Mr Sanjay Agrawal

Mr Sanjay Agrawal
Surgery
Central London


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Mr Sanjay Agrawal

Surgeon in
London
Hemel Hempstead &
Brentwood

MB BS MS FRCSEd FRCSGlasg FRCS(Gen. Surg) FASMBS

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Mr Sanjay Agrawal areas of expertise:

Professional statement

Mr Sanjay Agrawal is one of London's leading consultants in the specialty of bariatric, laparoscopic and pper GI Surgery and is certified as a 'Master Surgeon in Metabolic and Bariatric Surgery™ (MSMBS™)'. He has a broad range of surgical expertise and is one of the country's prominent experts in obesity and weight-loss surgery.

Mr Agrawal has undergone extensive training in the UK, Belgium, Japan and India and has undertaken more than 2,000 general surgical procedures so far. In addition, he has an experience of over 1,000 laparoscopic bariatric procedures to date.

Mr Sanjay Agrawal is a well-respected and very active member of the medical community, dividing his time between consultation and surgery, teaching, committee membership, publishing books and articles and even finding time for television appearances as an expert in his field. 

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Sanjay Agrawal Full MYC V5

 Doctor's articles

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What is a gastric sleeve?

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 Credentials

GMC: ‍5204374

 Professional experience

• More than 20 years of experience
• Consultant Surgeon, Homerton University Hospital (NHS) (present)
• Honorary Senior Lecturer, Blizard Institute, Barts and The London School of Medicine and Dentistry Queen Mary, University of London (present)
• Book Editor (Chief), ‘Obesity, Bariatric & Metabolic Surgery: A Practical Guide’ (Springer 2015)
• Fellow, American Society of Metabolic & Bariatric Surgery (FASMBS)

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 Sub-specialties

• Obesity surgery
• Bariatric surgery
• Weight loss surgery
• Gastric sleeve surgery
• Gastric band surgery
• Gastric bypass surgery
• Gallstone surgery
• Hernia surgery

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 Positions in public associations

• Member of International Scientific Committee in the 6th Congress of the International Federation for the Surgery of Obesity and Metabolic Disorders, European Chapter (IFSO-EC) held at Square Congress Centrum, Belgium (2014)
• Member of International Committee in the American Society for Metabolic & Bariatric Surgery (ASMBS) (2015 - 2016)

 Teaching posts

• Honorary Senior Lecturer, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary, University of London (present)

 Education

• FRCS (General Surgery), Intercollegiate Specialty Examination in General Surgery (September 2007)
• FRCSGlasg, The Royal College of Surgeons, Glasgow (1999)
• FRCSEd, The Royal College of Surgeons, Edinburgh (1999)
• Master of Surgery (MS) in General Surgery, Seth G.S. Medical College & King Edward VII Memorial (KEM) Hospital, University of Bombay, India (1999)
• MBBS, R.G. Kar Medical College & Hospital, University of Calcutta, India (1994)

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 Publications and conferences

• Invited to be speaker at many conferences, and has made a number of television documentary appearances representing obesity and bariatric surgery
• Edited and published two books and has written chapters in a further three including the popular textbook 'Obesity, Bariatric and Metabolic Surgery: A Practical Guide' http://www.obesitybariatricmetabolicsurgery.com/
• Published over 25 peer-reviewed articles, see http://www.mrsanjayagrawal.com/publications/

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 Prizes and awards

• Awarded ‘Fellow’ of the American Society for Metabolic & Bariatric Surgery society - FASMBS in 2016.
• International Book release for the textbook titled ‘Obesity, Bariatric & Metabolic Surgery: A Practical Guide’ published by Springer at the 20th World Congress of the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) held on 27th August, 2015 in Hofburg Imperial Palace, Vienna, Austria.
• Nominated & inclusion in the Silver Jubilee (25th) Edition of the Asian Who’s Who International publication – launched at the London Dorchester Hotel on 10th December, 2012.
• Awarded Certificate of “Bariatric Surgeon of ExcellenceTM”, “BSOETM” (now called ‘Surgeon of Excellence in Metabolic and Bariatric SurgeryTM’, ‘SOEMBSTM’) by Surgical Review Corporation (SRC) of United States of America (USA) in October, 2012.
• Awarded ASiT Bariatric Fellowship with Dr Bruno Dillemans in Brugge (Bruges), Belgium for 3months (5th October, 2009 to 18th December, 2009).
• Awarded the first Post-CCT Bariatric Fellowship under the National Surgical Fellowship Scheme through the Royal College of Surgeons of England in partnership with the Surgical Specialist Associations at Musgrove Park Hospital, Taunton in 2008 for 12 months (13th March, 2009 to 12th March, 2010).
• Awarded Ethicon Short Term Clinical Visit Grant by the Royal College of Surgeons of Edinburgh for the Gastric Fellowship at National Cancer Center & Cancer Institute Hospital in Tokyo in September, 2008.

