Colon / Rectum Cancer Surgery

The colon and rectum are parts of the digestive system. They form a long, muscular tube called the large intestine (also called the large bowel). The colon is the first 4 to 5 feet of the large intestine, and the rectum is the last several inches.

Colon Rectum Cancer Surgery

Partly digested food enters the colon from the small intestine. The colon removes water and nutrients from the food and turns the rest into waste (stool). The waste passes from the colon into the rectum and then out of the body through the anus.

What is Colon / rectum cancer

Tumors can be benign or malignant:

  1. Benign tumors are not cancer:
    1. Benign tumors are rarely life-threatening.
    2. Most benign tumors can be removed. They usually do not grow back.
    3. Benign tumors do not invade the tissues around them.
    4. Cells from benign tumors do not spread to other parts of the body.
  2. Malignant tumors are cancer:
    1. Malignant tumors are generally more serious than benign tumors. They may be life-threatening.
    2. Malignant tumors often can be removed. But sometimes they grow back.
    3. Malignant tumors can invade and damage nearby tissues and organs.
    4. Cancer cells can break away from a malignant tumor and spread to other parts of the body. Cancer cells spread by entering the bloodstream or the lymphatic system. The cancer cells form new tumors that damage other organs. The spread of cancer is called metastasis.

When colorectal cancer spreads outside the colon or rectum, cancer cells are often found in nearbylymph nodes. If cancer cells have reached these nodes, they may also have spread to other lymph nodes or other organs. Colorectal cancer cells most often spread to the liver.

When cancer spreads from its original place to another part of the body, the new tumor has the same kind of abnormal cells and the same name as the original tumor. For example, if colorectal cancer spreads to the liver, the cancer cells in the liver are actually colorectal cancer cells. The disease is metastatic colorectal cancer, not liver cancer. For that reason, it is treated as colorectal cancer, not liver cancer. Doctors call the new tumor "distant" or metastatic disease.

WHAT IS Colon-Rectum CANCER SURGERY?

The choice of treatment depends mainly on the location of the tumor in the colon or rectum and the stage of the disease.

Treatment for colorectal cancer may involve surgery, chemotherapy, biological therapy or radiation therapy. Some people have a combination of treatments. These treatments are described below.

Colon cancer sometimes is treated differently from rectal cancer. Treatments for colon and rectal cancer are described separately below.

Your doctor can describe your treatment choices and the expected results. You and your doctor can work together to develop a treatment plan that meets your needs.

Cancer treatment is either local therapy or systemic therapy:

  1. Local therapy: Surgery and radiation therapy are local therapies. They remove or destroy cancer in or near the colon or rectum. When colorectal cancer has spread to other parts of the body, local therapy may be used to control the disease in those specific areas.
  2. Systemic therapy: Chemotherapy and biological therapy are systemic therapies. The drugs enter the bloodstream and destroy or control cancer throughout the body.

Because cancer treatments often damage healthy cells and tissues, side effects are common. Side effects depend mainly on the type and extent of the treatment. Side effects may not be the same for each person, and they may change from one treatment session to the next. Before treatment starts, your health care team will explain possible side effects and suggest ways to help you manage them.

Surgery

Surgery is the most common treatment for colorectal cancer.

  1. Colonoscopy: A small malignant polyp may be removed from your colon or upper rectum with a colonoscope. Some small tumors in the lower rectum can be removed through your anus without a colonoscope.
  2. Laparoscopy: Early colon cancer may be removed with the aid of a thin, lighted tube (laparoscope). Three or four tiny cuts are made into your abdomen. The surgeon sees inside your abdomen with the laparoscope. The tumor and part of the healthy colon are removed. Nearby lymph nodes also may be removed. The surgeon checks the rest of your intestine and your liver to see if the cancer has spread.
  3. Open surgery: The surgeon makes a large cut into your abdomen to remove the tumor and part of the healthy colon or rectum. Some nearby lymph nodes are also removed. The surgeon checks the rest of your intestine and your liver to see if the cancer has spread.

When a section of your colon or rectum is removed, the surgeon can usually reconnect the healthy parts. However, sometimes reconnection is not possible. In this case, the surgeon creates a new path for waste to leave your body. The surgeon makes an opening (stoma) in the wall of the abdomen, connects the upper end of the intestine to the stoma, and closes the other end. The operation to create the stoma is called a colostomy. A flat bag fits over the stoma to collect waste, and a special adhesive holds it in place.

For most people, the stoma is temporary. It is needed only until the colon or rectum heals from surgery. After healing takes place, the surgeon reconnects the parts of the intestine and closes the stoma. Some people, especially those with a tumor in the lower rectum, need a permanent stoma.

People who have a colostomy may have irritation of the skin around the stoma. Your doctor, your nurse, or an enterostomal therapist can teach you how to clean the area and prevent irritation and infection. The "Rehabilitation" section has more information about how people learn to care for a stoma.

The time it takes to heal after surgery is different for each person. You may be uncomfortable for the first few days. Medicine can help control your pain. Before surgery, you should discuss the plan for pain relief with your doctor or nurse. After surgery, your doctor can adjust the plan if you need more pain relief.

It is common to feel tired or weak for a while. Also, surgery sometimes causes constipation or diarrhea. Your health care team monitors you for signs of bleeding, infection, or other problems requiring immediate treatment.

Chemotherapy

Chemotherapy uses anticancer drugs to kill cancer cells. The drugs enter the bloodstream and can affect cancer cells all over the body. Anticancer drugs are usually given through a vein, but some may be given by mouth. You may be treated in an outpatient part of the hospital, at the doctor's office, or at home. Rarely, a hospital stay may be needed. The side effects of chemotherapy depend mainly on the specific drugs and the dose. Your health care team can suggest ways to control many of these side effects. Most side effects usually go away after treatment ends.

