Does intra gastric balloon has any role in weight loss?

Intra Gastric Balloon insertion is an endoscopic non surgical procedure to treat obesity.

Eligibility –
Bariatric surgeries are indicated when the body mass index is greater than = 32.5 kg/m2 and life style modifications are enough when BMI is less than 27.5 kg/m2. When BMI is between 27.5 and 32.5 kg/m2, and patients are not able to lose weight by lifestyle modifications, then intra gastric balloon insertion can be considered. It can be considered even in those whose BMI is greater than = 32.5 kg/m2 who need bariatric surgery but are afraid to undergo the surgery. Generally it is considered in patients with 05 to 10 kg overweight.

Procedure –
For any balloon procedure it is necessary to do upper gastrointestinal endoscopy, to make sure that there are no contraindications for balloon insertion such as large hiatal hernia, reflux esophagitis, gastric ulcers and gastritis

Procedure is done under short general anaesthesia. After performing the upper GI endoscopy, silicon balloon along with tube and guide wire is introduced into the stomach. After making sure that the balloon crossed the gastro-esophageal junction, guide wire is removed and balloon is filled with 500 to 700 ml saline mixed with methylene blue through the tube connected to the balloon. The actual volume upto which balloon is filled is decided under vision. Once balloon is filled to the desired volume, tubing is pulled out and a valve seals the balloon and tubing junction.
Orbera balloon is an FDA approved balloon which can be kept for 6 months
Orbera 365 balloon can be kept for 1 year.

In Spatz adjustable balloon, there is an elastic tube attached to the balloon. It can be used to fill the balloon more than once. Initially balloon is filled to 300 to 400 ml. Once patient gets adjusted to the presence of balloon, endoscopy can be done to refill the balloon to increase to the desired volume of 600 to 800 ml. Volume can be further adjusted in future depending on whether the weight loss is as per the expectations or if there is balloon intolerance.

Once the duration of 6 months or 1 year is over balloon has to be removed by doing endoscopy

How does it work –
Weight loss is because of food restriction. It doesn’t change the hormones controlling body fat. So it is very inferior compared to bariatric surgeries

What are the results –
IGB combined with lifestyle modifications can result in 5 to 10% of the total body weight loss. To improve the outcomes Oral Semaglutide can be added. On average patients lose 05 to 10 kg of the weight. There are people who lost more than 30 kg weight also. But that will be 1 or 2 out of 100. Based on those 1 or 2, we can’t claim that everyone loses weight similarly. And some people may not lose weight at all after balloon insertion. And even some more will gain weight even in the presence of balloon.

Advantages –
No scars on the tummy.
Can be done as a day care procedure.
Patients will be in a position to leave hospital 12 hrs after the procedure.

Disadvantages –
It is very safe procedure.
But in the initial 1 week to 10 days, patients can have severe nausea, vomitings and colicy abdominal pain. Generally these symptoms will subside with medications and stomach gets adjusted for the presence of balloon. If the symptoms are intolerable, some may require balloon removal.
Spontaneous balloon leak or deflation can occur rarely. If the patient notices, urine turning into light blue color, then U have to consult your doctor to consider balloon removal. If balloon deflation or leak is unnoticed, it can deflate completely and pass through intestines. If it happens, it can block the intestine leading to intestinal obstruction requiring laparoscopic removal by opening the intestine.

Perforation of stomach is a rare complication of the balloon which requires laparoscopic management.

There will be some fullness as long as ballon is inside.

Post procedure –
Just like after any bariatric surgery, follow up at regular intervals is needed. Initial 2 weeks will be liquid diet, followed by healthy soft diet and then healthy normal diet.

In general balloons are very less effective, compared to bariatric surgeries. Balloons are generally for temporary weight loss. Endoscopic Sleeve Gastroplasty is a better choice compared to Intra Gastric Balloon if anyone is afraid of surgery.

