Bengaluru hospital achieves feat in weight-loss surgery

The patient, who underwent the 'redo operation' at the Fortis Hospital in Bengaluru's Cunningham Road, had earlier undergone a bariatric surgery eight years ago.

In a prominent medical feat, a team of doctors at the Fortis Hospital in Bengaluru has successfully managed to perform a 'redo bariatric surgery', a revisional weight-loss treatment, on a 50-year-old woman who weighed 117kg. The surgical achievement is being considered 'noteworthy' in view of the fact that 'redo weight loss' medical procedures are often quite complicated, involving work on patients who have already had such weight-loss surgeries before, and the new procedure is aimed at correcting a post-surgical complication or converting the operation into another type.

The team which led the revisional procedure was led by Dr Ganesh Shenoy, senior consultant (minimal access, gastrointestinal and bariatric surgery)  (Photo via Fortis)

The patient, who underwent the 'redo operation' at the Fortis Hospital in Bengaluru's Cunningham Road, had earlier undergone a bariatric surgery eight years ago at some other hospital. At the time of the earlier surgery, she weighed 114kg and had lost 23kg post-operation.

The patient regained weight over the years and was weighing 117kg at present, thus requiring a 'redo bariatric surgery', this time at the Fortis Hospital.

What caused the weight gain?

According to the Fortis Hospital, 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 for 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.

Redo bariatric surgery

The team which led the revisional procedure was led by Dr Ganesh Shenoy, senior 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 anesthesiologists was led by Dr Dattatreya Prabhakumar (senior consultant, anesthesiology) and Dr Meenakshi.

“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,” explained Dr Shenoy, who led the procedure. "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.”

Notably, obesity has more than doubled in the last decade, putting 80%-85% of the population at risk of diabetes, according to Fortis Hospital.

Terming obesity and its related disorders as “silent killers”, Dr Shenoy said that Laparoscopic Sleeve gastrectomy, Roux-en-Y Gastric Bypass (RYGB) & Mini Gastric Bypass (MGB) are the three most common bariatric surgeries performed in our country.

“In the long term, 10%-15% of the patients may need redo bariatric surgery for weight regain,” he said. "The laparoscopic redo bariatric surgeries are quite challenging and are rarely performed as very few patients may need this surgery in the long run.”