Biological Therapy

Some people with colorectal cancer that has spread receive a monoclonal antibody, a type of biological therapy. The monoclonal antibodies bind to colorectal cancer cells. They interfere with cancer cell growth and the spread of cancer. People receive monoclonal antibodies through a vein at the doctor's office, hospital, or clinic. Some people receive chemotherapy at the same time.

During treatment, your health care team will watch for signs of problems. Some people get medicine to prevent a possible allergic reaction. The side effects depend mainly on the monoclonal antibody used. Side effects may include rash, fever, abdominal pain, vomiting, diarrhea, blood pressure changes, bleeding, or breathing problems. Side effects usually become milder after the first treatment.

Radiation Therapy

Radiation therapy (also called radiotherapy) uses high-energy rays to kill cancer cells. It affects cancer cells only in the treated area.

Doctors use different types of radiation therapy to treat cancer. Sometimes people receive two types:

  1. External radiation: The radiation comes from a machine. The most common type of machine used for radiation therapy is called a linear accelerator. Most patients go to the hospital or clinic for their treatment, generally 5 days a week for several weeks.
  2. Internal radiation (implant radiation or brachytherapy): The radiation comes from radioactivematerial placed in thin tubes put directly into or near the tumor. The patient stays in the hospital, and the implants generally remain in place for several days. Usually they are removed before the patient goes home.

Side effects depend mainly on the amount of radiation given and the part of your body that is treated. Radiation therapy to your abdomen and pelvis may cause nausea, vomiting, diarrhea, bloody stools, or urgent bowel movements. It also may cause urinary problems, such as being unable to stop the flow of urine from the bladder. In addition, your skin in the treated area may become red, dry, and tender. The skin near the anus is especially sensitive.

You are likely to become very tired during radiation therapy, especially in the later weeks of treatment. Resting is important, but doctors usually advise patients to try to stay as active as they can.

Treatment for Colon Cancer

Most patients with colon cancer are treated with surgery. Some people have both surgery and chemotherapy. Some with advanced disease get biological therapy.

A colostomy is seldom needed for people with colon cancer.

Although radiation therapy is rarely used to treat colon cancer, sometimes it is used to relieve pain and other symptoms.

Treatment for Rectal Cancer

For all stages of rectal cancer, surgery is the most common treatment. Some patients receive surgery, radiation therapy, and chemotherapy. Some with advanced disease get biological therapy.

Radiation therapy may be used before and after surgery. Some people have radiation therapy before surgery to shrink the tumor, and some have it after surgery to kill cancer cells that may remain in the area. People also may have radiation therapy to relieve pain and other problems caused by the cancer.

SYMPTOMS

A common symptom of colorectal cancer is a change in bowel habits. Symptoms include:

  1. Having diarrhea or constipation.
  2. Feeling that your bowel does not empty completely.
  3. Finding blood (either bright red or very dark) in your stool.
  4. Finding your stools are narrower than usual.
  5. Frequently having gas pains or cramps, or feeling full or bloated.
  6. Losing weight with no known reason.
  7. Feeling very tired all the time.
  8. Having nausea or vomiting.

Most often, these symptoms are not due to cancer. Other health problems can cause the same symptoms. Anyone with these symptoms should see a doctor to be diagnosed and treated as early as possible. Usually, early cancer does not cause pain. It is important not to wait to feel pain before seeing a doctor.

RISK FACTORS

Studies have found the following risk factors for colorectal cancer:

  1. Age over 50: Colorectal cancer is more likely to occur as people get older. More than 90 percent of people with this disease are diagnosed after age 50. The average age at diagnosis is 72.
  2. Colorectal polyps: Polyps are growths on the inner wall of the colon or rectum. They are common in people over age 50. Most polyps are benign (not cancer), but some polyps (adenomas) can become cancer. Finding and removing polyps may reduce the risk of colorectal cancer.
  3. Family history of colorectal cancer: Close relatives (parents, brothers, sisters, or children) of a person with a history of colorectal cancer are somewhat more likely to develop this disease themselves, especially if the relative had the cancer at a young age. If many close relatives have a history of colorectal cancer, the risk is even greater.
  4. Genetic alterations: Changes in certain genes increase the risk of colorectal cancer.
  5. Hereditary nonpolyposis colon cancer (HNPCC) is the most common type of inherited (genetic) colorectal cancer. It accounts for about 2 percent of all colorectal cancer cases. It is caused by changes in an HNPCC gene. Most people with an altered HNPCC gene develop colon cancer, and the average age at diagnosis of colon cancer is 44.
  6. Familial adenomatous polyposis (FAP) is a rare, inherited condition in which hundreds of polyps form in the colon and rectum. It is caused by a change in a specific gene called APC. Unless FAP is treated, it usually leads to colorectal cancer by age 40. FAP accounts for less than 1 percent of all colorectal cancer cases.

Family members of people who have HNPCC or FAP can have genetic testing to check for specific genetic changes. For those who have changes in their genes, health care providers may suggest ways to try to reduce the risk of colorectal cancer, or to improve the detection of this disease. For adults with FAP, the doctor may recommend an operation to remove all or part of the colon and rectum.

  1. Personal history of cancer: A person who has already had colorectal cancer may develop colorectal cancer a second time. Also, women with a history of cancer of the ovary, uterus (endometrium), or breast are at a somewhat higher risk of developing colorectal cancer.
  2. Ulcerative colitis or Crohn disease: A person who has had a condition that causes inflammationof the colon (such as ulcerative colitis or Crohn's disease) for many years is at increased risk of developing colorectal cancer.
  3. Diet: Studies suggest that diets high in fat (especially animal fat) and low in calcium, folate, andfiber may increase the risk of colorectal cancer. Also, some studies suggest that people who eat a diet very low in fruits and vegetables may have a higher risk of colorectal cancer. However, results from diet studies do not always agree, and more research is needed to better understand how diet affects the risk of colorectal cancer.
  4. Cigarette smoking: A person who smokes cigarettes may be at increased risk of developing polyps and colorectal cancer.

