Bariatric Surgery Malaysia

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Bariatric Surgery in Malaysia

Weight loss surgery is a life-altering desicion - one of the most important
decisions a person will ever make. With that in mind, we've pullef together the
information you need about obesity, weight loss surgery, making the choice,
finding a surgeon, life after surgery, and additional resources to help in the
decision - making process..

WHAT IS BARIATRIC SURGERY?

Bariatric surgery is a type of surgery performed for the treatment of obesity and
metabolic syndrome. It helps the individual to help limit food intake and/or
absorption in order to achieve a healthy weight loss. It usually involves the
reduction of the volume of the stomach so that the individual is only able to take
smaller amounts of food.

WHY BARIATRIC SURGERY?

It is NOT the fault of the individual
if the excess weight could not be
shed effectively when he or she
has already adopted a healthy
eating regimen and a physically
active lifestyle. It could be a
familial or genetic predisposition
to easily regain weight or even a
hormonal or medical disorder that
makes the individual put on
weight easily.

How many times have we

enviously encountered friends
and relatives who would eat
unhealthily and consume lots of
ice-creams, chocolates, candies
etc. and yet have managed to
remain slim and fit! In such
individuals, the consumption of
calories just doesnt make
mathematical sense at all.

While bariatric surgery is not the only option for weight loss it certainly is the most
effective option. Before deciding upon surgery however, one should earnestly try
their level best to lose weight by eating healthily and exercising regularly.
Guidance can be sought from the doctor, dietitian, physiotherapist or the fitness
instructor to learn about adopting a healthy lifestyle.

WHAT IS MORBID OBESITY?

Therefore it is important to
recognise and treat morbid
obesity at the early stage
before the illnesses (metabolic
syndrome) sets in or before the
metabolic syndrome worsens.
There are several levels of
obesity and the body mass
index (BMI) is used to classify
the different categories of
obesity. BMI however is not the
only marker used to determine
the levels of obesity but it is
nonetheless a good indicator of
the amount of excess weight
that an individual has.

Obesity is more than just an

appearance. It means that the amount
of fat that is stored in our body has
reached abnormally high levels. Fats
may be stored beneath the skin or
inside our organs or both. When
obesity is severe or when it is
associated with obesity related
illnesses like diabetes mellitus,
hypertension, obstructive sleep apnea,
infertility, etc, it is known as morbid
obesity.
Metabolic syndrome is the diseases
associated with obesity like diabetes
mellitus, hypertension, etc. As the
word suggests, morbid obesity means
that this type of obesity may lead to
medical disorders or even premature
death.

TYPES OF SURGERY
As mentioned in the beginning, there are several types of surgery. This section will
shed some light into some of the common surgeries performed today.

1.
2.
3.
4.
5.
6.
7.
8.

Adjustable Gastric Banding (AGB)

Greater Curvature Plication (GCP)
Banded Greater Curvature Plication (BGCP)
Sleeve Gastrectomy (SG)
Roux-en Y Gastric Bypass (RYGB)
Mini Gastric Bypass (MGB)
Duodenal Jejunal Bypass (DJB)
Bilio-Pancreatic Bypass and Duodenal
Switch (BPD-DS)

Before we look at the different types of surgeries, let us try to understand some
basic gastrointestinal anatomy in the following illustration, with emphasis on the
stomach and small intestines.

ROUX-EN Y GASTRIC BYPASS

During the procedure, the surgeon creates a small stomach pouch. The surgeon
then attaches a section of the small intestines directly to the pouch. This allows
foods to bypass a portion of the small intestines, which absorbs calories and
nutrients. Having the smaller stomach pouch causes the patients to feel full earlier
and eat less foods; bypassing a portion of the small intestines means the patients
body absorb fewer calories. Like other metabolic surgeries, it also helps to
establish a lower, healthier body fat set point by changing the signals between the
stomach, brain and liver.
Gastric bypass patients can also
experience dumping syndrome. This
syndrome is a rapid movement of food
through the small intestine that leaves
the patients feeling flush and
uncomfortable, but it may also be
seen as a benefit, as its provides
important warning signs that too much
sugar or foods is being consumed.

INCISION TYPES FOR BARIATRIC

SURGERY
1) Incisions for laparoscopic bariatric surgery
2) Incisions for open bariatric surgery
3) Incisions for single port bariatric surgery

Most, if not all, bariatric surgeries are performed using the laparoscopic technique,
usually with only 4 or 5 small holes in the tummy. Most of these holes disappear
after a few weeks, resulting in a small faint scar. The sleeve gastrectomy can even
sometimes be performed using only one hole (single port sleeve gastrectomy).
More importantly, a less invasive surgery results in less pain and a shorter hospital
stay.

MECHANISM OF WEIGHT LOSS IN

BARIATRIC SURGERY
Bariatric surgery helps an individual achieve a healthy weight by allowing smaller
healthier portions of food and early fullness (satiety). It should be viewed as a tool
or an adjunct to help the individual gain a healthier lifestyle. It is by no means a
magical solution that will make the individual automatically lose weight without
any effort. The individual must make healthier choices of food and perform regular
physical activities. This compliance from the part of the patient is an important
aspect to ensure a successful weight loss journey towards a healthier weight.

The stomach will be smaller in size after bariatric surgery and this would limit the
amount of solid food that one is able to tolerate at a time. So in order not to be
short of nutrition, one should eat small frequent meals and try to consume a variety
of food, which includes good oils and high protein food.

About Bariatric Surgery Expert

Dr Tikfu Gee is a bariatric surgery expert and metabolic surgeon lecturing in
Universiti Putra Malaysia. After obtaining a Masters Degree in Surgery, he
went on to specialise in the field of Minimally Invasive Surgery and Bariatric
Surgery in France. He has a fellowship from the Institute of Laparoscopic
Surgery, Bordeaux and did his higher surgical training in Hospital Diaconese
Croix Saint Simon, Paris. He currently leads the Bariatric and Digestive Surgery
Unit in the Department of Surgery of UPM, based in Hospital Serdang and
Hospital Kuala Lumpur. He has published articles in various international
journals and is actively conducting clinical trials with the university.

He has performed large series of Bariatric and Metabolic surgeries, Digestive

surgeries and Endocrine surgeries, mostly employing key hole techniques. Dr
Tikfu Gee is also a Visiting Consultant Bariatric, Metabolic and Minimally
Invasive Surgeon at Princecourt Medical Centre and Tropicana Medical Centre.

About Bariatric Surgery Expert

Dr Tikfu Gee is a bariatric surgery expert and metabolic surgeon lecturing in
Universiti Putra Malaysia. After obtaining a Masters Degree in Surgery, he
went on to specialise in the field of Minimally Invasive Surgery and Bariatric
Surgery in France. He has a fellowship from the Institute of Laparoscopic
Surgery, Bordeaux and did his higher surgical training in Hospital Diaconese
Croix Saint Simon, Paris. He currently leads the Bariatric and Digestive
Surgery Unit in the Department of Surgery of UPM, based in Hospital Serdang
and Hospital Kuala Lumpur. He has published articles in various international
journals and is actively conducting clinical trials with the university.
He has performed large series of Bariatric and Metabolic surgeries, Digestive
surgeries and Endocrine surgeries, mostly employing key hole techniques. Dr
Tikfu Gee is also a Visiting Consultant Bariatric, Metabolic and Minimally
Invasive Surgeon at Princecourt Medical Centre and Tropicana Medical Centre.
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