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BRAIN ATTACK:

Super Obese Brothers Lose 60 kg with Bariatric Surgery at Max Patparganj

in Max Super Speciality Hospital, Patparganj

Sep 05 , 2022

Two morbidly obese brothers, weighing 205 kg and 168 kg, underwent Bariatric Surgeries at Max Super Speciality Hospital, Patparganj. They suffered from several obesity-related diseases, including Obstructive Sleep Apnoea, Liver Cirrhosis, Diabetes and Hypertension. A team of specialist doctors led by Dr. Vivek Bindal, Head, Max Institute of Minimal Access, Bariatric & Robotic Surgery, Max Hospital, Patparganj, operated on the patients. The brothers lost 17 kg each in the first month after the surgery. 

Super Obesity for Indian patients is defined as having a BMI of more than 47.5, Super–super Obesity is for someone with a BMI of more than 57.5, and Triple-obesity people have a BMI of more than 67.5. 

The 43-year-old brother came to the hospital with a BMI of 79.9 (Triple Obesity) and has been obese for the last 25 years. He weighed 135 kg at the beginning of 2020. During the lockdown, he gained additional 70 kilos. Meanwhile, his younger brother also suffered from obesity for the last 20 years and had gained excessive weight during the recent lockdown. He weighed 168 kg at the time of surgery.

Both the brothers faced a social stigma from their family and friends. They used to avoid all social gatherings. They also had a tough time purchasing clothes and had difficulty doing their everyday activities. This had started affecting their mental health as well. For the past 2-3 years, both the brothers had started seeking a solution for their excess weight. They tried dieting on multiple occasions, but that did not help. They also tried numerous Ayurvedic medicines but were still not able to lose weight. 

The younger brother’s condition was severe as he also suffered from Liver Cirrhosis, Diabetes, Hypertension, and severe Obstructive Sleep Apnoea. Liver Cirrhosis increases the chance of bleeding during the intra and post-operative periods. Portal Hypertension in the setting of liver Cirrhosis makes Bariatric Surgery challenging and requires advanced expertise and skill. Similarly, the elder brother had Diabetes, Hypertension, and Obstructive Sleep Apnoea.

After the surgery, both the patients were mobilized on the same day, and a liquid diet was started 6 hours post-surgery. Both patients had an excellent recovery and were discharged on day two post-surgery. They lost 60 kg (35 kg & 25 kg respectively) in 2 months and are expected to lose more in the coming months. Obstructive Sleep Apnoea was entirely resolved. Their blood sugar levels are now under reasonable control, and now they are not taking any medicine for it. The dose of antihypertensive drugs was also reduced.

Robotic Bariatric Surgery was performed on the younger brother, while the elder brother underwent Laparoscopic Bariatric Surgery and Cholecystectomy. The challenges in their cases were – managing an enlarged liver, multiple life-threatening co-morbidities, difficult laparoscopic access and complex ergonomics, a huge amount of omentum, diffcult anesthesia, and difficult post-operative mobilization.