Weight Loss Surgery Abroad

About weight loss surgery abroad, the following contains general information that may not apply to you. You should consult with your physician about your specific situation.

Cost of weight loss surgery abroad

High quality, low cost weight loss surgery in India is now within reach.

Procedure	Cost in US	Cost abroad
Lap Band	$18,000	$7,800
Gastric Bypass (RNY)	$23,000	$9,100
Duodenal Switch	$28,000	$12,500

Am I a Candidate for Weight Loss Surgery?

You may be a candidate for weight loss surgery if you have:

A body mass index (BMI) of 33 or more or about 100 pounds overweight for men and 80 pounds for women
An understanding of the operation and the lifestyle changes you will need to make.

Is Weight Loss Surgery for You?

Weight loss surgery may be the next step for people who remain severely obese after trying non surgical approaches, or for people who have an obesity-related disease. Anyone thinking about undergoing this type of weight loss surgery should understand what it involves. Answers to the following questions may help you decide whether weight loss surgery is right for you.

Are you:

Unlikely to lose weight or keep weight off long-term with non surgical measures?
Well informed about the surgical procedure and the effects of the weight loss surgery?
Determined to lose weight and improve your health?
Aware of how your life may change after the operation (adjustment to the side effects of the operation, including the need to chew food well and inability to eat large meals)?
Aware of the potential for serious complications, dietary restrictions, and occasional failures related to weight loss surgery?

Remember: There are no guarantees for any method, including surgery, to produce rapid weight loss and maintain it. Success with weight loss surgery is possible only with maximum cooperation and commitment to behavioral change and medical follow-up and this cooperation and commitment must be carried out for the rest of your life.

There are many types of weight loss surgery. Clients usually choose one of the following three types of surgeries:

LAP-BAND®
Gastric Bypass (RNY)
Duodenal Switch

What is Lap Band Surgery?

The LAP BAND System is an adjustable gastric band designed to help you lose excess body weight, improve weight-related health conditions and enhance quality of life. It reduces the stomach capacity and restricts the amount of food that can be consumed at one time. The LAP-BAND® System procedure does not require stomach cutting and stapling or gastrointestinal re-routing to bypass normal digestion. The LAP BAND System is the only adjustable and reversible weight-loss surgery available in the United States and the only weight-loss surgery approved for use by the Food and Drug Administration (FDA).

The name "LAP-BAND" comes from the surgical technique used, laparoscopic, and the name of the implanted medical device, gastric band. The LAP BAND System is a silicone ring designed to be placed around the upper part of the stomach and filled with saline on its inner surface. This creates a new, smaller stomach pouch that can hold only a small amount of food, so the food storage area in the stomach is reduced. The band also controls the stoma (stomach outlet) between the new upper pouch and the lower part of the stomach. When the stomach is smaller, you feel full faster, while the food moves more slowly between your upper and lower stomach as it is digested. As a result, you eat less and lose weight.

Lap Band

The Minimally Invasive Procedure

During the procedure, surgeons usually use laparoscopic techniques (making tiny incisions rather than a large incision and inserting long-shafted instruments through "ports"), to wrap the LAP-BAND® System around the patient's stomach. A narrow camera is passed through a port so the surgeon can view the operative site on a nearby video monitor. Like a wristwatch, the band is fastened around the upper stomach to create the new stomach pouch that limits and controls the amount of food you eat. The band is then locked securely in a ring around the stomach.

Since there is no stomach cutting, stapling, or gastrointestinal re-routing involved in the LAP-BAND® System procedure, it is considered the safest, least invasive, and least traumatic of all weight-loss surgeries. The laparoscopic approach to the surgery also has the advantages of reduced post-operative pain, shortened hospital stay, and quicker recovery. If for any reason the LAP-BAND® System needs to be removed, the stomach generally returns to its original form.

Adjustable Weight Loss

Once placed around the stomach, tubing connects the LAP BAND to an access port fixed beneath the skin of your abdomen. This allows the surgeon to change the stoma (stomach outlet) size by adding or subtracting saline, or salt water, inside the inner balloon through the access port. This adjustment process helps determine the rate of weight loss. If the band is too loose and weight loss is inadequate, adding more saline can reduce the size of the stoma to further restrict the amount of food that can move through it. If the band is too tight, the surgeon will remove some saline to loosen the band and reduce the amount of restriction.

The diameter of the band can be modified to meet your individual needs, which can change as you lose weight. For example, pregnant patients can expand their band to accommodate a growing fetus, while patients who aren't experiencing significant weight loss can have their bands tightened.

The LAP BAND System is also the only adjustable weight-loss surgery available in the United States to help maintain restriction and keep the weight off long-term.

