Frequently Asked Questions

The purpose of the surgery is to shed off excess body weight and dangerous fat resulting in multiple diseases.

Doctors all over the world recommend weight loss surgery  if patient falls into any one of the following criteria:

• BMI > 37.5 or 40 kg excess weight
• BMI > 32.5 and obesity related medical condition. Such as diabetes mellitus, high blood pressure, sleep apnea, fatty liver disease, arthritis and other joint diseases, cholesterol problems, heart disease, gastrointestinal disorders etc.
• BMI > 27.5 in selected patients with poorly controlled diseases.

The measure of excess fat stored in the body is known as Body Mass Index (BMI).  The weight in kilograms is divided by the square of height in meters.

For eg if your wt is 105 kg and ht is 5 ft 6 inches (1.67 meters).

BMI = 105 /1.67 X 1.67 = 37.76 which means morbid obesity.

BMI Criteria for Asians is as follows:

Another way to measure is the ratio of waist to hip called WHR or Waist –Hip Ratio. For eg. A person with 30 inch waist and 38 inch hips as a WHR of about 0.78. According to the World Health Organization (WHO) , WHR greater than one is indicative of a higher risk of getting a heart disease.  WHR of 0.90 or less in men and 0.85 or less in women is considered healthy WHR.

Obese patients are at much greater risk of dying from heart disease, high blood pressure, Type II Diabetes and certain cancers. They have 10 to 50 % increased risk of death. There are multiple benefits including:

• Improvement or cure of obesity related diseases
• Increases life expectancy for about 15 years
• Improved quality of life
• Sustained and successful weight loss
• Improved self confidence and body image
• Reduced risk/significantly decreases chances of Myocardial Infarction
• Incidence of death from breast cancer decreases
• Attractive physical appearance

The choice of operation depends on your age, access weight, obesity related diseases and your targets. It is decided in consultation with the surgeon.

There is no upper age limit for this type of surgery. Patients general health and heart, lung function is taken into consideration.
Early teens can undergo surgery depending on the sexual maturity and bone age growth.

If 50 % access weight is lost, the surgery is considered successful. In gastric bypass patient looses 60 to 80 % access weight whereas in sleep gastrectomy, access weight loss is 60 to 70 %.

Generally, hospital stay is 24 hours. Sometimes the stay is of 48 hours.

Duration of the surgery varies depending on the selection of operation. Laparoscopic gastric bypass operation lasts for 2 to 3 hours. Sleep gastrectomy takes about 60 to 90 minutes.  Incase of previous abdominal operations in certain conditions it may take a bit longer.

After discharge patients are able to function on their own. Most of them return to work after one week. If the work is more physical, it may take upto four weeks.  One can drive after pain killers are not required and active movements are pain free.

After discharge patients are able to function on their own. Most of them return to work after one week. If the work is more physical, it may take upto four weeks.  One can drive after pain killers are not required and active movements are pain free.

1. A) Laparoscopic Sleeve Gastrectomy (Food restriction):

Almost 80% of stomach is removed and remaining portion is converted into a small banana shaped pouch.

This is your “new stomach”.

It is the most common weight loss surgery throughout the world.

The hunger hormone Ghrelin secretion is significantly reduced. Decreased appetite and early satiety help in limited food consumption.

There is a rapid weight loss and resolution of diabetes, blood pressure, fatty liver disease etc.

This procedure is less recommended in patients with acid reflux disease (reverse flow of food content and acid from stomach to feeding tube) and sweet addiction.

This operation is irreversible.

1. B) Laparoscopic MGB-OAGB (Food restriction + Malabsorption):

It is also called Mini-gastric bypass/One anastomosis gastric bypass.

This operation has an excellent safety profile, longer and durable weight loss and resolution of diseases better than sleeve gastrectomy. Due to the very low weight regain, this procedure is gaining rapid popularity among surgeons and patients.

It is a completely reversible procedure and more appropriate for patients with sweet addiction and acid reflux disease. People require life-long vitamin supplements and yearly blood tests after surgery. Due to the larger pouch size, the quality of eating is better than RYG bypass.

A sleeve like tube is cut out from the stomach; which restricts food intake. The remaining stomach is left in place. The small intestine, 150 to 200cm from its start is lifted up and attached to the stomach tube, which then leads to lesser absorption of food.

C: RNY Gastric bypass, (LRYGB) (Food restriction + Malabsorption):

A small stomach pouch, approximately 30 ml, is created close to the upper end of stomach. The first portion of the small intestine is divided, and the bottom end of the divided intestine is attached to the stomach pouch. The top portion of the divided small intestine is connected to intestine further down.

The complication rates are slightly higher but the results are equal to MGB-OAGB.

There are two intestinal joints, instead of one.

There is a risk of internal herniation.

Life-long vitamin supplements and yearly blood tests are compulsory.

It varies on the type of operation, duration of surgery and selection of the hospital. Range of packages are available which includes all expenses of hospital stay.

Currently insurance companies of Pakistan do not provide coverage for the surgery. In some cases, reimbursement is possible.

Absolutely, we have worked with patients from America, United Kingdom, Saudia Arabia and UAE already. You can generate an online consultation for initial assessment and plan to visit the clinic on arrival. We advise to plan five to seven days stay in Karachi after operation.

Appetide is suppressed soon after the operation and hunger is not an issue. The bariatric nutritionist will take you through from first two days of liquids to normal household cuisine. As every individual is different, It can take from ten weeks to 16 weeks. You will be able to dine out and enjoy with smaller portion size.

This operation is done via key hole surgery which inflicts minimal pain.

Actually, obesity makes it difficult for many women to get pregnant.  The chances of getting pregnant is significantly increased during and after weight loss.  Its recommended to plan pregnancy 12 to 18 months after the operation, when the weight reduction becomes stable.

All abdominal operations carry these risks.

• Bleeding
• Infection of the wound/abdomen
• Blood Clot in the vessels of leg or lung
• Blockage of intestine
• Risks associated with anesthesia
• Leak from the suture line
• Risk of death is 0.2 % which is same as for gall bladder, joint replacement and hysterectomy