Department of Bariatric Surgery
The IGALS Metabolic Surgery Program offers patients who are Diabetes the latest surgical procedures as tools to achieve a healthy lifestyle. These procedures are performed by IGALS’s highly skilled, multidisciplinary team of Metabolic specialists, many of whom are leaders in the field of Diabetes treatment. With more than 10 years of experience in weight loss surgery, the Institute of Gastroenterology and LIver Surgery & Department of Metabolic Surgery Program collectively performs more than 100 procedures each year, making it one of the most active in the Western India region. The Dept Metabolic Surgery Program has also been actively involved in clinical trails and research in metabolic syndrome.
Are you a Candidate for Bariatric Surgery?
Are you the right Candidate?
- BMI ≥ 40, or more than 100 pounds overweight.
- BMI ≥35 and at least two obesity-related co-morbidities such as type II diabetes (T2DM), hypertension, sleep apnea and other respiratory disorders, non-alcoholic fatty liver disease, osteoarthritis, lipid abnormalities, gastrointestinal disorders, or heart disease.
- Inability to achieve a healthy weight loss sustained for a period of time with prior weight loss efforts.
What should you read before you choose for surgery?
We have many details articles and post based on Bariatric surgery. We would wish you to read each and every details available on our website. We would also encourage you to go through the details of the ” Journey from Obese to a New you life”. There are many testimonials on our feedback, feel free to download and read the originally written by our patients. We would also recommend you to look into many websites that rate doctors and you would be happy to know that most of our patients have rated us excellent. If you have a doubt and you need a review consultation, feel free to utilize our ONLINE CONSULTATION so that you don’t have to travel so long to us.
A new U!
Initial Orientation Visit and Information Session with Dr. Tapan Shah
Bring your Identity Card, Past Medical Records and Investigations carried out. Please fill out the patient form completely and if needed take our online help for the same.You will have a private consultation with Dr. Tapan Shah. At this visit, your medical history will be reviewed; the risk and benefits of surgery will be discussed. You will be examined and Dr. Tapan Shah will determine if you are an appropriate candidate for surgery. Our dietician is usually available at this initial visit; therefore you will have the opportunity to have your formal Nutrition Assessment at this point. During your initial visit with the Dietitian you will begin to discuss some realistic goals as well as lifestyle changes that will help you develop good habits that allow good sugar control and eventually healthy life. At times you have have to schedule an separate meeting with Dietician in case He/she is not available.
During the initial visit, we will perform a blood check and refer you for a sonogram which helps evaluate liver size, fatty infiltration of your liver and the presence of Gallstones. There would be an elaborate discussion on the type of different procedures and their potential after effects. There would be also a lengthy discussion on the lifestyle changes and quantity as well as quality of food opted after the surgery. We will explain the all possible operations that are performed and would be suitable to the patient. There are chances that a pre determined surgical interventions can not be fixed for a patient and the choice of surgery may change during surgery. We will make recommendations for you but ultimately remember that it is your body and you need to make an informed decision based on your expectations and lifestyle preferences. We encourage you to have a detail idea of the changes these type of surgeries bring and ask as many questions as you have, as most of such surgeries are difficult to redo or reverse out.
While waiting for your first appointment
There are many materials available on our book section or in our elibrary, feel free to communicate with our reception to help you with your needed informations. Please feel free to bring as many relatives as you think are need to make this vital decision. We have a team of counsellor who would guide you everything regarding your diseases and the surgery you wish to undergo. They are there to answer your smallest doubts and stand by you during this hour of anxiety. Call your insurance carrier to ask what they require to ensure payment of your surgery. These requirements vary and change often. For example, some insurance providers require documentation of at least 3 last year policies.