Because people who have colorectal cancer may develop colorectal cancer a second time, it is important to have checkups. If you have colorectal cancer, you also may be concerned that your family members may develop the disease. People who think they may be at risk should talk to their doctor. The doctor may be able to suggest ways to reduce the risk and can plan an appropriate schedule for checkups. See the "Screening" section to learn more about tests that can find polyps or colorectal cancer.

DIAGNOSIS

If you have screening test results that suggest cancer or you have symptoms, your doctor must find out whether they are due to cancer or some other cause. Your doctor asks about your personal and family medical history and gives you a physical exam. You may have one or more of the tests described in the "Screening" section.

If your physical exam and test results do not suggest cancer, your doctor may decide that no further tests are needed and no treatment is necessary. However, your doctor may recommend a schedule for checkups.

If tests show an abnormal area (such as a polyp), a biopsy to check for cancer cells may be necessary. Often, the abnormal tissue can be removed during colonoscopy or sigmoidoscopy. A pathologistchecks the tissue for cancer cells using a microscope.

STAGING

If the biopsy shows that cancer is present, your doctor needs to know the extent (stage) of the disease to plan the best treatment. The stage is based on whether the tumor has invaded nearby tissues, whether the cancer has spread and, if so, to what parts of the body.

Your doctor may order some of the following tests:

  1. Blood tests: Your doctor checks for carcinoembryonic antigen (CEA) and other substances in the blood. Some people who have colorectal cancer or other conditions have a high CEA level.
  2. Colonoscopy: If colonoscopy was not performed for diagnosis, your doctor checks for abnormal areas along the entire length of the colon and rectum with a colonoscope.
  3. Endorectal ultrasound: An ultrasound probe is inserted into your rectum. The probe sends out sound waves that people cannot hear. The waves bounce off your rectum and nearby tissues, and a computer uses the echoes to create a picture. The picture may show how deep a rectal tumor has grown or whether the cancer has spread to lymph nodes or other nearby tissues.
  4. Chest x-ray: X-rays of your chest may show whether cancer has spread to your lungs.
  5. CT scan: An x-ray machine linked to a computer takes a series of detailed pictures of areas inside your body. You may receive an injection of dye. A CT scan may show whether cancer has spread to the liver, lungs, or other organs.

Your doctor may also use other tests (such as MRI) to see whether the cancer has spread. Sometimes staging is not complete until after surgery to remove the tumor. (Surgery for colorectal cancer is described in the "Treatment" section.)

Doctors describe colorectal cancer by the following stages:

  1. Stage 0: The cancer is found only in the innermost lining of the colon or rectum. Carcinoma in situ is another name for Stage 0 colorectal cancer.
  2. Stage I: The tumor has grown into the inner wall of the colon or rectum. The tumor has not grown through the wall.
  3. Stage II: The tumor extends more deeply into or through the wall of the colon or rectum. It may have invaded nearby tissue, but cancer cells have not spread to the lymph nodes.
  4. Stage III: The cancer has spread to nearby lymph nodes, but not to other parts of the body.
  5. Recurrence: This is cancer that has been treated and has returned after a period of time when the cancer could not be detected. The disease may return in the colon or rectum, or in another part of the body.

Prevention

Whether you're at risk of obesity, currently overweight or at a healthy weight, you can take steps to prevent unhealthy weight gain and related health problems. Not surprisingly, the steps to prevent weight gain are the same as the steps to lose weight: daily exercise, a healthy diet, and a long-term commitment to watch what you eat and drink.

  • Exercise regularly.
  • Follow a healthy-eating plan
  • Know and avoid the food traps that cause you to eat.
  • Monitor your weight regularly
  • Be consistent

Overview of Cancer Surgery

Goal of Cancer Surgery

Depending on your cancer type and stage, our goals for treatment are:

  1. Cure : This is the most important goal of cancer surgery. In fact as a cancer patient you are also strongly willing to have cure of cancer for forever. For most of the Liver & Gastro-intestinal cancers perhaps surgery is the first step for cure. Radiation &/or Chemotheray may be advised as an additional tool to achieve this goal.
  2. Control : If your cancer is at a later stage or if previous treatments have been unsuccessful, we aim to control your cancer by removing as much as safely possible. Once you recover from surgery, radiation or chemotherapy is advised as important tool to control your cancer.
  3. Comfort : If you have an advanced stage of cancer or one that hasn't responded to treatments and having symptoms because of tumor i.e pain, jaundice, vomiting, bleeding either in vomitus or in stool, then our multi-specialist team work together to sure you are free of pain and other symptoms.

Role of Surgery for Cancer treatment:

Surgery can be done for many reasons for treatment of cancer.

Curative Surgery

Curative surgery is done when cancer is found in only one area, and it’s likely that all of the cancer can be removed. In this case, curative surgery can be the main treatment. It may be used alone or along with chemotherapy or radiation therapy, which can be given before or after the operation.

Diagnostic & Staging Surgery

This type of surgery is used to take out a piece of tissue (biopsy) to find out if cancer is present or what type of cancer it is. The diagnosis of cancer is made by looking at the cells under a microscope. Staging surgery is done to find out how much cancer there is and how far it has spread. The physical exam and the results of lab and imaging tests are used to figure out the clinical stage of the cancer. But the surgical stage (also called the pathologic stage) is usually a more exact measure of how far the cancer has spread. Examples of surgical procedures commonly used to stage cancers, like laparoscopy or laparotomy.

Palliative Surgery

This type of surgery is used to treat problems caused by advanced cancer. It is not done to cure the cancer. For example, cancers of intestine may grow large enough to block off (obstruct) the intestine, or tumor is bleeding and unable to control bleed by medical/endoscopic technique. If this happens, surgery can be used to remove the blockage/control bleeding.

Approach for Surgery:

How surgery is performed? (Special surgery techniques):

Open Surgery:

It is the Gold Standard approach for Liver & Gastro-Intestinal cancer. An incision is given on the belly depending upton the underlying location of tumor so that surgeon can directly approach the cancer on cutting the belly. Open Surgery help to remove tumor safely if its adherent to near by blood vessels or organ, that is otherwise difficult in laparoscopic surgery.