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 Professional membership

• Fellow of the American Society of Metabolic and Bariatric Surgery (ASMBS)
• Member of the International Federation of Surgical Obesity (IFSO)
• Member of the British Association of Obesity and Metabolic Surgeons (BOMSS)
• Fellow of the Royal College of Surgeons of Edinburgh
• Fellow of the Royal College of Surgeons of Glasgow
• Member of the British Medical Association

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Languages spoken

  • English

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12/03/2018

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Diseases, Medical Tests and Treatments

Bariatric surgery

Bariatric surgery uses of a set of techniques and surgical procedures that help fight obesity and improve the patient's health. It is not to be mistak ...

Gallstones

What are gallstones? Gallstones are hard lumps or stones, usually made of cholesterol or sometimes other substances like bilirubin that form in the ...

Gastric band

What is a gastric band? Getting a gastric band is a type of bariatric surgery (weight loss surgery). Bariatric surgery aims to reduce the amou ...

Gastric sleeve

The gastric sleeve is a surgical technique in bariatric surgery for obesity.

Hernia

A hernia appears as a lump, most commonly in the abdominal or groin area. The occur when an organ, often the bowel, protrudes through the cavity which normally contains it. ...

Obesity surgery

What is obesity surgery? Obesity surgery, otherwise known as bariatric or weight-loss surgery, describes a range of procedures that are designed to treat people with obesity. Whilst there are different types of gastric surgery, the aim of the procedure is always to reduce the size of the stomach. Why would you do it? Bariatric surgery is a type of treatment for people who are obese. The surgery helps a person to lose weight and is generally carried out to reduce the risk of serious weight-related health problems which can be potentially life-threatening. Over time obesity can lead to multiple conditions such as heart disease, diabetes, high blood pressure and an increased risk of stroke. As a general rule, bariatric surgery is usually for those with a BMI of over 40 or those with a BMI of over 35, accompanied by a serious weight-related health problem. What does it involve? Some of the most common procedures, aimed at reducing the size of the stomach and making the patient feel full sooner and/or decreasing the ability to absorb nutrients are as follows: A gastric band can be fitted around the stomach in order to reduce its size. The band is usually placed around the top part of the stomach and is adjustable. A gastric bypass joins the top part of the stomach to the small intestine, thereby bypassing most of the stomach and small intestine. A sleeve gastrectomy removes part of the stomach, decreasing its volume significantly. All types of weight-loss surgery are done under general anaesthetic. Depending on the circumstances, the operation can be performed using open surgery or laparoscopically using smaller incisions and cameras to guide the process. The latter is also known as keyhole surgery. How to prepare for it Preparation for obesity surgery will depend on the individual to an extent. Restrictions are often placed on food and drink prior to surgery and certain medications may also need to be stopped for a period. Post-operative care Obesity surgery is a major operation and patients will normally wake up in a recovery room before being moved to a ward. There is no food or drink allowed for the first couple of days to allow the stomach and digestive system time to heal. After that, patients can progress to clear liquids and are often discharged around three days after surgery, providing everything goes well. A specific diet will then need to be followed for some weeks after surgery, usually centered on liquids and soft foods. Permanent lifestyle changes after surgery are also required to help keep weight off. Regular exercise and a balanced diet should be maintained to ensure that patients don’t put the weight they have lost back on. ...

Gallbladder surgery

Gallbladder surgery is the removal of the gallbladder, an organ located under the liver that produces bile. Removal is necessary when the patient has pain or symptoms caused by the formation of calculi (stones) in the gallbladder. The operation can be minimally invasive or open. In the first case, the surgeon will make three or four incisions in the abdomen and insert a laparoscope (a thin, lighted tube connected to a camera that enables the interior of the organ to be viewed) and other instruments for the procedure. Gas is injected to expand the abdomen so the bile duct and blood vessels that lead to the gallbladder can be cut. The organ is then removed. When the disease is more severe or there are complications during gallbladder surgery, an open operation is performed. This involves making a small cut in the abdomen to open it and remove the gallbladder through the incision. ...

