Sleeve Gastrectomy gains popularity in India

23 Feb 2009, 1224 hrs IST, PTI

NEW DELHI: It is good news for those battling life-threatening obesity and living with diabetes. A widely resorted to surgery in the developed
nations -- Sleeve Gastrectomy -- is now promising to help Indians reduce "accumulated fat" and may even help diabetics go off insulin.

Not only is it a one-time procedure, one of the greatest advantages of this surgery is the removal of a part of the stomach, which also results in elimination of hunger stimulating hormones produced within, experts explain.

"This is one of the Bariatric operations, which is quite effective like bypass and is a one-time procedure," says Dr Sandeep Aggarwal, associate professor of Surgical Disciplines at the AIIMS here.

"It has shown great results. In fact, ten out of twelve diabetic patients could be put off insulin after this surgery We have been operating these surgeries at AIIMS since Jan 31 2008, so its over one year and 40 such operations have carried out in the last 10 months here," he said.

"It is not a cosmetic surgery. It reduces weight as much as 70-100 kg. It is a life-saving surgery like a heart or coronary-bypass," said Dr Pradeep Chowbey, secretary general of Asia Pacific Bariatric Surgery Society (APBSS) and president of Obesity Surgery Society of India (OSSI).

Only six-years-old, this surgery has shown promising results, getting rid of the problems arising from obesity to giving an active lifestyle, the experts feel.

However, Dr Narender Saini, president-elect, Delhi Medical Association, advocates the natural way to combat obesity.

"No doubt this surgery has shown good results but I would still not recommend it. I would suggest the natural way of diet control and regular exercise," he says.

Saini is of the opinion that this surgery is a short-term measure to get rid of the extra-weight. "If a healthy and controlled lifestyle is not followed, then patient may put on the weight again. The causes of obesity should be identified and eliminated from the core," he adds.

The cost of this surgery is not fixed and varies from hospital to hospital. "These operations are almost free with nominal charges as low as Rs 5,000 to 10,000 here at AIIMS. But in future, it might get increase due to the material cost.

"The material costs around Rs 60,000 to 70,000. While, elsewhere, the cost for the surgery might range from Rs 2 to 5 lakh," Aggarwal said.

The surgery is only on the stomach and does not involve the intestine. It basically consists of making the stomach that looks like a pouch into a long tube and therefore the name "sleeve."

"The surgery removes two-thirds of the stomach, which provides for quicker satiety (sense of fullness) and decreased appetite," Dr A K Kriplani, the Bariartic surgeon at Indraprastha Apollo Hospital said.

"The smaller stomach pouch restricts food intake by allowing only a small amount of food to be eaten at one time," Kripalini said, adding that it is a safe surgery and is useful for those who are concerned about the complications of bypass operation.

"My weight was 132 kg before the surgery but now it is just 75. I feel better as many of the other problems I used to face due to obesity are no more. My blood pressure is normal and the joints pain no more bothers me," says Rekha Raghuvanshi of Burari who recovered within 10 days of the surgery at AIIMS free of cost.

Perhaps the greatest advantage of the gastric sleeve lies in the fact that it does not involve any bypass of the intestinal tract and patients do not therefore suffer the complications of intestinal bypass.

The surgery also helped Brian Andrew Adair, a Canadian, weighing 400 pound regain his confidence by getting 60 to 70 per cent of his stomach removed laparoscopically and leaving a cylindrical or sleeve shaped stomach. He was operated by Dr Deep Goel a month ago at Gurgaon-based ARTEMIS Health Institute.