Laparoscopic Surgery

A laparoscope is a long, thin, flexible tube that can be put through a small cut (incision) to look inside the body. In recent years, doctors have found that by creating small holes and using special instruments, the laparoscope can be used to perform surgery without making a large cut. This can help reduce blood loss during surgery and pain afterward. It can also shorten hospital stays and allow people to heal faster.

The role of laparoscopic surgery in cancer treatment is not yet clear. Doctors are now studying whether it is safe and effective to use laparoscopic surgeries for cancers of the stomach, colon, rectum & liver. It may prove to be as safe and work as well as standard surgery while cutting less and causing less damage to healthy tissues (being less invasive).

Biopsy of Cancer before Surgery

Biopsy is procedure to confirm the presence of cancer. It’s not essential before surgery. Usually biopsy is performed when-

1. Suspicion is cause other than cancer,

2. When surgery cannot be done for cancer due to advanced stage of cancer or

3. Patient is unfit to undergo surgery. In these situation, biopsy guides for further therapy.

If all investigations suggest that cancer can be removed in totality from body, then biopsy can be avoided in to minimize the risk of spillage of cancer cell during biopsy procedure.

There is variety of way to perform biopsies:

Fine Needle Aspiration (FAN) biopsy

  1. Fine needle aspiration (FNA) uses a very thin needle attached to a syringe to pull out small bits of tissue. The needle is guided into the tumor by looking at it using an imaging test, like an ultrasound or CT scan.
  2. The main advantage of FNA is that there is no need to cut through the skin, so there is no surgical incision.
  3. A drawback is that in some cases the needle can’t take out enough tissue for an exact diagnosis. A more invasive type of biopsy (one that involves larger needles or a cut in the skin) may then be needed.

Core Needle biopsy

  1. This type of biopsy uses a larger needle to take out a core of tissue and done under guidance of imaging test like an ultrasound or CT scan. The advantage of core biopsy is that it usually collects enough tissue to find out whether the tumor is cancer.

Excisional or Incisional biopsy

  1. For these biopsies, the surgeon remove the entire tumor (excisional biopsy) or a small part of the tumor (incisional biopsy).

Preparation for surgery

Our expert team members shall help you to prepare you for surgery. You are strongly advised to stop smoking, stop drinking alcohol, try to improve your diet, lose weight, or actively exercise before surgery.

Pre-operative testing

In most cases, you will need some tests before your surgery. The tests routinely used include:

  1. Blood tests to measure your blood counts, your risk of bleeding or infection, and how well your liver and kidneys are working. Your blood group type is also be checked in case you need blood transfusions during the operation.
  2. Chest x-ray and ECG (electrocardiogram) to check your lungs and your heart’s electrical system.
  3. USG/CT scans/ MRI to look at the size and location of the tumors and see if the cancer looks like it has spread to nearby tissues.

Anaesthetic Assessment before Surgery:

Our expert team of Anaesthetist will ask you questions pertaining to your health and to assess your fitness for surgery. You are requested to tell them in detail about your current and past medical ailments, allergic reactions you’ve had in the past and current medicines that you are taking like blood thinning medicine. This medicine should be stopped 1 week prior to surgery.

Informed Consent

Informed consent is one of the most important parts of “getting ready for surgery”. It is a process during which you are told about all aspects of the treatment before you give your doctor written permission to do the surgery.

Getting ready for Surgery

Depending on the type of operation you have, there may be things you need to do to be ready for surgery:

  1. Emptying your stomach and bowels (digestive tract) is important. Vomiting while under anaesthesia can be very dangerous because the vomit could get into your lungs and cause an infection. Because of this, you will be asked to not eat or drink anything starting the night before the surgery.
  2. Laxative: You may also be asked to use a laxative or an enema to make sure your bowels are empty.
  3. Shaving of Operative part: You need to have an area of your body shaved to keep hair from getting into the surgical cut (incision). The area will be cleaned before the operation to reduce the risk of infection.

Anaesthesia

Anaesthesia is the use of drugs to make the body unable to feel pain for a period of time. General anaesthesia puts you into a deep sleep for the surgery. It is often started by having you breathe into a face mask or by putting a drug into a vein in your arm. Once you are asleep, an endotracheal or ET tube is put in your throat to make it easy for you to breathe. Your heart rate, breathing rate, and blood pressure (vital signs) will be closely watched during the surgery. A doctor watches you throughout the procedure and until you wake up. They also take out the ET tube when the operation is over. You will be taken to the recovery room to be watched closely while the effects of the drugs wear off. This may take hours. People waking up from general anaesthesia often feel "out of it" for some time. Things may seem hazy or dream-like for a while. Your throat may be sore for a while from the endotracheal (ET) tube.

recovery from surgery

Your recovery right after surgery depends on many factors, including your state of health before the operation and how extensive the operation was performed.

Pain

You may feel pain at the site of surgery. We aim to keep you pain free after surgery with the help of latest and most effective technique or analgesic (pain relieving medicine).

Tube/ Drains

  1. You may also have Ryle’s Tube (tube going through nose to stomach) that drain out intestinal fluid. This tube helps to relieve nausea and vomiting after surgery and usually removed 1-2 day after surgery.
  2. You may also have “Tube” (called a Foley catheter) draining urine from your bladder into a bag. This will be taken out soon after surgery, once you are comfortable enough to go to bathroom.
  3. You may have a tube or tubes (called Drains) coming out of the surgical opening in your skin (incision site). Drains allow the excess fluid that collects at the surgery site to leave the body. Drain tube will also be removed once they stop collecting fluid, usually a few days after the operation.

Leg Stocking / Compression boot

As you are remains in bed on day of surgery, circulation of blood in leg become sluggish that may increase possibility of thrombo-embolism. To minimise it, you will be wearing leg stocking/ pneumatic compression boot to improve your leg circulation thus minimising the risk of thrombolism.