Gastric bypass

What is a gastric bypass? Gastric bypass surgery is a type of bariatric surgery. Bariatric surgery aims to reduce the patient’s food and/or calorie intake via operations on the upper digestive system (particularly the stomach), which physically and psychologically affect the patient’s approach to food. A gastric bypass involves dividing the stomach into two “pouches”, and connecting the smaller top pouch directly to the small intestine, allowing food to “bypass” most of the stomach. This means that fewer calories are absorbed by the stomach, and due to the smaller space, the patient feels full quicker. As a consequence, they eat less.   Why would you have a gastric bypass? Gastric bypasses are used to treat a variety of conditions which require the patient to eat less or reduce calorie intake. It is commonly used as a weight loss treatment for morbid obesity, although surgery is rarely the first option – major operations carry risks, and can be expensive, so trying to lose weight via exercise and dietary changes is usually the first port of call. If this doesn’t help you to lose weight, your doctor might discuss surgical options, such as a gastric bypass. Other conditions that could warrant a gastric bypass include type 2 diabetes, sleep apnoea and hypertension. Long-term mortality of gastric bypass patients has been shown to be reduced by 40%.   What does it involve? The amount of food a patient can eat is limited by creating a small pouch in the upper stomach and dividing it from the rest of the stomach. This can either be done by creating a partition (which runs the risk of the stomach healing and returning to its pre-operative function) or by totally separating the two parts. The small intestine is reconstructed so that both parts of the stomach drain into it, rather than just from the bottom of the stomach. The surgery is often laparoscopic, i.e. using small incisions to insert a small camera and specialised surgical equipment to perform the operation without cutting the patient open.   How long does it take to recover from gastric bypass surgery? If the surgery is done laparoscopically, the patient may stay in the hospital for 2-3 days, and should be fully recovered in 3-5 weeks. Recovery time will be longer if open surgery is performed.   How much weight will you lose after a gastric bypass? On average, following gastric bypass surgery patients lose 60% of their extra weight.  Studies have shown it also significantly reduces the risk of impaired glucose tolerance (IGT) progressing to type 2 diabetes.  ...

Gastric reflux

Gastroesophageal reflux is a digestive disorder where acid from the stomach leaks back into the oesophagus. It usually occurs because of weakness in the lower oesophageal sphincter, the ring of muscle between the oesophagus and stomach. It also occurs regularly in healthy people, where it manifests as heartburn or acid indigestion but these are usually short, sporadic episodes compared to long-term gastroesophageal reflux disease. ...

Hiatal hernia

A hiatal hernia occurs when a portion of the stomach ascends to the thorax, through an opening located in the diaphragm, the barrier that separates the thorax from the abdomen. When the stomach moves to the thorax, the aforementioned separation loses its function and a gastroesophageal reflux occurs, that is, the gastric contents return to the oesophagus and irritate it. Symptoms caused by this condition may be burning in the chest or throat, hoarseness, asthma or breathing problems. The symptoms worsen after eating, when sleeping or bending over. The treatment of hiatal hernia depends on its severity, and sometimes it does not require any type of therapy. In mild cases, the aim is to control the symptoms, which improve with changes in the diet and postural changes. In the most severe cases, an operation, usually performed with fundoplication technique (minimally invasive laparoscopy), may be chosen. ...

Hiatal hernia surgery

What is hiatal hernia surgery? A hiatal hernia happens when a section of your stomach pushes up through an opening (called a hiatus) in your diaphragm. The diaphragm is a sheet of muscle located between the abdomen and chest. Hiatal hernia surgery involves pulling the stomach down into the abdomen and then making the hiatus opening in the diaphragm smaller. Why is hiatal hernia surgery performed? Surgery is required when a hiatal hernia does not respond to medication or lifestyle changes. Sometimes surgery is required for emergency cases. Surgery is also recommended if you have persistent symptoms, but do not want to be on medication long-term. What does it involve? Hiatal hernia surgery is usually performed using a laparoscope, which is a form of key-hole surgery. It involves a number of small abdominal cuts and the use of carbon dioxide to inflate a section of the abdomen. This allows the surgeon room to work. The laparoscope has a tiny camera on it, allowing the surgeon to see the inside of your body whilst they operate. During this surgery, the stomach is returned to its correct position, and the diaphragm around the oesophagus is tightened to ensure no more acid moves back out of the stomach. Surgery is performed under general anaesthetic to ensure there is no pain. This form of surgery takes 1-2 hours to complete. How to prepare for it Before surgery it is likely that your doctor will want to run tests on both how well the oesophagus moves, and how much acid is refluxed in a 24 hour period. Prior to surgery happening, the surgeon will explain fully the procedure and what to expect, as well as any possible side effects. Such side effects include: Bloating and flatulence Dysphagia (difficulty swallowing) Post-operative care Patients who have had hiatal hernia surgery can leave the hospital after the general anaesthetic has worn off, which usually takes two to three days. Most patients are able to return to work after three to six weeks post-surgery. It is also recommended that after surgery soft foods are eaten, such as soup or pureed vegetables for the first six weeks.   ...

