgical weight-loss and is decided by a bariatric surgeon. We will take a thorough obesity history and discuss all of the alternatives, including sleeve Gastrectomy and gastric bypass surgery.

We advise Mini gastric bypass surgery for super obese, non-smoker, non-vegetarian patients.

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Simpler and safer

• Suitable for patients on non-vegetarian diet
• Rapid and sustained weight-loss.
• Patient can eat much more than any other bariatric procedure because of longer pouch and bigger anastomosis at gastrojejunostomy.
• Lesser follow-ups are required
• Reversible to Normal anatomy

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Requires lifelong nutritional supplements like iron, calcium, proteins and multi-vitamins.

• Not much suitable for vegetarian patients and smokers.
• Dyspepsia (5.6% of patients)
• Dumping syndrome, Marginal ulcers and malnutrition can occur if proper diet or instructions are not followed post-surgery.

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The patient will lose 60 – 80% of their excess weight in the first two years after the procedure. In first 3-4 months, weight loss is the maximum, after which the rate of weight loss slows down to 3-7 Kgs/ month depending on initial BMI of the patient and patient’s willingness to follow health lifestyle and eating habits.

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Laparoscopic Mini gastric bypass takes about 90-120 minutes to perform and requires 2-3 nights in the hospital post-surgery. During the surgery you will be under general anesthesia and won’t feel any pain.  Post-surgery, you will be shifted to the recovery room where you will be kept under observation for 3-4 hours. You will be ambulated in the recovery room before shifting to the private room.

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After Mini gastric bypass, you will be able to eat much more than patients who have undergone a gastric bypass or a sleeve gastrectomy. You have to eat diet rich in proteins, calcium and iron.

Eating sweets, high carbohydrate diet, eating too much and drinking water after food can cause ‘dumping syndrome’. It occurs as a result of food passing too quickly into the intestine. The symptoms of dumping syndrome are: Nausea, diarrhea, weakness, vomiting, palpitations, sweating and a sense of fullness accompanied by discomfort. The best treatment is to keep a note of problem foods and avoid their intake. Dumping syndrome often improves on its own without medical treatment or after adjusting your diet.

Avoid smoking as it can cause marginal ulcers.

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Complications that can happen include bleeding, infection, internal herniation, malnutrition and a leak from the site of anastomosis i.e. gastrojejunostomy resulting in an infection or abscess, deep venous thrombosis or pulmonary embolism. However, at our center, the total complication rate is less than 1% which is similar to other procedures, like a gall bladder or hernia surgery.

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We encourage you to walk 3-4 hours after the surgery as being active and mobile reduces the risk of deep vein thrombosis. On third day, you are discharged from the hospital and you can return to work within a week.

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You will need to be on a liquid diet for first 7 days after the surgery. This is followed by 15 days of semi-solid foods and then you progress onto solids. Within one month, you can have all kinds of foods.

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Mini gastric bypass surgery cost varies from 3 lakhs to 5 lakhs based on the patients BMI, comorbid conditions, room category & hospital choice.

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Obesity was earlier prevalent in western countries but with the massive introduction of western diets in the Asian population has led to a dramatic rise in the incidence of obesity and obesity associated comorbidities. Today obesity is more common in females as compared to men and is growing rapidly to affect the younger population also.
Increasing weight not only affects your physical appearance but also leads to multiple health issues and reduces life expectancy. Today Morbid obesity is the preventable cause of early death worldwide and is a serious matter of Concern.
Many weight loss options like diets, exercising, medications, liposuction etc are available but Bariatric surgery is the only proven method for long term sustainable weight loss.
What is Bariatric surgery ?
Bariatric surgery is also known as weight reduction or weight loss surgery and is recommended for patients with BMI of more than 35 Kg/m2 who have tried dieting and exercise for more than 6 months with no results. Although bariatric surgery involves 6 – 7 types of weight loss procedure, gastric sleeve and mini gastric bypass are the most common procedures among all.

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You should first know the risks and benefits of all common bariatric procedures. For high-risk patients and super obese patients, we advise LSG as a first-stage procedure prior to gastric bypass. Ultimately, the decision regarding which procedure to perform is based on each patient’s operative risk and their expectations and goals for surgical weight-loss and is decided by a bariatric surgeon.

Read more

Laparoscopic gastric bypass takes about 120- 150 minutes to perform and requires 2-3 nights in the hospital post-surgery. During the surgery you will be under general anesthesia and won’t feel any pain.

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After LRYGB, you will be able to eat less because of small stomach pouch. You have to eat small bites and chew the food in mouth properly before you swallow it.

Eating sweets, high carbohydrate diet, eating too much and drinking water after food can cause ‘dumping syndrome’. It occurs as a result of food passing too quickly into the intestine. The symptoms of dumping syndrome are: Nausea, diarrhea, weakness, vomiting, palpitations, sweating and a sense of fullness accompanied by discomfort. The best treatment is to keep a note of problem foods and avoid their intake. Dumping syndrome often improves on its own without medical treatment or after adjusting your diet.
Avoid smoking as it can cause marginal ulcers.

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Complications that can happen include a leak from the site of anastomosis i.e. gastrojejunostomy and jejunojeunostomy resulting in an infection or abscess, deep venous thrombosis or pulmonary embolism. Internal herniation can happen because of the mesenteric defects created even though both the defects are closed during surgery. However, at our center, the total complication rate is less than 1% which is similar to other procedures, like a gall bladder or hernia surgery.

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We encourage you to walk 3-4 hours after the surgery as being active and mobile reduces the risk of deep vein thrombosis. On third day, you are discharged from the hospital and you can return to work within a week.

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The patient will lose 60 – 80 percent of their excess weight in the first two years after the procedure. In first 3-4 months, weight loss is the maximum, after which the rate of weight loss slows down. It further depends on initial BMI the patient and patient’s willingness to follow health lifestyle and eating habits.

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You will need to be on a liquid diet for first 15 days after the surgery. This is followed by 15 days of semi-solid foods and then you progress onto solids. Within 2 to 3 months you can have all kinds of foods though in limited quantities

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ROUX-EN-Y gastric bypass cost varies from 3 lakhs to 5 lakhs based on the patients BMI, comorbid conditions, room category & hospital choice.

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Many bariatric procedures have been described throughout the years and some of these procedures are no longer performed. The indications for revisions can be many and they vary depending on the primary procedure.
Below is a list some of the most common reasons why patients might need a revision. The list below is for educational purposes only and just because you experience one or more of the below mentioned problems doesn’t mean that you need a revision. You need to discuss your particular situation with your doctor surgeon.

• Inadequate weight loss
• Weight regain
• Stomal or anastomotic stricture (narrowing)
• Dysphagia (difficulty swallowing)
• Frequent vomiting
• Abdominal pain
• Stomach ulcers
• Gastrointestinal reflux or bile reflux
• Gastric or esophageal dilation (enlargement)
• Band erosion
• Band slippage or prolapse
• Gastro-gastric fistula
• Internal hernias or bowel obstruction

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