Eating and Drinking

You may not feel much like eating or drinking, but this is an important part of the recovery process. Our health care team may start you out with ice chips or clear liquids. The stomach and intestines (digestive tract) is one of the last parts of the body to recover from the drugs used during surgery. You will need to have signs of stomach and bowel activity before you will be allowed to eat. You will likely be on a clear liquid diet until this happens. Once it does, you may get to try solid foods.

Activity

  1. Our health care team will try to have you move around as soon as possible after surgery. They may even have you out of bed and walking the same day. While this may be hard at first, it helps speed your recovery by getting your digestive tract moving. It also helps your circulation and helps prevent blood clots from forming in your legs.
  2. Our team shall also encourage you to do deep breathing exercises. This helps fully inflate your lungs and reduces the risk of pneumonia. You are advised to take deep breaths and cough every hour to help prevent lung infections. You will use an incentive spirometer (a small device used in breathing exercises to prevent complications after major surgery) 10-15 times every hour.

Going home

Once you are eating and walking, all tube/drains placed during surgery are removed, and then you may be ready to go home. Before leaving for home our health care team shall give you detailed guidance regarding diet, activities, medications & further plan of treatment.

Risks and Side effects of SUrgery

There are risks that go with any type of medical procedure and surgery is no longer an exception. Success of surgery depends upon 3 factors: type of disease/surgery, experience of surgeon and overall health of patients. What’s important is whether the expected benefits outweigh the possible risks.

Doctors have been performing surgeries for a very long time. Advances in surgical techniques and our understanding of how to prevent infections have made modern surgery safer and less likely to damage healthy tissues than it has ever been. Still, there’s always a degree of risk involved, no matter how small. Different procedures have different kinds of risks and side effects. Be sure to discuss the details of your case with our health care team, who can give you a better idea about what your actual risks are. During surgery, possible complications during surgery may be caused by the surgery itself, the drugs used (anesthesia), or an underlying disease. Generally speaking, the more complex the surgery is the greater the risk.

Complications in major surgical procedures include:

  1. Complications related to Anaesthesia : Reactions to drugs used (anesthesia) or other medicines. Although rare, these can be serious because they can cause dangerously low blood pressures. Your doctors will watch your heart rate, breathing rate, blood pressure, and other signs throughout the procedure to look for this.
  2. Complications related to underlying medical illness like heart disease, diabetes, kidney disease, obesity, malnutrition.
    1. Lung : Pneumonia, Atelectasis (collapse of lung), effusion (fluid in chest) can occur, especially in patients with reduced lung function, such as smokers. Doing deep breathing exercises as soon as possible after surgery helps lessen this risk.
    2. Thrombosis (blood clot) in leg & embolism (blood clot) in lung : Blood clots can form in the deep veins of the legs after surgery, especially if a person stays in bed for a long time. Such a clot can become a serious problem if it breaks loose and travels to another part of the body, such as a lung. This is a big reason why you will be encouraged to get out of bed to sit, stand, and walk as soon as possible.
    3. Cardiovascular : Myocardial infarction (heart attach), Arrhythmia (irregular heart beat), Stroke (cerebro-vascular accidents).
    4. Kidney & urinary tract infection, acute kidney failure if patient has uncontrolled/non-responding infection.
  3. Complications related to Specific Operations
    1. There are specific complications related to type of surgery. You are encouraged with discuss in detail with our health care team before you give your consent for surgery.
    2. Bile leak
    3. Bleed
  4. Complications related to Major Surgery
    1. Infection : Infection at the site of the wound, lung and urinary infection. Infection risk is more if intestine is perforated before surgery, operated for colon and rectum, stent in placed in bile duct to relieve jaundice or intestinal joint is leaking.
    2. Bleeding : The risk of bleeding during or after surgery is more if patient taking blood thinning medicine till day of surgery or having liver dysfunction. Bleeding during surgery that may cause you to need blood transfusions. There is a risk of certain problems with transfusions, some of them serious. Still, some operations involve a certain amount of controlled blood loss. Bleeding can happen either inside the body (internally) or outside the body (externally). It can occur if a blood vessel sealed during surgery opens up or if a wound opens up. Serious bleeding may cause the person to need another operation to find the source of the bleeding and stop it.
    3. Leakage from anastomosis (joint of anastomosis) & fluid collection in tummy.
    4. Blockage of intestine (Intestinal obstruction)

Life after Surgery

Nutrition

Following treatment, you may feel change in your taste. This improves over a time and we encourage having health food habit like fresh vegetables, fruits and high protein diet.

Exercise

Along with healthy food habits, we also encourage for exercise. Exercise improves your health in different ways: It improves your heart and circulation, makes your muscles stronger & makes you feel happier. You should do your regular activities like walking, and rather increase day by day. Weight lifting and strenuous exercise are avoided for initial 2-3 months.

Follow up care

  1. You'll need regular check-ups after treatment for cancer. This help to find out any change in your recovery. Sometimes cancer comes back after treatment. Our health care team will check for return of cancer. Checkups may include a physical exam, blood tests, ultrasound / CT scan.
  2. If you have any health problems between checkups, you should contact our health care team. Report to our health care team, if you have any redness/ swelling or discharge of any type of fluid from your operative incision site, pain abdomen, vomiting or fever, breathing difficulty etc.

Obesity is a complex disease involving an excessive amount of body fat. Obesity isn't just a cosmetic concern. It is a medical problem that increases your risk of other diseases and health problems, such as heart disease, diabetes, high blood pressure and certain cancers.

There are many reasons why some people have difficulty avoiding obesity. Usually, obesity results from a combination of inherited factors, combined with the environment and personal diet and exercise choices.

The good news is that even modest weight loss can improve or prevent the health problems associated with obesity. Dietary changes, increased physical activity and behavior changes can help you lose weight. Prescription medications and weight-loss procedures are additional options for treating obesity.

