Gastric Bypass In Iran

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What is Gastric Bypass Surgery?

Gastric bypass surgery shrinks the size of your stomach, so you can't eat as much as you used to. The surgeon will also re-route, or bypass, part of your digestive system so you don't absorb as much food.

There are several types of gastric bypass surgery in Iran:

Roux-en-Y gastric bypass: This is the most common gastric bypass surgery done in Iran. Surgeons can do it through a small cut, which has a quicker recovery time than more complicated surgery.
First, the surgeon makes a small stomach pouch by stapling part of the stomach together or by vertical banding. This limits how much food you can eat.
Next, the surgeon attaches a Y-shaped section of the small intestine to the pouch. That creates a bypass for food, so it skips part of your digestive system. As a result, you absorb fewer calories and nutrients.

Extensive gastric bypass (biliopancreatic diversion): This is a more complicated type of gastric bypass in Iran. The surgeon removes the lower part of the stomach. He then connects the small pouch that remains directly to the last part of the small intestine, completely bypassing the first two parts. It works for weight loss, but it's not widely used because it has a high complication rate and can leave you short on nutrients.



Who is a Candidate for gastric bypass Surgery?

Qualifications for gastric bypass surgery at Mediranco:
1. BMI ≥ 40, or more than 100 pounds overweight.
2. BMI ≥ 35 and at least one or more 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.
3. Inability to achieve a healthy weight loss sustained for a period of time with prior weight loss efforts.
also recommend that surgery be performed by a board certified surgeon with specialized experience/training in bariatric and metabolic surgery, and at a center that has a multidisciplinary team of experts for follow-up care. This may include a nutritionist, an exercise physiologist or specialist, and a mental health professional.



What can I expect at a gastric bypass consultation?

Your initial consultation is an introductory meeting that takes place at our specially-designed facility. There, an experienced bariatric surgeon will answer all your questions, both medical and personal. Be assured it’s conducted in the strictest confidence, and you will be treated with the respect, dignity, and understanding you deserve.
The first priority of Mediranco is to make certain all your concerns are thoroughly addressed as you prepare for weight loss surgery. Unlike the one-size-fits-all approach you find at other medical facilities, we specialize in bariatric surgery, laparoscopic gastric bypass, lap band and the laparoscopic gastric sleeve procedure, providing you a very personal individual care program that large general hospitals all over the world cannot offer.


What are the benefits and risks of gastric bypass?

Advantages


Gastric bypass surgery in Iran is done to help you lose excess weight and reduce your risk of potentially life-threatening weight-related health problems, including:

  • Gastroesophageal reflux disease
  • Heart disease
  • High blood pressure
  • Severe sleep apnea
  • Type 2 diabetes
  • Stroke

Gastric bypass and other weight-loss surgeries in Iran are typically done only after you've tried to lose weight by improving your diet and exercise habits.

Disadvantages


As with any major surgery, gastric bypass and other weight-loss surgeries pose potential health risks, both in the short term and long term.

Risks associated with the surgical procedure can include:
  • Excessive bleeding
  • Infection
  • Adverse reactions to anesthesia
  • Blood clots
  • Lung or breathing problems
  • Leaks in your gastrointestinal system
  • Death (rare)
Longer term risks and complications of weight-loss surgery vary depending on the type of surgery. They can include:
  • Bowel obstruction
  • Dumping syndrome, causing diarrhea, nausea or vomiting
  • Gallstones
  • Hernias
  • Low blood sugar (hypoglycemia)
  • Malnutrition
  • Stomach perforation
  • Ulcers
  • Vomiting
  • Death (rare)


What are the steps for gastric bypass surgery?

You will have general anesthesia before this surgery. You will be asleep and pain-free.
There are 2 steps during gastric bypass surgery:

  • The first step makes your stomach smaller. Your surgeon uses staples to divide your stomach into a small upper section and a larger bottom section. The top section of your stomach (called the pouch) is where the food you eat will go. The pouch is about the size of a walnut. It holds only about 1 ounce (oz) or 28 grams (g) of food. Because of this you will eat less and lose weight.
  • The second step is the bypass. Your surgeon connects a small part of your small intestine (the jejunum) to a small hole in your pouch. The food you eat will now travel from the pouch into this new opening and into your small intestine. As a result, your body will absorb fewer calories.


