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Bariatric (Weight loss or obesity or Motapa) Surgery is a safe procedure for weight loss/obesity, with promising long term positive effects and weight maintenance. Burden of obesity has tripled over last three decades and exponential rise is expected by year 2030.  when other options to reduce weight (diet, exercise, medicines) fail or  anticipated to fail due to morbid obesity i.e. around 30 kgs above the ideal body weight (BMI more than 35),  Bariatric (Weight loss or obesity or Motapa) Surgery is indicated.

Obesity (motapa) is no more a personal problem; it’s a disease which affects rich and poor equally. RIMS Trauma Hospital offers high quality and safe operation with superb ambiance; all at an affordable cost with the intention to make this procedure in the reach of every stratum of society; not limited to affluent people only. Bariatric (Weight loss or obesity or Motapa) Surgery is a durable solution to a disease, not a luxury limited to rich people. The cost of Bariatric (weight loss or obesity) surgery at RIMS trauma hospital starts from 3 lac rupees, as compared to a range of 5-15 lacs for this procedure in other hospitals of Karachi/Pakistan.

What is Bariatric (Weight loss or obesity or Motapa) Surgery?

A laparoscopic operation, performed through keyhole incisions of 1cm size, through which the size of stomach is reduced to a capacity of 150-200 mls, for less hunger and early satisfaction. It may be accompanied by bypass of small bowel to decrease absorption. Resultantly, there would be decreased food intake and weight loss.

Is Bariatric (Weight loss or obesity or Motapa) surgery same as tummy tuck/liposuction?

No. These are cosmetic operations preferred in patients with ideal or near ideal body weight, who want to have their body in a smart and in shape. These neither reduce weight nor treat obesity or its related complications.

What are the indications of Bariatric (Weight loss or obesity or Motapa) surgery?

For Asians, the indications of surgery are any one of the following: 1) BMI more than 37.5, 2)BMI 32.5 or above with obesity related diseases i.e. diabetes, hypertension, heart or lung disease, joint pain, Polycystic Ovarian Syndrome (PCOS) etc.

How Bariatric (Weight loss or obesity or Motapa) Surgery is performed?

Laparoscopic or keyhole surgery. With the help of modern stapling devices and instrument, we trim the stomach through five button holes on the belly.

How to decide whether to opt sleeve gastrectomy or gastric bypass procedure?

No absolute answer. In patients with sweet craving, diabetes mellitus, acid reflux; bypass is preferred. Bypass is avoided in smokers. Otherwise, short term results are equal in both. Bypass is reversible and offers better long term results as opposed to sleeve.

What is recovery time Bariatric (Weight loss or obesity or Motapa) surgery?

A patient is able to perform daily life activities on average of 7 days (2-15 days) without support. It depends on weight, comorbidities, confidence & determination of patient. We take the patient out of bed with in 3-4 hours after surgery.

How much weight loss is anticipated after Bariatric (Weight loss or obesity or Motapa) surgery?

8 kgs (range: 6-20kgs) in first month, then 1-2 kgs each month till a flat phase is achieved which is variable for different patients. The speed of weight loss depends upon the initial excess weight; therefore, every patient is different from other.

What are immediate complications/side effects of Bariatric (Weight loss or obesity or Motapa) surgery?

99% go home safe and happy, 1% experience serious complications i.e. leak, bleeding, clotting of blood in legs, chest infection etc. despite of strict precautions.

What are long term complications/side effects of Bariatric (Weight loss or obesity or Motapa) surgery?

Protein and vitamin deficiency. Therefore, lifelong follow up and compliance to the dietician is paramount.

What is the cost of bariatric (weight loss) surgery at RIMS Trauma Hospital, Karachi, Pakistan?

It starts from 3 lacs depending upon the choice of accommodation. The estimate includes accommodation (one day), Operation Theater, anesthesia, surgeon fee, nursing, drugs and disposables. Welfare is also given to eligible patients. Cost of bariatric surgery in Karachi (other institutes) ranges from 5 to 15 lacs. The major difference is hospital charges and surgeon fee, which are highly subsidized at RIMS in order to make this procedure affordable to patients of different socioeconomical status.

Which brand of instruments is used for Bariatric (Weight loss or obesity or Motapa) Surgery at RIMS Trauma Hospital?

Covidien (Medtronic) and Ethicon. These are two international brands commonly used worldwide.

Is there weight regain after Bariatric (Weight loss or obesity or Motapa) Surgery?

Yes, in upto 30% patients after sleeve Gastrectomy and 15% after gastric bypass. The key to success is a constant surveillance and regular follow up. In the absence of these two, patients revert to unhealthy life style or may succumb to the body physiology that retaliates after significant weight loss and increases hunger.

Can a woman of child bearing age conceive after Bariatric (Weight loss or obesity or Motapa) Surgery?

Yes, but after one year. In the first year, a patient is in a dynamic state of weight loss with several physiological changes already going on in the body. Pregnancy with in one year after Bariatric (Weight loss or obesity or Motapa) Surgery  would be superimposed; inhibiting weight loss as well. There is very low risk of having underweight baby born due to nutritional deficiencies.

Can a woman of child bearing age conceive after Bariatric (Weight loss or obesity or Motapa) Surgery?

Yes, but after one year. In the first year, a patient is in a dynamic state of weight loss with several physiological changes already going on in the body. Pregnancy with in one year after Bariatric (Weight loss or obesity or Motapa) Surgery  would be superimposed; inhibiting weight loss as well. There is very low risk of having underweight baby born due to nutritional deficiencies.

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