Causes

Although there are genetic, behavioral, metabolic and hormonal influences on body weight, obesity occurs when you take in more calories than you burn through exercise and normal daily activities. Your body stores these excess calories as fat.

When most of the diets are too high in calories & often from fast food and high-calorie beverages. People with obesity might eat more calories before feeling full, feel hungry sooner, or eat more due to stress or anxiety.

Symptoms

Obesity is diagnosed when your body mass index (BMI) is 30 or higher. To determine your body mass index, divide your weight in pounds by your height in inches squared and multiply by 703. Or divide your weight in kilograms by your height in meters squared.

BMI Weight status
Below 18.5 Underweight
18.5-24.9 Normal
25.0-29.9 Overweight
30.0 and higher Obesity

For most people, BMI provides a reasonable estimate of body fat. However, BMI doesn't directly measure body fat, so some people, such as muscular athletes, may have a BMI in the obesity category even though they don't have excess body fat.

Risks

Obesity usually results from a combination of causes and contributing factors:

  • Family inheritance and influences
  • Lifestyle choices
  • Certain diseases and medications
  • Social and economic issues
  • Age
  • Other factors (Pregnancy, Quitting smoking, Lack of sleep, Stress, Microbiome, Previous attempts to lose weight etc)

Even if you have one or more of these risk factors, it doesn't mean that you're destined to develop obesity. You can counteract most risk factors through diet, physical activity and exercise, and behavior changes.

Prevention

Whether you're at risk of obesity, currently overweight or at a healthy weight, you can take steps to prevent unhealthy weight gain and related health problems. Not surprisingly, the steps to prevent weight gain are the same as the steps to lose weight: daily exercise, a healthy diet, and a long-term commitment to watch what you eat and drink.

  • Exercise regularly.
  • Follow a healthy-eating plan
  • Know and avoid the food traps that cause you to eat.
  • Monitor your weight regularly
  • Be consistent

When to see a doctor

If you're concerned about weight-related health problems, you have come at the right place Request a Callback to discuss about obesity management. We can evaluate your health risks and discuss your weight-loss options.

How we can HELP

Obesity Doctor is one of the most renowned & awarded Obesity/Weight Loss Clinic in India.

Obesity Clinic is a Super Speciality Surgery Center specializing in Bariatric Surgery procedures. We specialize in laparoscopic (key-hole surgery) surgery, Single incision or Scar-less surgery. These techniques are much kinder to the patients as compared to open surgery. Laparoscopy leads to less pain, early recovery and faster return to work.

  • Super Specialist

    in Gastro Intestinal & Laproscopic Surgery
  • 5000+

    surgeries performed successfully
  • Awards & Accolades

    Recipient from various National & International Medical Associations
Request a Callback

What our patients say

Testimonials say it all, Where Patients come first.
Check out More Testimonails

Types of Weight Loss Surgery

Bariatric Surgery / Weight Loss Surgeries / Obesity Surgeries.

Consult with our specialist to clear doubts about Weight Loss Surgeries.

Consult Now
  • Roux-en Y Gastric Bypass Surgery

  • Gastric Balloon Surgery

  • Gastric Sleeve Surgery OR Sleeve Gastrectomy

  • Single Incision Sleeve Gastrectomy

  • Adjustable Gastric Banding Surgery

  • c

  • Duodenal Switch (DS) & Duodeno-Jejunostomy (DJB)

  • Revisional Bariatric Surgery

Why Surgery ?

Benefits of Bariatric Surgery and Why you sould choose it.

Bariatric/weight loss surgery is the only valid treatment option that leads to sustained weight loss in patients suffering from clinically severe obesity. Most people who suffer from obesity have usually tried all methods to lose weight without success before they consider surgery.

Bariatric surgery is recommended for people who are suffering from morbid obesity (if they are more than 30 to 35 kg above their ideal body weight). Bariatric surgery is also a very good treatment option for obese people who suffer from type 2 diabetes mellitus. Surgery leads to significant improvement in diseases associated with obesity such as- diabetes, high blood pressure, dyslipidemia, knee joint pains, PCOD, obstructive sleep apnoea, fatty liver disease, infertility and so on.

Bariatric surgery is the only way people can lose massive amount of weight. It is also easier to maintain the weight loss after surgery than after any other method of losing weight. Surgery also leads to a significant improvement in the quality of life of these patients.

On a daily basis, we see patients who put in their heart and soul into their efforts to lose weight. They have been to every weight loss clinic, celebrity dieticians, gyms, yoga gurus and weight loss retreats. Unfortunately, more often than not, they meet with disappointment and tend to yo-yo between weight loss and weight gain. This entire process is extremely disheartening and demotivating for the patients.

So, if you have tried hard to lose weight without success and the weight is bearing you down, you have come to the right place because bariatric surgery is the only way at the moment that can lead to sustained weight loss in patients suffering from morbid obesity.

Frequently Asked Questions

  1. How much weight can I lose after bariatric surgery and how much time does it take?

    Bariatric surgery leads to about 65 to 75% excess weight loss. Excess weight is calculated as actual weight minus ideal body weight. It takes about 12 to 18 months to lose this weight. Weight loss is very quick in the first 6 months and then it tends to slow down.

  2. Obesity is a chronic progressive disease. Diet and lifestyle modification are an integral part of management of obesity. Patients who embrace the diet and lifestyle modification after surgery tend to get better results. Some degree of weight regain is expected in the long term but it can be controlled if the patient is following a healthy lifestyle.

  3. After bariatric surgery, patients need to be on a liquid diet for about 15 days. This is followed by a phase of semi-solid or soft diet for another 15 days. After a month, most patients are able to have normal food, albeit in limited quantity. Initially the intake is very low but over a period of time, patients are able to eat better. It is also advised to have nutritional supplements in the form of protein supplement, iron, calcium and multivitamins. These will be advised by your doctor based upon your reports as well as the type of surgery.