How you prepare

If you qualify for gastric bypass or other weight-loss surgeries, your health care team gives you instructions on how to prepare for your specific type of surgery. You may need to have various lab tests and exams before surgery. You may have restrictions on eating and drinking and which medications you can take. You may be required to start a physical activity program and to stop any tobacco use.

You may also need to prepare by planning ahead for your recovery after surgery. For instance, arrange for help at home if you think you'll need it.



What Can You Expect After Gastric Bypass in Iran?

After gastric bypass and other types of weight-loss surgery, you generally won't be allowed to eat for one to two days so that your stomach and digestive system can heal. For the first month, you will only be able to handle small amounts of soft food and liquids. But gradually, you will be able to add solid foods back into your diet. You will notice feeling full very quickly – after eating about two tablespoons of food. Your physician may also recommend that you take nutritional supplements.

You'll also have frequent medical checkups to monitor your health in the first several months after weight-loss surgery. You may need laboratory testing, blood work and various exams.

Within the first two years, you can expect to lose one-half to two-thirds of your excess body weight. Weight loss will continue, in most cases, for a year and a half before stabilizing.



How can you obtain the best results?

Many patients lose more than 100 lbs during their first year. Some patients lose weight for more than two years following the procedure, and may lose in excess of 200 lbs during that time. Results vary from patient to patient, with the best results coming from those who are committed to lifestyle change. Keep in mind, weight loss surgery isn’t a miracle cure. It’s important to set realistic weight loss goals for yourself right from the start. A loss of about 2 to 3 pounds a week in the first year after the operation is possible, but a pound a week is more likely. You’re aiming for gradual, steady weight loss.



Gastric bypass costs in Iran

Cost of gastric bypass surgery as other types of procedure depends on many factors like location, hospital and surgery team fees. In fact the main element is location because, costs of living and services are the factors which determine facility cost and team fees. That’s why Iran is the most affordable place for most treatments. Bariatric surgery is not an exception, Iran is the most affordable place to undergo bariatric surgery. The cost of a same quality gastric bypass surgery is about 4,000 in Iran while it is about 20,000$ in Canada and 24,000$ in US. Adding travel costs to this figure, gastric bypass surgery costs up to 5,000$ in Iran tops.

