Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) in Punjab-Dr Amit Garg | Fortis Hospital (Mohali)

Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) in Punjab, also known as Mini gastric bypass surgery, is a mixed restrictive and malabsorptive weight loss procedure offered in Punjab, India. This surgical intervention involves creating a new, small gastric pouch and rearranging the digestive tract to limit food intake and reduce calorie absorption, resulting in significant and sustained weight loss.

During LRYGB, specialized stapling instruments are used to create a small 30 cc gastric pouch without removing the remaining stomach. The outlet of this pouch is connected to the small intestine, bypassing a portion of the intestine and redirecting digestive juices back into the common channel in a “Y” shape hookup, hence the name Roux-en-Y Gastric Bypass. This arrangement leads to early satiety, reduced appetite, and decreased calorie absorption, resulting in substantial weight loss ranging from 60% to 80% of excess weight over approximately 2 years.

Dr. Amit Garg , a leading weight loss surgeon in Punjab with over 10 years of experience, specializes in performing LRYGB. Dr. Garg’s expertise includes addressing severe reflux issues and controlling type 2 diabetes through modified Roux-en-Y Gastric Bypass, which has shown promising results in diabetes remission. Despite advancements in other procedures like gastric sleeve and mini gastric bypass, LRYGB remains a powerful and effective option for select patients with specific health concerns.

Dr Amit Garg

Minimal Access Bariatric

Metabolic & GI Surgeon

Candidate Criteria for Gastric Bypass Surgery

Ideal candidates for gastric bypass surgery in Punjab include individuals with a BMI greater than 40 kg/m² or a BMI ranging from 35 to 39.9 kg/m² with serious obesity-related health problems such as type 2 diabetes, hypertension, or severe sleep apnea.

Bariatric surgery is now covered by  health insurance companies in India from October 2020, making it accessible to more individuals seeking treatment for obesity and related health issues.

Procedure Details and Recovery after Roux-en-Y or Gastric Bypass Surgery

LRYGB is performed laparoscopically under general anesthesia, with an approximate duration of 2 hours. Patients with BMI > 50 might require a pre surgery liquid diet in order to reduce the size of the left lobe of liver. For super obese patients, LRYGB might be difficult to perform and in these patients RYGB is done as a staged procedure. In the first stage gastric sleeve is done so that patients can lose 30-40 kgs of excess weight and then after 6 months gastric sleeve is converted into a gastric bypass so that patient can reach ideal weight.

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During LRYGB, after port placements, the liver is retracted using Nathansons liver retractor. Lesser sac is opened at the level of the 2nd vessel on lesser curvature. Horizontal and then vertical staplers are fired in order to create a small stomach pouch of 30 cc. Ligament of Treitz is identified and 100 cm of small intestine is bypassed and connected to small stomach pouch . The intestine is divided using staplers proximal to the anastomosis and again connected to the distal intestine 100cm from gastrojejunostomy. Inter-mesenteric defect is closed and Petersons defect is closed to prevent formation of internal hernias using non absorbable sutures. A methylene blue dye leak test is done to check for leaks from Gastrojejunostomy. After achieving hemostasis, ports are closed.

Possible Risks and Complications of Gastric Bypass Surgery in Punjab

Like any abdominal surgery, LRYGB carries risks such as excessive bleeding, infection, leakage, bowel obstruction, dumping syndrome, gallstones, hernia, and malnutrition. However, with proper preoperative evaluation and postoperative care, these risks can be minimized, and patients can experience significant improvements in obesity-related conditions like gastroesophageal reflux disease, heart disease, hypertension, obstructive sleep apnea, and infertility.

Gastric bypass for Type 2 diabetes / metabolic surgery for type 2 diabetes / Diabetes surgery in Punjab

Gastric bypass was earlier done to treat Obesity but over the years, studies have shown diabetes remission of 83% in patients who have undergone gastric bypass surgery. Recently, Gastric bypass has regained popularity to treat type 2 diabetes in non-obese patients. It is recommended for patients with BMI > 27.5Kg/m2 as the second line of treatment. In a modified RYGB to treat Type 2 diabetes, biliopancreatic limb is kept 150cm in spite of 100 cm and alimentary limb is kept 100cm.

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LRYGB has shown better results in diabetes remission as compared to mini gastric bypass and sleeve gastrectomy. In a comparative study with Loop duodenojejunal bypass (LDJB), LDJB has shown diabetes remission of 94%. RYGB is going to be the best procedure for patients with Type 2 diabetes.

Conclusion

Laparoscopic Roux-en-Y Gastric Bypass in Punjab, India, offers a gold standard surgical option for achieving substantial and long-term weight loss in eligible patients. With the expertise of Dr. Amit Garg and advancements in bariatric surgery, individuals can achieve improved health and quality of life through sustainable weight management.

Highlights – Gastric Bypass Surgery /weight loss surgery in Punjab, India

  • Highlights – Gastric Bypass Surgery /weight loss surgery in Punjab, India
  • The approximate duration of the surgery is 2 hours, and patients are encouraged to walk on the same day of the procedure
  • It is a potent surgical intervention for addressing obesity and type 2 diabetes.
  • Globally recognized as the gold standard procedure for weight loss.
  • The majority of patients are discharged on the third day post Roux-en-Y Gastric Bypass (RYGB) surgery.
  • Liquid diet initiation occurs shortly after the completion of gastric bypass surgery.
  • Lifelong supplementation of multivitamins, iron, and calcium is essential following Gastric Bypass.
  • Expect around 70% excess weight loss within one year, with long-term efficacy.
  • Expect around 70% excess weight loss within one year, with long-term efficacy.
  • It may lead to improvement or resolution of conditions commonly associated with obesity, including Gastroesophageal reflux disease, heart disease, high blood pressure, obstructive sleep apnea, and infertility.

Dr. Amit Garg is recognized as the best surgeon for Gastric Bypass surgery / weight loss surgery in Punjab, providing comprehensive care and long-term support to patients on their weight loss journey. He has extensive experience in performing various bariatric or metabolic surgery procedures and has more than 2000+ successful cases to his credit.

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