Which bariatric surgery is right for me?

Written by: Mr Krishna Moorthy
Published:
Edited by: Laura Burgess

Bariatric surgery is indicated in patients who have a BMI of more than 35. Once a patient crosses a certain level of BMI, they are at a higher risk of developing serious medical conditions such as diabetes, high blood pressure, and sleep apnoea. These can give rise to more serious illnesses such as heart disease, stroke, and cancer.
 

Now, there is a lot of evidence that bariatric surgery not only prevents the occurrence of these serious medical conditions, but also that weight loss surgery reverses them and can actually help patients live longer. Therefore it prolongs the survival of these patients when they have undergone surgery. Expert bariatric surgeon Mr Krishna Moorthy discusses how a patient can choose the best weight loss surgery procedure for them…

What are the types of weight loss surgery?

There are four common procedures performed using laparoscopic surgery. There is gastric banding, the gastric sleeve with a sleeve gastrectomy and the gastric bypass. In terms of endoscopic procedures there is the gastric balloon, and altogether these are the four most common procedures to help patients lose weight.

Which bariatric surgery is best for me?

All of these surgeries have a role to play as they are all effective in different ways for different patients. The two most common procedures that Mr Moorthy performs are the gastric sleeve and the gastric bypass. Both of these procedures are very effective in helping patients lose weight but also in the sustaining of their weight loss. The sleeve gastrectomy comes without the long-term sides effects of a gastric bypass. The easy part of the decision-making process from the patient is that they have decided to consider surgery to lose weight. The next challenge for a patient is to then choose the procedure that they think will work best for them. It is very important that the bariatric surgeon helps the patient to make that choice but that choice has to be theirs as the patient is the one who is going to live with this operation for the rest of their life.

Choosing the best weight loss surgery

All of these procedures work really well in some patients, but may not work so well in other patients. The procedures are also chosen based on other factors such as a patient's eating behaviours. Some patients may eat very bulky meals and therefore a procedure like a sleeve gastrectomy would be ideal. Some patients may already have diabetes mellitus, and for them the gastric bypass would probably be the procedure of choice. So the decision-making process very much is a partnership between the patient and the Surgeon.

What are the success rates of weight loss surgery?

Bariatric surgery is highly successful and that is the reason why there are so many procedures that are being performed safely and effectively across the whole world. A sleeve gastrectomy and a gastric bypass are associated with nearly 25-30% of total body weight loss, usually at one year, two, or two and a half years and these are sustained even up to ten or fifteen years after surgery. Another way to measure the success of bariatric surgery is the resolution of diabetes. Diabetes can actually be treated via surgery and up to 50-70% of patients can have complete resolution of diabetes.

By Mr Krishna Moorthy
Surgery

Mr Krishna Moorthy is a ground-breaking London surgeon with specialist expertise in upper gastrointestinal surgery and hernia surgery. His upper gastrointestinal expertise includes surgery for cancer, weight loss (bariatric) and gastro-oesophageal reflux. He also specialises in all types of hernia surgery varying from simple inguinal hernias to complex hernias such as hiatal and incisional hernias. Mr Moorthy currently works at his private clinics alongside a clinic with the NHS.

With more than 25 years of experience in his speciality, Mr Moorthy has dedicated many years to research and development beyond his clinic hours. Most notably, Mr Moorthy was the first to perform the robotic gastric bypass and gastric band in the UK. Over the years, Mr Moorthy has performed thousands of laparoscopic procedures for all upper gastrointestinal conditions and complex hernias. Additionally, he is a specialist in the surgical management of cancers of the stomach and the oesophagus, and at present works in the reputable surgical unit in Imperial College.

Mr Moorthy has also published in over 80 peer-reviewed papers that have been in highly regarded journals. Furthermore, Mr Moorthy's research extends from the surgical table to patient, with topics including information transfer in surgery, multi-disciplinary handover, safety and teamwork in the operating theatre, and safety and quality of care of patients who are undergoing either elective and emergency surgery.

He focuses on improving patient safety and quality of care in surgery. He was involved in the development of the World Health Organisation surgical checklist which is now used throughout the NHS and often gives lectures on surgical training, patient safety in surgery, quality improvement and bariatric surgery. Mr Moorthy received the BMJ Surgical Team of the Year 2017 award for his lead in developing a novel prehabilitation programme called "PREPARE for surgery", which is a holistic patient programme regularly used within the NHS.

Mr Moorthy's most recent efforts have been co-founding a digital cancer programme called Onko to help prepare and support patients undergoing cancer treatment. It "combines the expert support you would get as an inpatient with all the convenience you would have as an outpatient"

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