  4. The cost of bariatric surgery depends on the type of surgery and the room category that you choose. At the moment insurance companies do not cover it routinely but evaluate on case to case basis. There is also an option of medical loan through which patients can get the facility of paying for the surgery in monthly EMIs.

Request a Callback
  • Roux-en Y Gastric Bypass Surgery

  • Gastric Balloon Surgery

  • Gastric Sleeve Surgery OR Sleeve Gastrectomy

  • Single Incision Sleeve Gastrectomy

  • Adjustable Gastric Banding Surgery

  • c

  • Duodenal Switch (DS) & Duodeno-Jejunostomy (DJB)

  • Revisional Bariatric Surgery

Calculate your BMI

Enter your height for eg : 175 cm or 5.8 feet & Enter weight like 60 or 80 kg

*(Please enter numbers only)


Download the App

The Obesity Calculator App

The obesity calculator app lets you manage your weight, using various calculators like BMI calculator for Adult, BMI calculator for Child, Body Fat calculator, Calorie calculator, Diet calculator and the “All in One Calculator” which will display all three result of BMI, Body Fat & Calorie.

Download the App Now

Editors Pick

She was blessed for miraculous recovery from Advanced Stage 4 Gallbladder Cancer

She was blessed for miraculous recovery from Advanced Stage 4 Gallbladder Cancer

While being diagnosed with cancer can be hard for a patient as well as their loved ones, here we want to share a patient’s story that will definitely give you hope that miracles can happen.

Pancreas- Anatomy, Functions and Conditions

Pancreas- Anatomy, Functions and Conditions

The pancreas contains glands that release substances to help with digestion and control blood sugar.


Medical Tourism

Dwarika clinic is based in Ahmedabad, Gujarat, India and is headed by Dr Avinash Tank (Mch) who is a Super specialist Surgeon with over 5000+ successfull surgeries and Exp of over 20+ years. Dr Tank has been awarded several times by many National and International Medical associations across the Globe for his work in Gasteroentrology and Laparoscopic Surgery (Minimal Invasive Surgery) techniques and expertise.

Patients from across the globe have been provided Medical care by Dwarika clinic. If you are located in UK, USA, UAE, Australia, Newzealand, European Country, Singapore, Africa, Saudi Arabia, Russia or any other location and are planning for a healthcare procedure please fill the "NRI Consultation Form" and our team will get in touch to discuss your medical ailment and provide the necessary guidance on how to plan your Medical Procedure at Dwarika Clinic, Ahmedabad, India.

  • Best in class medical care

  • Better treatment for Better price

  • Complete Dietary and Accomodation Package

  • Post Treatment Care via Online Consultation

Contact Us

Your message has been sent. Thank you!

By submiting this form you agree that the team from Dwarika Clinic can contact you at the shared/submitted contact information for the Medical Condition / Subject shared to discuss about Medical Procedure planning and consultation.

Your Privacy is our first concern, any information shared via submitting this form will only be used to connect with you for medical consultation.

Detail Article Page

  • Freezer
  • Obesity
  • Works

Medical Travel

How to Manage your Travel Plan during COVID times

A study finds that planning while mindfully staying in the moment may improve responses to stressful events.

Its better to plan ahead for your Medical Surguries

Were you planning a surgery procedure, know the best way to plan your Medical Surgeries.

Obesity is one of the biggest health problems in the world.

It’s associated with several related conditions, collectively known as metabolic syndrome. These include high blood pressure, elevated blood sugar and a poor blood lipid profile.

People with metabolic syndrome are at a much higher risk of heart disease and type 2 diabetes, compared to those whose weight is in a normal range.

Over the past decades, much research has focused on the causes of obesity and how it could be prevented or treated.

Many people seem to think that weight gain and obesity are caused by a lack of willpower.

That’s not entirely true. Although weight gain is largely a result of eating behavior and lifestyle, some people are at a disadvantage when it comes to controlling their eating habits.

The thing is, overeating is driven by various biological factors like genetics and hormones. Certain people are simply predisposed to gaining weight ( 1 Trusted Source ).

Of course, people can overcome their genetic disadvantages by changing their lifestyle and behavior. Lifestyle changes require willpower, dedication and perseverance.

Nevertheless, claims that behavior is purely a function of willpower is far too simplistic.

They don’t take into account all the other factors that ultimately determine what people do and when they do it.

Here are 10 factors that are leading causes of weight gain, obesity and metabolic disease, many of which have nothing to do with willpower.

Obesity has a strong genetic component. Children of obese parents are much more likely to become obese than children of lean parents.

That doesn’t mean that obesity is completely predetermined. What you eat can have a major effect on which genes are expressed and which are not.

Non-industrialized societies rapidly become obese when they start eating a typical Western diet. Their genes didn’t change, but the environment and the signals they sent to their genes did.

Put simply, genetic components do affect your susceptibility to gaining weight. Studies on identical twins demonstrate this very well ( 2 Trusted Source ).

Summary Some people appear to be genetically susceptible to weight gain and obesity.

Heavily processed foods are often little more than refined ingredients mixed with additives.

These products are designed to be cheap, last long on the shelf and taste so incredibly good that they are hard to resist.

By making foods as tasty as possible, food manufacturers are trying to increase sales. But they also promote overeating.

Most processed foods today don’t resemble whole foods at all. These are highly engineered products, designed to get people hooked.

Summary Stores are filled with processed foods that are hard to resist. These products also promote overeating.

Many sugar-sweetened, high-fat junk foods stimulate the reward centers in your brain ( 3, 4 Trusted Source ).

In fact, these foods are often compared to commonly abused drugs like alcohol, cocaine, nicotine and cannabis.

Junk foods can cause addiction in susceptible individuals. These people lose control over their eating behavior, similar to people struggling with alcohol addiction losing control over their drinking behavior.

Addiction is a complex issue that can be very difficult to overcome. When you become addicted to something, you lose your freedom of choice and the biochemistry in your brain starts calling the shots for you.