Questions about gastric bypass

1How long after gastric bypass surgery will I have to be out of work?
After surgery, most patients return to work in one or two weeks. You will have low energy for a while after surgery and may need to have some half days, or work every other day for your first week back. Your surgeon will give you clear instructions. Most jobs want you back in the workplace as soon as possible, even if you can’t perform ALL duties right away. Your safety and the safety of others are extremely important – low energy can be dangerous in some jobs.
Many patients are worried about getting hernias at incisions. That is almost never a problem from work or lifting. Hernias are more often the result of infection. You will not feel well if you do too much.
2When can I start exercising again after surgery?
Right away! You will take gentle, short walks even while you are in the hospital. The key is to start slow. Listen to your body and your surgeon. If you lift weights or do sports, stay “low impact” for the first month (avoid competition, think participation). Build slowly over several weeks. If you swim, your wounds need to be healed before you get back in the water.
3Does type 2 diabetes make surgery riskier?
It can. Be sure to follow any instructions from your surgeon about managing your diabetes around the time of surgery. Almost everyone with Type 2 Diabetes sees big improvement or even complete remission after surgery. Some studies have even reported improvement of Type 1 Diabetes after bariatric procedures.
4Can I have laparoscopic surgery if I have heart disease?
Yes, but you may need medical clearance from your cardiologist. Bariatric surgery leads to improvement in most problems related to heart disease including:
● High Blood Pressure
● Cholesterol
● Lipid problems
● Heart enlargement (dilated heart, or abnormal thickening)
● Vascular (artery and vein) and coronary (heart artery) disease
During the screening process, be sure to let your surgeon or nurse know about any heart conditions you have. Even those with atrial fibrillation, heart valve replacement, or previous stents or heart bypass surgery usually do very well. If you are on blood thinners of any type, expect special instructions just before and after surgery.
5When can I get pregnant after gastric bypass surgery? Will the baby be healthy?
Most women are much more fertile after surgery, even with moderate pre-op weight loss. Birth control pills do NOT work as well in patients who are overweight. Birth control pills are not very reliable during the time your weight is changing. For this reason, having an IUD or using condoms and spermicide with ALL intercourse is needed. Menstrual periods can be very irregular, and you can get pregnant when you least expect it!
Most groups recommend waiting 12-18 months after surgery before getting pregnant.
Many women who become pregnant after surgery are several years older than their friends were when having kids. Being older when pregnant does mean possible increased risks of certain problems. Down syndrome and spinal deformities are two examples. The good news is that, after surgery, there is much less risk of experiencing problems during pregnancy (gestational diabetes, eclampsia, macrosomia) and during childbirth. There are also fewer miscarriages and stillbirths than in women with obesity who have not had surgery and weight loss.
Kids born after mom’s surgery are LESS at risk of being affected by obesity later, due to activation of certain genes during fetal growth. There is also less risk of needing a C section.
6Will I need to have plastic surgery? Does insurance pay for plastic surgery?
Most patients have some loose or sagging skin, but it is often more temporary than expected. You will have a lot of change between 6 and 18 months after surgery. Your individual appearance depends upon several things, including how much weight you lose, your age, your genetics and whether or not you exercise or smoke. Generally, loose skin is well-hidden by clothing. Many patients wear compression garments, which can be found online, to help with appearance. Some patients will choose to have plastic surgery to remove excess skin. Most surgeons recommend waiting at least 18 months, but you can be evaluated before that. Plastic surgery for removal of excess abdominal and breast skin is often covered by insurance for reasons of moisture, hygiene and rash issues.
Arms and other areas may not be covered if they are considered “purely” cosmetic by your insurer. Some of these “less invasive” operations can be done in the clinic, however – so they can be much more affordable!
7Will I lose my hair after gastric bypass surgery?
Some hair loss is common between 3 and 6 months following surgery. The reasons for this are not totally understood. Even if you take all recommended supplements, hair loss will be noticed until the follicles come back. Hair loss is almost always temporary. Adequate intake of protein, vitamins and minerals will help to ensure hair regrowth, and avoid longer term thinning.
8Will I have to take vitamins and minerals after surgery? Will my insurance pay for these?
You will need to take a multivitamin for life. You may need higher doses of certain vitamins or minerals, especially Iron, Calcium, and Vitamin D. You will also need to have at least yearly lab checks. Insurance almost never pays for vitamin and mineral supplements but usually does pay for labs. You can pay for supplements out of a flex medical account.
9Will I have to go on a diet before I have surgery?
Yes. Most bariatric surgeons put their patients on a special pre-operative diet, usually 2 or 3 weeks just before surgery. The reason for the pre-operative diet is to shrink the liver and reduce fat in the abdomen. This helps during the procedure and makes it safer.
Some insurance companies require a physician-monitored diet three to six months prior to surgery as part of their coverage requirement. These diets are very different from the short term diets, and usually are more about food education and showing a willingness to complete appointments and to learn.
10Will I have to diet or exercise after the procedure?
No and Yes.
Most people think of a “diet” as a plan that leaves you hungry. That is not the way people feel after surgery. Eventually, most patients get some form of appetite back 6-18 months after surgery. Your appetite is much weaker, and easier to satisfy than before.
This does not mean that you can eat whatever and whenever you want. Healthier food choices are important to best results, but most patients still enjoy tasty food, and even “treats.”
Most patients also think of exercise as something that must be intense and painful (like “boot camp”). Regular, modest activity is far more useful in the long term. Even elite athletes can’t stay at a “peak” every week of the year. Sometimes exercise is work, but if it becomes a punishing, never-ending battle, you will not keep going. Instead, work with your surgeon’s program to find a variety of activities that can work for you. There is no “one-size-fits-all” plan. Expect to learn and change as you go!
For many patients (and normal weight people, too) exercise is more important for regular stress control, and for appetite control, than simply burning off calories. As we age, inactivity can lead to being frail or fragile, which is quite dangerous to overall health. Healthy bones and avoiding muscle loss partly depends on doing weekly weight bearing (including walking) or muscle resistance (weights or similar) exercise.
11Am I unable to walk?
Almost everyone is able to find some activity to “count” as moderate exercise, even those who are partially paralyzed, or who have arthritis or joint replacement or spine pain. Special therapists may be needed to help find what works for you.
12Can I go off some of my medications after surgery?
As you lose weight, you may be able to reduce or eliminate the need for many of the medications you take for high blood pressure, heart disease, arthritis, cholesterol, and diabetes. If you have a gastric bypass, sleeve gastrectomy or a duodenal switch, you may even be able to reduce the dosage or discontinue the use of your diabetes medications soon after your procedure.
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