If anyone need 5 to 10 weight loss and want to check if IGB is the right choice, please do not hesitate to contact me.

ARE YOU SUFFERING FROM OBESITY AND SEVERE DIABETES?
TAKE EXPERT OPINION NOW…

Subscribe to watch more videos
www.youtube.com/drvamar

BOOK APPOINTMENT NOW..
Dr. AMAR VENNAPUSA
Chief Consultant Bariatric & Metabolic Surgeon
Dr. Amar Bariatric & Metabolic Center,
Hyderabad, India
www.drvamar.com
+91 9676675646
drvamar@gmail.com.

The post Are Intra Gastric Balloons effective for weight loss?- Can they replace Bariatric Surgery?- Dr. Amar appeared first on Dr V Amar.

Swallowable Intra Gastric Balloons

Do swallowable intra gastric balloons have any extra advantage over regular balloons?

Intra Gastric Balloon insertion is an endoscopic non surgical procedure to treat obesity. In general balloons are indicated for those people whose BMI is between 27.5 and 32.5 kg/m2, and are not able to lose weight by lifestyle modifications. Balloons can be considered even in those whose BMI is greater than or equal to 32.5 kg/m2 who need bariatric surgery but are afraid to undergo the surgery. Generally it is considered in patients with 05 to 10 kg overweight.

Swallowable balloons are recent addition and the companies claim that there is
no need for endoscopy
no need for anaesthesia
no need for surgery
How far these claims are valid?
And what is being hidden?

In swallowable balloons, patient swallows the ballon which is in the form of a pill. Its position is confirmed by the fluoroscopy and balloon is filled upto 400 to 550 ml. Anaesthesia is not required for this balloon insertion. After 16 weeks, balloon spontaneously degrades and passes out through the anal canal.

For any balloon procedure it is necessary to do upper gastrointestinal endoscopy, to make sure that there are no contraindications for balloon insertion such as gastric ulcers, gastritis, large hiatal hernia or reflux esophagitis. Saying that no endoscopy is required is actually misleading the patients.

Weight loss is because of food restriction. It doesn’t change the hormones controlling body fat. So it is very inferior compared to bariatric surgeries. So any balloon procedure can’t replace bariatric surgeries. Those who require bariatric surgeries don’t actually benefit from balloons.

No anaesthesia is required but what about radiation? Fluoroscopy has a radiation equal to 75 to 300 Chest X Rays. We are exposing the patient to unnecessary radiation. Anaesthesia is better than radiation.

What are the results –
IGB combined with lifestyle modifications can result in 5 to 10% of the total body weight loss. To improve the outcomes Oral Semaglutide can be added. On average patients lose 05 to 10 kg of the weight. And some people may not lose weight at all after balloon insertion. And even some more will gain weight even in the presence of balloon.

Is it more effective than regular balloon?
In general balloons are very less effective, compared to bariatric surgeries. And swallowable balloons are even less effective because the volume is relatively less. Ballons are generally for temporary weight loss. Even if it is swallowable balloon, it is not advisable to do the procedure without prior upper gastrointestinal endoscopy to rule out any contraindications. And patient is exposed to unnecessary radiation.

Endoscopic Sleeve Gastroplasty is a better choice compared to Intra Gastric Balloon if anyone is afraid of surgery.

Its volume is 400 to 550 ml. Regular balloons upto 800 ml.

It stays only for 4 months. Regular balloons stay for 6 months to 1 year.

There is radiation equal to 75 to 3000 Chest X Rays with Fluoroscopy (Needed for this balloon). No radiation with regular balloons.

At the end any balloon is ineffective as it don’t change hormones
For More Details…

ARE YOU SUFFERING FROM OBESITY AND SEVERE DIABETES?
TAKE EXPERT OPINION NOW…

Subscribe to watch more videos
www.youtube.com/drvamar

BOOK APPOINTMENT NOW..
Dr. AMAR VENNAPUSA
Chief Consultant Bariatric & Metabolic Surgeon
Dr. Amar Bariatric & Metabolic Center,
Hyderabad, India
www.drvamar.com
+91 9676675646
drvamar@gmail.com.

