Govt hospitals new hot spots for bariatric surgery

NEW DELHI: Bariatric surgery, to lose weight and treat conditions such as diabetes, hypertension and sleep apnoea (temporary cessation of breathing, especially during

NEW DELHI: Bariatric surgery, to lose weight and treat conditions such as diabetes, hypertension and sleep apnoea (temporary cessation of breathing, especially during sleep) in morbidly obese people, has also picked up in government hospitals in a big way, with Delhi government’s Lok Nayak Hospital recently completing 100 surgeries.

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The surgery that costs anywhere between Rs 3-4 lakh in private hospitals is performed free of cost in the three government hospitals — All India Institute of Medical Sciences, Ram Manohar Lohia and Lok Nayak hospital.

“The patients might have to pay for certain consumables at times. However, the maximum cost incurred would be Rs 1 lakh, which is less than one third the cost of the surgery in private centres,” said Pawanindra Lal, director professor of surgery at Lok Nayak Hospital, the only hospital under Delhi government that performs the surgery.

At government set-ups, which usually cater to poor and middleincome households also receive 15-20% obese and overweight patients. And, a patient has to fulfil certain criteria to get selected for the surgery. The person has to be morbidly obese, having associated conditions like diabetes, hypertension, sleep apnoea or heart diseases that might reverse or improve as a result of weight loss.

A person is considered to be morbidly obese if their body mass index (BMI) — height to weight ratio — is higher than 38. The normal range is between 18.5 and 24.9.

The doctors also look at the dedication of the patients in following the prescribed diet and exercise regimen.

“We ask the patients to visit the clinic every other week for three to six months before the surgery. During this time we note whether they follow the suggested regimen. In some cases we have allowed people to overtake others who are not that committed,” said Dr Lal.

The regular follow-ups are continued even after the surgery. “The regular visits ensure that the patients follow the prescribed regimen and break the unhealthy habits they have cultivated over the years,” he said.

To help with the regular follow-up, Lok Nayak hospital has also developed a mobile application, which can be purchased for a one-time payment of ` 1,000, and will remind the person about their eating and exercise schedule. Plus, they will be able to directly contact the doctor on the application.

“The app was launched in April and helps us in monitoring their (patients) habits and capturing data. Sadly, half the people who come to our OPD do not have smart phones,” said Dr Lal.

The metabolic surgery programme at Lok Nayak hospital was started in 2010 and has operated upon 101 people till now. Within a few weeks after the surgery, 57 out of 66 patients with hypertension and 23 out of 25 with diabetes were completely cured. In the remaining, the doses of medicine have significantly reduced. All 36 patients with sleep apnoea have been cured.