The LAP BAND System Advantages at a Glance

Minimal Trauma

Least invasive surgical option
No intestinal re-routing
No cutting or stapling of the stomach wall or bowel
Small incisions and minimal scarring
Reduced patient pain, length of hospital stay and recovery period

Fewer Risks and Side Effects

10 times less operative and short-term mortality than gastric bypass
Low risk of nutritional deficiencies associated with gastric bypass
Reduced risk of hair loss
No "dumping syndrome" related to dietary intake restrictions

Adjustable

Allows individualized degree of restriction for ideal rate of weight-loss
Adjustments performed without additional surgery
Supports pregnancy by allowing stomach outlet size to be opened to accommodate increased nutritional needs
Only surgical option designed to help maintain long-term weight loss

Reversible

Removable at any time
Stomach and other anatomy are generally restored to their original forms and functions

Effective Long-Term Weight Loss

More than 300,000 LAP BAND System devices placed worldwide
Standard of care for hundreds of surgeons around the world
#1 selling adjustable gastric band for weight loss
Academic publications with up to 10 years of follow-up

Lap Band Surgery Preparation

As part of your Lap Band surgery preparation abroad you will fill out a detailed bariatric specific questionnaire, which will allow the doctors that we work with to determine your eligibility for Lap Band surgery. If you are not ready to make lifestyle changes (and have not tried hard to do so already), you will not be considered eligible for the procedure. After hospital admission, you will receive psychological advice. This will help you adhere to a healthier lifestyle. Without changing your lifestyle, the surgery will not be a success. You will also receive nutritional counseling before (and after) your surgery.

Lap Band Surgery Recovery

One of the benefits of the LAP-BAND® System is that patients return to normal activity relatively quickly after surgery. The length of hospital stay is usually around 48 hours. It also takes most people about a week to return to work and a month to six weeks to resume strenuous exercising.

LAP-BAND® System surgery is the first step on the road to successful and sustained weight loss. However, you must take the next step by adopting a lifelong program that will help you meet your goals. This multifaceted program will include routine check-ups with your surgeon, ongoing band adjustments if necessary, and regular attendance at support group meetings. You will need to work closely with your surgeon and weight-management team, follow their advice, and communicate openly with them. You will also need to learn to use the LAP-BAND® System as a tool to help you lose your excess weight.

Post-Surgery Nutrition

After surgery, you will need a new nutrition plan. Your surgeon and/or dietitian can help you learn about and get used to the changes in lifestyle and eating habits you need to make. It is very important to follow the eating and drinking instructions beginning immediately after the operation.In the first few weeks after your surgery, you will be on a liquid diet since only thin liquids will be tolerated by your stomach at that time. As you heal, you will gradually progress to pureed foods (three to four weeks post-op) and then soft foods (five weeks post-op). Finally, you will be able to eat solid foods.

When you can eat solid foods without problems you will need to pay close attention to your diet. The LAP-BAND® System is designed to restrict solids, not liquids, so drinking liquids will not make you feel full. You also should not drink liquids during or immediately after meals as they will flush food through the reduced stomach pouch, which means you will not get the prolonged feeling of satiety needed to help you eat less. However, staying hydrated and drinking lots of water throughout the day is important. You will also need to learn to eat slowly and chew your food very thoroughly.

It is recommended that you eat only three small meals a day and make sure that these meals contain adequate nutrients. You will need to make good food choices and learn to avoid problem foods, such as high-fiber, high-fat, and dry foods, since these are more difficult for the small stomach pouch to digest. Good food choices include fruit and vegetables, lean protein, some bread and cereal, and some dairy products. Foods that have a concentrated supply of calories with little nutritional value, such as milkshakes, syrups, jam, and pastries, should be avoided as much as possible.

Exercise Plan

Incorporating regular physical activity into your daily routine is as important as following your nutrition plan. Often patients have been sedentary due to decreased activity tolerance, psychological constraints, and in some cases, physical disabilities. After LAP-BAND® surgery, aerobic activities - particularly walking and swimming - are generally best tolerated. You will need to consult with your surgeon and weight-management team to find out which activity is right for you.

Adjustments

Being able to adjust the band is a unique feature of the LAP BAND System and is a normal part of the post-surgery follow-up. This feature allows your surgeon to the right level of restriction to meet your individual needs.

Adjustments are simple office visits that only take 10 or 15 minutes. They are performed without surgery using a thin needle to inject or withdraw saline from the band via the access port. This widens or narrows the band opening to control the rate of your weight loss. The most common reasons for adjustments are that you are not able to eat much of anything without feeling uncomfortable and vomiting (your band is too tight) or that you are not losing weight (your band is too loose). The first adjustment is typically done 4 to 6 weeks after surgery, and the total number of adjustments you may have will depend on your individual weight-loss rate and results.

Your Motivation: Key to Success

To work, the LAP BAND System needs your active participation. Your success will depend on you and the partnership between you and your medical team. Your surgeon will not perform the operation unless he or she is sure that you understand the problems your excess weight is causing. Your surgeon will also make sure you understand your responsibilities, including adopting and maintaining new eating patterns and a healthy lifestyle.