The post Swallowable Intra Gastric Balloons – How far claims are true ? – Dr. V. Amar – Hyderabad appeared first on Dr V Amar.

Robotic Laparoscopic Bariatric & Metabolic Surgeries.

Bariatric and metabolic surgeries are performed for long lasting weight loss and long term diabetes remission.

They are performed by laparoscopic method. We can also perform these surgeries by Robotic laparoscopic method. It is the most advanced form of laparoscopy in which surgeon performs the bariatric surgeries using a robot. Davinci Xi is the latest Robotic system which is very advanced compared to the outgoing model.

There will be a robot which has 4 robotic arms. Robotic camera and instruments are attached to 3 or 4 robotic arms and introduced into the abdomen through ports. Surgeon performs surgery by sitting in front of a surgeon’s console having an immersion 3D technology. Surgeon’s hand movements are transferred to the robotic arms and flawless surgery is performed.

Advantages of robotic laparoscopic bariatric surgeries are-

Degree of freedom and range of movements of robotic instruments are significantly better than those of laparoscopic instruments so multiple tasks can be performed without lifting the elbow or abducting the shoulder. Hand movements will be just like in open surgery but done in a laparoscopic method.

Robotic arm movements are very refined. Tremors of surgeon’s hands if any, will be filtered and will not be transferred to the robotic arms.

There is an excellent depth perception with the 3D vision. Suturing using Robotic arms is very fast. There are highly advanced robotic staplers available to divide stomach and small intestine. Overall surgery duration is significantly reduced. Surgery is more refined and can be performed with additional safety.

Even difficult surgeries in individuals whose BMI is 60 or more than that, can be performed effortlessly.

If you are suffering from severe obesity or severe type 2 diabetes, and to check your eligibility for Robotic bariatric and metabolic surgeries, please do not hesitate to contact me.

For More Details…

ARE YOU SUFFERING FROM OBESITY AND SEVERE DIABETES?
TAKE EXPERT OPINION NOW…

Subscribe to watch more videos
www.youtube.com/drvamar

BOOK APPOINTMENT NOW..
Dr. AMAR VENNAPUSA
Chief Consultant Bariatric & Metabolic Surgeon
Dr. Amar Bariatric & Metabolic Center,
Hyderabad, India
www.drvamar.com
+91 9676675646
drvamar@gmail.com.

The post Robotic Laparoscopy – Is This The Future of Bariatric & Metabolic Surgeries? – Dr. Amar – Hyderabad appeared first on Dr V Amar.

Today’s topic is about a non surgical weight loss procedure specially for those who are afraid of bariatric surgeries. It is also a procedure for those who can’t lose weight by lifestyle modifications, at the same time are not eligible for bariatric surgeries.

Endoscopic Sleeve Gastroplasty is an endoscopic non surgical procedure to for weight loss.

Eligibility –
Bariatric surgeries are indicated when the body mass index is greater than equal to 32.5 kg/m2 and life style modifications are enough when BMI is less than 27.5 kg/m2. When BMI is between 27.5 and 32.5 kg/m2, there are no effective treatment methods until now. This ESG fills the gap and is useful for these people between 27.5 and 32.5 kg/m2. It can be done even in those whose BMI is greater than equal to 32.5 kg/m2 who need bariatric surgery but are afraid to undergo the surgery. Generally it is the perfect method to treat patients with 10 to 20 kg overweight. It can also be considered in patients suffering from uncontrolled type 2 diabetes in whom even 5 to 10 kg weight loss can bring back control. It also can be considered for those people who regained some weight after gastric sleeve or gastric bypass surgery.