Morbid obesity

Morbid obesity is also known as severe obesity or class III obesity. People are considered morbidly obese when their body mass index is above 40, or even 35 if the patient has a disease or severe disability as a result of being overweight. In many countries it is a public health problem due to the new eating habits of the society. Morbid obesity can be treated with a low calorie diet and regular exercise. In extreme cases patients can have bariatric surgery. ...

Obesity

Obesity is defined as having an abnormal or excessive accumulation of fat on the body, enough so that it can be a risk to the health of the person. There most common way of classifying the amount of weight on the body, and what constitutes as a healthy balance, is the body mass index (BMI), which is calculated by dividing your weight in kilograms, by your height, squared. The NHS classifies obesity as having a body mass index of 30 to 39.9, with those over 40 being classified as severely obese, though it is not necessarily the case as those with a large amount of muscle could be classified as obese due to their weight, when it may not actually be accurate. Another way of measuring excess fat is to measure waist circumference, for men, obesity is generally considered as being larger than 94cm (37in), and 80cm (21.5in) for women.   What causes obesity?   Simply speaking, obesity is caused by consuming more calories than are burned off through physical activity. When food is consumed, especially excessive amounts of fat and sugar in the diet, the body stores it as energy, in the form of fat. There are some health conditions that can lead to obesity and weight gain, such as problems with the thyroid, especially hypothyroidism.   How is obesity treated?   The best ways of treating obesity is to increase the amount of physical activity you perform on a regular basis, and to reduce the amount of calories eaten, along with eating a healthy, balanced diet. There are a number of ways that you can do this, such as joining a weight loss group to help you manage your diet and motivate you to continue sticking to it. You can also start activities such as walking, swimming or running. You can begin with exercising for short periods of time, before building up to longer periods. There are a number of surgical procedures available to help deal with weight loss in more severe circumstances, such as gastric band, gastric bypass, and biliopancreatic diversion.   What problems can obesity lead to?   Obesity can be detrimental to the health, leading to problems in different areas of the body. It can cause strain on the heart, leading to coronary artery disease, high blood pressure, high cholesterol, and other conditions. It is one of the leading causes of diabetes type 2, polycystic ovarian syndrome (PCOS), and infertility and can also have detrimental psychiatric effects such as depression along side often having a social stigma. To see a specialist to help with obesity, click here. Obesity is one of the most common diseases of modern society, caused by bad eating habits that cause a metabolic disorder in the form of excess fat and consequently overweight. If the caloric intake that provides the body is greater than that required or consumed is stored as fat. Besides, obesity may result in the acquisition of other diseases, such as diabetes mellitus, hypertension, high cholesterol or cardiovascular risk. In any case, obesity treatment tailored to each person according to their age, physique, medical history and daily habits is required. By measuring the body mass index patient's degree of obesity it is known and established a slimming diet should be low calorie, low fat, with the establishment of a rehabilitation plan of eating habits and exercise. The tandem diet-exercise physical is essential for weight loss. Obesity is one of the most common diseases of modern society, caused by bad eating habits that cause a metabolic disorder in the form of excess fat and consequently overweight. If the caloric intake that provides the body is greater than that required or consumed is stored as fat. Besides, obesity may result in the acquisition of other diseases, such as diabetes mellitus, hypertension, high cholesterol or cardiovascular risk. In any case, obesity treatment tailored to each person according to their age, physique, medical history and daily habits is required. By measuring the body mass index patient's degree of obesity it is known and established a slimming diet should be low calorie, low fat, with the establishment of a rehabilitation plan of eating habits and exercise. The tandem diet-exercise physical is essential for weight loss. ...

