117-kg woman successfully undergoes 'redo' bariatric surgery

Bengaluru: A 50-year-old woman, weighing 117 kg successfully underwent a 'redo' bariatric surgery at Fortis Hospital, Cunningham Road. The patient had earlier undergone a bariatric surgery eight years back at some other hospital. At the time of the earlier surgery, she weighed 114 kg and lost 23 kg post-surgery.

As a result of gastric sleeve dilation, she regained weight over the years and was weighing 117 at present, thus requiring a 'redo' bariatric surgery.

The procedure was led by Dr Ganesh Shenoy, Sr. Consultant - Minimal Access, Gastrointestinal and Bariatric Surgery along with his team Dr B S Ramesh, Senior Consultant General & Laparoscopic Surgery and Dr Sandeep D, Registrar General & Laparoscopic Surgery. The team of anaesthesiologists was led by Dr Dattatreya Prabhakumar, Senior Consultant Anesthesiology along with Dr Meenakshi.

The patient had undergone multiple surgeries in the past including Caesarean sections, open appendectomy, tubectomy, umbilical and incisional hernia repairs and surgery for intestinal obstruction. She also has a medical history of hypertension, sarcoidosis, knee joint pains and neuroendocrine tumour of the first part of the duodenum. She also underwent endoscopic submucosal resection of neuroendocrine tumour recently.

The cause of weight regain in the patient was the dilatation of the previously performed gastric sleeve which was confirmed by CT scan and endoscopy.

Due to excessive weight gain, she was experiencing severe knee pain and back pain which had affected her daily chores. Failure to lose the regained weight after bariatric surgery despite regular exercise and diet regimen, the recent onset of knee joint pain was a major concern for the patient.

Dr Ganesh Shenoy explains, "In view of the need for upper GI endoscopy during follow up at regular intervals the patient was planned for laparoscopic re-sleeve surgery and not bypass surgery. This decision was taken after a detailed discussion with the medical gastroenterologist, the patient, and her husband. The patient is now stable, ambulant, and tolerating liquids orally."

"Obesity and related disorders remains silent killers as its affects a larger number of people, than any other non-communicable disease leading to untimely deaths. Laparoscopic Sleeve gastrectomy, Roux-en-Y Gastric Bypass (RYGB) & Mini Gastric Bypass (MGB) are the three most common bariatric surgeries performed in our country. Long term 10-15% of the patients may need redo bariatric surgery for weight regain. Laparoscopic redo bariatric surgeries are quite challenging and is rarely performed as very few patients may need this surgery in the long run" added Dr. Ganesh Shenoy.

Obesity has more than doubled in the last decade, putting 80-85% of the population at risk of diabetes. Obesity affects 30% of children and adolescents in urban environments. It has been linked to pneumonia, non-alcoholic fatty liver disease, gall bladder problems, gynaecologic abnormalities, idiopathic intracranial hypertension, stroke cataracts, coronary heart disease, and cancer. The chances of a highly obese person decreasing weight below 35 BMI are only 3% or less. Morbidly obese people are unable to exercise adequately due to joint pain.