Summary Some people experience strong food cravings or addiction. This especially applies to sugar-sweetened, high-fat junk foods which stimulate the reward centers in the brain.

Junk food producers are very aggressive marketers.

Their tactics can get unethical at times and they sometimes try to market very unhealthy products as healthy foods.

These companies also make misleading claims. What’s worse, they target their marketing specifically towards children.

In today’s world, children are becoming obese, diabetic and addicted to junk foods long before they’re old enough to make informed decisions about these things.

Summary Food producers spend a lot of money marketing junk food, sometimes specifically targeting children, who don’t have the knowledge and experience to realize they are being misled.

Insulin is a very important hormone that regulates energy storage, among other things.

One of its functions is to tell fat cells to store fat and to hold on to the fat they already carry.

The Western diet promotes insulin resistance in many overweight and obese individuals. This elevates insulin levels all over the body, causing energy to get stored in fat cells instead of being available for use ( 5 Trusted Source ).

While insulin’s role in obesity is controversial, several studies suggest that high insulin levels have a causal role in the development of obesity ( 6 Trusted Source ).

One of the best ways to lower your insulin is to cut back on simple or refined carbohydrates while increasing fiber intake ( 7 Trusted Source ).

This usually leads to an automatic reduction in calorie intake and effortless weight loss — no calorie counting or portion control needed ( 8 Trusted Source , 9 Trusted Source ).

Summary High insulin levels and insulin resistance are linked to the development of obesity. To lower insulin levels, reduce your intake of refined carbs and eat more fiber.

Many pharmaceutical drugs can cause weight gain as a side effect ( 10 Trusted Source ).

For example, antidepressants have been linked to modest weight gain over time ( 11 Trusted Source ).

Other examples include diabetes medication and antipsychotics ( 12 Trusted Source , 13 Trusted Source ).

These drugs don’t decrease your willpower. They alter the function of your body and brain, reducing metabolic rate or increasing appetite ( 14 Trusted Source , 15 Trusted Source ).

Summary Some medications may promote weight gain by reducing the number of calories burned or increasing appetite.

Leptin is another hormone that plays an important role in obesity.

It is produced by fat cells and its blood levels increase with higher fat mass. For this reason, leptin levels are especially high in people with obesity.

In healthy people, high leptin levels are linked to reduced appetite. When working properly, it should tell your brain how high your fat stores are.

The problem is that leptin isn’t working as it should in many obese people, because for some reason it cannot cross the blood-brain barrier ( 16 Trusted Source ).

This condition is called leptin resistance and is believed to be a leading factor in the pathogenesis of obesity.

Summary Leptin, an appetite-reducing hormone, doesn’t work in many obese individuals.

Another factor that dramatically influences people’s waistline is food availability, which has increased massively in the past few centuries.

Food, especially junk food, is everywhere now. Shops display tempting foods where they are most likely to gain your attention.

Another problem is that junk food is often cheaper than healthy, whole foods, especially in America.

Some people, especially in poorer neighborhoods, don’t even have the option of purchasing real foods, like fresh fruit and vegetables.

Convenience stores in these areas only sell sodas, candy and processed, packaged junk foods.

How can it be a matter of choice if there is none?

Summary In some areas, finding fresh, whole foods may be difficult or expensive, leaving people no choice but to buy unhealthy junk foods.

Added sugar may be the single worst aspect of the modern diet.

That’s because sugar changes the hormones and biochemistry of your body when consumed in excess. This, in turn, contributes to weight gain.

Added sugar is half glucose, half fructose. People get glucose from a variety of foods, including starches, but the majority of fructose comes from added sugar.

Excess fructose intake may cause insulin resistance and elevated insulin levels. It also doesn’t promote satiety in the same way glucose does ( 17 Trusted Source , 18 Trusted Source , 19 Trusted Source ).

For all these reasons, sugar contributes to increased energy storage and, ultimately, obesity.

Summary Scientists believe that excessive sugar intake may be one of the main causes of obesity.

People all over the world are being misinformed about health and nutrition.

There are many reasons for this, but the problem largely depends on where people get their information from.

Many websites, for example, spread inaccurate or even incorrect information about health and nutrition.

Some news outlets also oversimplify or misinterpret the results of scientific studies and the results are frequently taken out of context.

Other information may simply be outdated or based on theories that have never been fully proven.

Food companies also play a role. Some promote products, such as weight loss supplements, that do not work.

Weight loss strategies based on false information can hold back your progress. It’s important to choose your sources well.

Summary Misinformation may contribute to weight gain in some people. It can also make weight loss more difficult.

If you have concerns about your waistline, you should not use this article as an excuse to give up.

While you can’t fully control the way your body works, you can learn how to control your eating habits and change your lifestyle.

Unless there is some medical condition getting in your way, it is within your power to control your weight.

It often takes hard work and a drastic lifestyle change, but many people do succeed in the long run despite having the odds stacked against them.

The point of this article is to open people’s minds to the fact that something other than individual responsibility plays a role in the obesity epidemic.

The fact is that modern eating habits and food culture must be changed to be able to reverse this problem on a global scale.

The idea that it is all caused by a lack of willpower is exactly what food producers want you to believe, so they can continue their marketing in peace.

Is this Article Helpful

Share this Article

Related Stories

Work from Home

10 Ways to Prevent Stress Eating When You’re Stuck at Home

If you find yourself overeating due to stress or boredom, you’re not alone..

Nutrition

5 Ways to Strengthen Your Immune System

Bost your immune system with these 5 ways to better prevent against Corona Virus threat.

Immunocompromised

Best way to stay protected, Wear Masks

If you are stepping out please wear a protective mask.

Best Obesity Surgery Center in Gujarat

Best Obesity Surgery Center in Rajasthan

Best Obesity Surgery Center in Madhya Pradesh

ObesityDoctor.in uses cookies to improve your site experience and to show you personalized advertising. To learn more, please read our Privacy Policy.

Request a Callback

or Book an Appointment

Enquire Now!