Stomach reduction

What is stomach reduction? A stomach reduction is an operation to reduce the size of the stomach; it is mainly performed in people who are morbidly obese. Different techniques exist, some of which involve removal of specific parts of the stomach.   Why is it done? The operation is performed to eliminate excess weight in people who are morbidly obese. It is performed when the specialist the patient cannot lose weight via dieting and physical activity, and their BMI is higher than 40 or 35. What does it involve? Currently, there are operations that do not require traditional open surgery; rather they can be carried out using an endoscopy. Stomach reduction by endoscopy, also known as POSE (Primary Obesity Surgery Endoluminal), is a new minimally invasive technique that does not require incisions and is performed orally. Specifically, an endoscope is inserted through the mouth until it reaches the stomach. In the stomach, folds are created to reduce its size and capacity, and to slow emptying. Endoscopic stomach reduction has several advantages: it provides a permanent result without external scars and does not require a hospital stay.  How to prepare for the operation You will have to follow a strict diet for a few weeks before the operation, in order to reduce cardiac risk during the operation. It is also advisable to perform breathing exercises and physical activity. Post-operative care As a result of the operation, your body will have undergone a major change, in terms of how you digest food. You will, therefore, have to change your lifestyle. After the operation, your stomach will be about the size of a walnut, have a lower capacity and will absorb nutrients differently. Your stomach will increase in size over time; during this period, you should not eat excess food. A normal stomach can receive up to 1 litre of food, whereas a “reduced” stomach should not exceed 250 ml of food. ...

Stomach surgery

What is stomach surgery? Stomach surgery describes the group of surgical procedures that remove, repair or modify the stomach, depending on what the underlying illness or problem is. Stomach disorders that can require surgery include: Stomach acid disease – a condition in which the stomach overproduces stomach acid, and can lead to stomach ulcers forming. Stomach cancer Gastroparesis – a condition where the stomach cannot properly empty itself of food due to a damaged vagus nerve which controls the digestive system. Stomach dumping – a condition in which food moves too quickly along the small intestine. Dysphagia – a condition where patients are unable to swallow food properly. Gastric bypass for weight-loss – some patients suffering from obesity will undergo gastric bypass surgery (a type of bariatric surgery) to help them lose weight. Why would you need stomach surgery? Surgery is generally required if other means of treatment and lifestyle changes have not worked to cure or overcome a problem. For emergency problems, or later stage stomach cancer, surgery will usually be the best option for treatment. What does it involve? The various procedures for treating bad cases of stomach acid disease are: Vagotomy – a procedure where the vagus nerve, which stimulates stomach acid production, is cut. Pyloroplasty – a procedure that widens the opening in the lower part of the stomach, which allows food to empty into the small intestine more easily. Partial gastrectomy – this procedure involves removing a section of the stomach. This may be required when part of the stomach tissue is badly damaged by stomach acid. Surgery for treating stomach cancer will usually be combined with other treatments, such as chemotherapy or radiation therapy. To treat stomach cancer surgically, usually the stomach will need to be partially or completely removed. Often, nearby lymph nodes will also be removed. When the stomach is completely removed, the oesophagus will be connected directly to the small intestine. If gastroparesis is severe and nutrients and medications cannot reach the bloodstream, surgery will be recommended. For this condition, a gastrostomy tube might be inserted through the abdominal skin and into the stomach. This should decompress the stomach, and allow feeding through the tube. To surgically treat stomach (gastric) dumping, the pyloric sphincter muscle can be reconstructed to improve the controlled release of food into the small intestine from the stomach. Patients suffering from dysphagia may require a tube to be implanted into the stomach to allow the intake of nutrition and hydration. This tube can either be inserted endoscopically through the throat or via an incision made in the abdomen. Bariatric surgery is a group of procedures that assist in weight-loss for obese patients. Gastric bypass surgery is one of the most common options and involves decreasing the size of the stomach by stapling a section of the stomach together, thereby limiting the amount of food that can enter the stomach. Next, the small intestine is attached to this section of the stomach, meaning food bypasses a section of the digestive system and fewer calories and nutrients are absorbed. How to prepare for it Most of these surgical interventions require general anaesthetic and are relatively intensive procedures, each with their own sizeable recovery period. As these surgeries are dealing with the digestive system, a period of fasting will generally be necessary before surgery. Post-operative care Many of these stomach surgeries will result in necessary lifestyle changes, including dietary adjustments, portion control, the need to use a feeding tube, and being aware of taking in enough of the right nutrients. Each procedure will have its own set of adjustments to make after surgery with the support of a specialist to assist in these being actioned.  ...

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