Gastric Bypass (RNY) surgery

First, the surgeon creates a small stomach pouch to restrict food intake. Next, a Y-shaped section of the small intestine is attached to the pouch to allow food to bypass the lower stomach, the duodenum (the first segment of the small intestine), and the first portion of the jejunum (the second segment of the small intestine). This reduces the amount of calories and nutrients the body absorbs. Rarely, a cholecystectomy (gall bladder removal) is performed to avoid the gallstones that may result from rapid weight loss. More commonly, patients take medication after the operation to dissolve gallstones.

Gastric Bypass (RNY) Preparation

As part of your Gastric Bypass (RNY) preparation abroad you will fill out a detailed bariatric specific questionnaire, which will allow the doctors that we work with to determine your eligibility for Gastric Bypass (RNY). If you are not ready to make lifestyle changes (and have not tried hard to do so already), you will not be considered eligible for the procedure. After hospital admission, you will receive psychological advice. This will help you adhere to a healthier lifestyle. Without changing your lifestyle, the surgery will not be a success. You will also receive nutritional counseling before (and after) your surgery.

Gastric Bypass (RNY) recovery

Most people typically stay in the hospital for 2-3 days after gastric bypass surgery. Your doctor will approve your discharge to home once you can do the following:

Move without too much discomfort
Eat liquid and/or pureed food without vomiting
No longer require pain medication given by injection

You will remain on liquid or pureed food for several weeks after the surgery. Even after that time, you will feel full very quickly, sometimes only being able to take a few bites of solid food. This is because the new stomach pouch initially only holds a tablespoonful of food. The pouch eventually expands. However, it will hold no more than about one cup of thoroughly chewed food (a normal stomach can hold up to one quart).

Upon follow up, your doctor will determine if you need replacement of iron, calcium, vitamin B12, or other nutrients. Supplements, such as a multivitamin with minerals, will be prescribed to provide any nutrients that you may not be getting from your diet. This lack of nutrients can occur because you are eating less and because the food moves through your digestive system more quickly.

Once your diet begins to consist of more solid food, remember to chew each bite very slowly and thoroughly.

You will be instructed on eating small meals frequently throughout the day, rather than large meals that your stomach cannot accommodate.

Your new stomach probably won't be able to handle both solid food and fluids at the same time. So, you should separate fluid and food intake by at least 30 minutes and only sip what you are drinking. You won't be able to tolerate large amounts of fat, alcohol, or sugar. You should reduce your fat intake, especially fast food meals, deep-fried foods, and high-fat foods, as well as high-sugar foods like cakes, cookies, and candy.

Exercise and the support of others (for example, joining a support group with people who have undergone weight loss surgery) are extremely important to help you lose weight and maintain that loss following gastric bypass. You can generally resume exercise 6 weeks after the operation. Even sooner than that, you will be able to take short walks at a comfortable pace, with the approval and guidance of your doctor. Exercise improves your metabolism, while both exercise and attending a group support can boost your self-esteem and help you stay motivated.

The weight loss results of gastric bypass surgery are generally good. Most patients lose an average of 10 pounds per month and reach a stable weight between 18 and 24 months after surgery. Often, the greatest rate of weight loss occurs in the very beginning (that is, just following the surgery when you are still on a liquid diet).

Duodenal switch surgery

In a biliopancreatic diversion with duodenal switch, a smaller portion of the stomach is removed through making small key hole incisions (laparoscopic surgery), but the remaining stomach remains attached to the duodenum (the upper part of the small intestine). The duodenum is connected to the lower part of the small intestine. The fact that the duodenum stays in place leads to the main advantage of duodenal switch as a form of weight loss surgery which is that dumping does not occur.

Duodenal Switch Preparation

As part of your Duodenal Switch preparation abroad you will fill out a detailed bariatric specific questionnaire, which will allow the doctors that we work with to determine your eligibility for the procedure. If you are not ready to make lifestyle changes (and have not tried hard to do so already), you will not be considered eligible for the procedure. After hospital admission, you will receive psychological advice. This will help you adhere to a healthier lifestyle. Without changing your lifestyle, the surgery will not be a success. You will also receive nutritional counseling before (and after) your surgery.

Duodenal Switch recovery

Most people typically stay in the hospital for 4 days or less after duodenal switch surgery, followed by a stay in a nearby hotel for 4-7 days. Your doctor will approve your return back home once you can do the following:

Move without too much discomfort
Eat liquid and/or pureed food without vomiting
No longer require pain medication given by injection

Once your diet begins to consist of more solid food, remember to chew each bite very slowly and thoroughly. You will be instructed on eating small meals frequently throughout the day, rather than large meals that your stomach cannot accommodate.