Procedure –
In this procedure, we do an upper gastrointestinal endoscopy, and stomach volume is reduced by applying ‘U’ shaped interrupted sutures in the body of stomach using disposable endoscopic instruments and equipment called Apollo Overstitch. Upper part of the stomach (Fundus) and lower part of the stomach (Pyrloric antrum) are not sutured. Stomach body becomes like a tube.

How does it work?
Weight loss is because of food restriction, but it also causes some hormonal changes which reset fat mass to a lower level.

What are the results?
ESG combined with lifestyle modifications can result in 15 to 20% of the total body weight loss. To improve the outcomes Oral Semaglutide can be added.

Advantages –
No scars on the tummy.
Can be done as a day care procedure.
Patients will be in a position to leave hospital 12 hrs after the procedure.

Complications –
It is very very safe procedure. Apart from initial abdominal discomfort, nausea and vomitings in some patients, major complications are rare.

Post procedure –
Just like after any bariatric surgery, follow up at regular intervals is needed. Initial 2 weeks will be liquid diet, followed by healthy soft diet and then healthy normal diet.

If anyone need weight loss and want to check if ESG is the right choice, please consult me

For More Details…

ARE YOU SUFFERING FROM OBESITY AND SEVERE DIABETES?
TAKE EXPERT OPINION NOW…

Subscribe to watch more videos
www.youtube.com/drvamar

BOOK APPOINTMENT NOW..
Dr. AMAR VENNAPUSA
Chief Consultant Bariatric & Metabolic Surgeon
Dr. Amar Bariatric & Metabolic Center,
Hyderabad, India
www.drvamar.com
+91 9676675646
drvamar@gmail.com.

The post SCARED OF BARIATRIC SURGERY? – ENDOSCOPIC SLEEVE GASTROPLASTY – NON SURGICAL WEIGHT LOSS PROCEDURE appeared first on Dr V Amar.

Are Bariatric and Metabolic Surgeries dangerous?

What are the major complications after Bariatric and Metabolic Surgeries?
People think that are bariatric surgeries are very dangerous. But actually there are very very safe surgeries. Bariatric and Metabolic surgeries are performed for long lasting weight loss and long-term remission from type 2 diabetes. Infact obesity and type 2 diabetes are dangerous.
If anyone is suffering from severe obesity and severe diabetes there are at life risk.

Please check out the video of the rare complications of bariatric and metabolic surgeries and the measures taken to prevent these complications and how they are treated….

For More Details…

ARE YOU SUFFERING FROM OBESITY AND SEVERE DIABETES?
TAKE EXPERT OPINION NOW…

Subscribe to watch more videos
www.youtube.com/drvamar

BOOK APPOINTMENT NOW..
Dr. AMAR VENNAPUSA
Chief Consultant Bariatric & Metabolic Surgeon
Dr. Amar Bariatric & Metabolic Center,
Hyderabad, India
www.drvamar.com
+91 9676675646
drvamar@gmail.com.

The post Complications after Bariatric and Metabolic Surgeries – Dr. V. Amar appeared first on Dr V Amar.

HAIR LOSS AFTER BARIATRIC SURGERY

Bariatric surgeries are performed on individuals suffering from severe obesity to induce long lasting weight loss. These are life saving surgeries with several health benefits. Benefits of surgeries significantly outweigh the risks.

Hair loss (Alopecia) is one of the common problems noticed during weight loss period after bariatric surgeries in more than 1/3 of the individuals. It is generally a temporary problem noticed in the first one year after surgery.

Any type of weight loss can lead to temporary hair loss during weight loss period. Since weight loss is significant after bariatric surgeries, hair loss is more prominent. However hair loss stops once weight is stabilised.

Hair is one of the skin appendages. It grows out of the hair follicle (hair bulb) located in the dermis. Hair is mainly made up of keratin, an insoluble fibrous protein, rich in disulfide bonds.