Attend Support Group
Dr. Tapan Shah has designed a program that is more intimate and readily available to be personalized to your needs. Dr. Tapan shah along with his registered dietician also host weekly support groups in the office. These meeting offer a wonderful forum for patients who are considering or awaiting surgery as well as for those who have already had bariatric surgery. It offers new patients a chance to learn more about our program, surgical options and appropriate aftercare. For patients who already have had surgery, these groups offer a supportive environment to help manage the emotional changes that occur as a result of significant weight loss. Support Groups tend to be lively, upbeat and informative. Patients can learn a tremendous amount when sharing individual experiences. Although it is a requirement of our program to attend at least two of these sessions prior to having surgery, many patients enjoy the groups so much that they become regular attendants.
While on your Supervised Diet
Start making positive lifestyle changes. Ask friends or relatives who have had bariatric surgery explain to you what their experience has been like. Use the internet. Although some information can be misleading in general it is a very good source of research. Exercise is an important part of your weight loss plan. While seeing your primary care doctor in the months prior to your operation, it is very important that you try to get into shape and maximize your cardiovascular condition. Make sure that you speak to your regular doctor about your exercise plans and try to lose as much weight as possible before you have your procedure. Follow through with any recommendations provided by your primary care physician, dietician or Dr. Tapan Shah. This includes improving food choices, improving your exercise regime and quitting smoking. Avoid weight gain. Many patients might be kept on Liver Diet for few weeks to reduce the size of liver, hence to facilitate the recovery and ease while surgery.
Final Visit before Surgery : Test Done
Exercise Stress Test, Cardiology Clearance, Pulmonary Function Tests, Pulmonary Clearance, Endoscopy, Upper GI Series
FIRST STEP OF INVESTIGATION[su_expand]Blood tests– 1.Measure the Blood Glucose 2.C-peptide & Se. Insulin at Fasting (0 min), 60 mins (like OGTT test) with 75 gms Glucose & small piece of cheese. (No Insulin that morning & no Lantus Insulin the previous night; usual Tablets can be taken) 3. Se. Glucagon Fasting 4. HbA1c 5. Se. Lipids 6. Urine for Micro-albumin 7. GAD antibody, Islet-Cell Antibody (ICA) & Insulin auto-antibody (IAA2) tests will be done if required [/su_expand]
SECOND STEP OF INVESTIGATION[su_expand]A Clinical (physical) exam will be done, followed by an exhaustive list of investigations and anesthesia fitness, before you can be taken up for diabetic surgery. Investigations: 1. Complete Blood Picture 2. Fasting Blood sugar 3. HbA1c 4. Fasting Se. Insulin 5. BUN 6. Se. Creatinine 7. Prothrombin time, BT & CT 8. Liver function tests 9. Lipid profile 10. Se Uric Acid 11. Se. Iron 12. Se. T3, T4, TSH 13. Se.HbsAg, HIV, HCV 14. Se. Vit B-12 15. Se. Calcium 16. 25 OH Vit D3 17. Se. PTH 18. Se. Cortisol- Fasting 19. C- Reactive Protein 20. Blood group 21. Urine routine 22. X-Ray chest PA 23. ECG 24. Pulmonary function tests 25. 2-D Echo 26. Colour Doppler for Lower limbs (venous ) 27. Ultrasound exam -Whole abdomen 28. UGI Endoscopy with Rapid Urease test (RUT) with IV Midazolam[/su_expand]
THIRS STEP OF INVESTIGATION[su_expand]You are encouraged to bring an adult member of your family. Dr. Tapan Shah will review your test results. A surgery date will only be given if work-up is complete and the office is in receipt of all results and reports. The Obesity Quiz will be given at this point to ensure that you understand the risks and benefits of your decision.[/su_expand]
A Leap before the final GO! - Obesity Quiz
It is mandatory for patient to appear for a small Diabetes Quiz before the dates are fixed for surgery. This quiz would ensure that the patient has understood the surgery and its associated after-life. It also confirms the understanding of patient for the possible complication and dangers that includes death. Appear for Obesity Quiz
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