Growth cycle of hair follicles has 3 phases –
1. Anagen phase – Active hair growth phase (~ 5 years on scalp).
2. Catagen phase – Conversion from active growth to resting phase (~ 2 weeks on scalp).
3. Telogen phase – Resting phase at the end of which the club hair is shed off (~ 3 months on scalp).
On an average ~ 100 hairs may shed from the scalp on a daily basis in healthy individuals.

Hair loss varies from person to person. People having preexisting hair loss tendency will notice more hair loss.
Protein deficiency leads to hair loss.

Since keratin is a protein rich in disulfide bonds, deficiency of sulfur-containing amino acids such as cysteine and methionine leads to the formation of brittle and fragile hairs and subsequent shedding.

Nutritional deficiencies (Vitamins such as Biotin and minerals such as Zinc, Iron) shorten the anagen phase leading to a large number of hairs entering telogen phase simultaneously. This leads to thinning of the hairs and subsequent shedding.

Water soluble B complex vitamins (Including Biotin – Known as vitamin H or vitamin B7) act as co-enzymes in many metabolic reactions and help in maintenance of healthy hair and skin.
Zinc has a role in protein and nucleic acid synthesis in hair follicles and other body cells. Low ferritin (Iron reserves in the body) is also associated with significant hair loss.

Stress, poor intake also influence hair loss. Hair loss is more after operations where part of the intestine is bypassed (such as gastric bypass, sleeve + bypass combination surgeries).

PREVENTION OF HAIR LOSS –
1. Take adequate protein.
2. Take bariatric vitamin and mineral supplements to prevent deficiencies.
3. Hydrate yourself well.
4. Reduce stress – Prepare mentally for temporary hair loss. Lack of preparation increases stress which in turn aggravates hair loss.

If you notice hair loss even after weight is stabilised, then you need to consult a dermatologist to rule out unrelated conditions and for further treatment.

ARE YOU SUFFERING FROM OBESITY AND SEVERE DIABETES?
TAKE EXPERT OPINION NOW…

Subscribe to watch more videos
www.youtube.com/drvamar

BOOK APPOINTMENT NOW..
Dr. AMAR VENNAPUSA
Chief Consultant Bariatric & Metabolic Surgeon
Dr. Amar Bariatric & Metabolic Center,
Hyderabad, India
www.drvamar.com
+91 9676675646
drvamar@gmail.com.

The post Hair loss after bariatric surgery appeared first on Dr V Amar.

What are the parameters to define OBESITY ?

Here the parameters to define OBESITY Review

ARE YOU SUFFERING FROM OBESITY AND SEVERE DIABETES?
TAKE EXPERT OPINION NOW…

The post What are the parameters to define OBESITY ? appeared first on Dr V Amar.

Why Bariatric surgery safe & Right For You

Bariatric and metabolic surgeries are performed on the Gut. These surgeries induce long lasting weight loss and long term remission from type 2 diabetes by altering several genes and Gut hormones which control body fat mass and insulin.

These changes include reduced Ghrelin, increased GLP1 & Peptide YY, altered Gut flora, and altered bile acids. These changes lead to increased metabolism, increased heat production and fat set point is reset to a lower level leading to long lasting weight loss. These surgeries also lead to increased insulin production and increased insulin sensitivity leading to long term diabetes remission.

The post Why Bariatric surgery safe & Right For You appeared first on Dr V Amar.

World Diabetes Day – Eligibility for Metabolic Surgery

Here: Dr. Amar Chief Consultant Bariatric & Metabolic Surgeon Review

The post World Diabetes Day – Eligibility for Metabolic Surgery appeared first on Dr V Amar.

Why Do People Gain Weight?

Here-Dr. Amar Chief Consultant Bariatric & Metabolic Surgeon  Review

ARE YOU SUFFERING FROM OBESITY AND SEVERE DIABETES?
TAKE EXPERT OPINION NOW…

The post Why Do People Gain Weight? appeared first on Dr V Amar.