Bariatric Surgical Practice Guide

Dr. Praveen Raj completed his graduate medical training from PSG Institute of Medical Sciences, Coimbatore with honors, and masters in General Surgery from the prestigious Sri Ramachandra University, Chennai. He also secured his masters in Surgery and surgical gastroenterology from the National Board (DNB). He has been conferred with the Honorary Fellow in Advanced laparoscopy (FALS) by the Indian Association for Gastrointestinal Endosurgeons (IAGES). Currently, he is director at the GEM hospital group and heads the GEM Obesity and Diabetes Surgery Centre. His center is recognized by the Dr. MGR Medical University for conducting a tw- year fellowship program in bariatric surgery. Through his bi-annual training program, he has trained more than 150 surgeons in the field of bariatric surgery.Dr. Praveen Raj is currently the President of the Indian chapter of the International Excellence Federation of Bariatric Surgery. He and his center were the first in South India to beaccredited as an International Center of Excellence by the Surgical Review Corporation, USA. He has authored several papers on laparoscopic and bariatric surgery and presents frequently at conferences. His recently completed NASHOST trial, aimed to study the influence of bariatric surgery on non-alcoholic fatty liver disease is the first registered clinical trial on bariatric surgery in the country. He has also commenced a trial on lower BMI metabolic surgery for the treatment of type 2 diabetes mellitus, which when completed will be the first of its kind in the world. He has also instituted international fellowship programs where physicians from abroad train with him in India. Dr. Saravana Kumar graduated in surgery from the Madurai Medical College, India. He later acquired his laparoscopic skills at the renowned Gem Hospital & Research Centre, Coimbatore under Prof. C. Palanivelu. He is currently a consultant in the department of Bariatric and upper GI surgery at the same Institute. He has many international publications in the field of bariatric surgery and, along with Dr. Praveen Raj and Professor Palanivelu, is actively involved in training of surgeons. He is a member of the Obesity Surgery Society of India, Association of Minimal Access Surgeons of India, and also the International Federation for Surgery of Obesity. Dr Rachel Maria Gomes graduated and completed her surgical training with accolades from the Goa Medical College under the Goa University of India. She then further specialized in GI and Laparoscopic surgery at the Bhatia hospital and the Jaslok hospital at Mumbai. She is a Consultant GI & Laparoscopic Surgeon in Goa and is currently associated with the Upper Gastrointestinal Surgery and Minimal Access Surgery unit of GEM Hospital and Research Centre at Coimbatore. She has to her credit more than 50 peer-reviewed national and international publications and has delivered numerous presentations at national and international conferences with several awards for outstanding presentations. She is a member of the Association of Surgeons of India, the Indian Association of Surgical Gastroenterology and the Indian Association of Gastrointestinal and Endoscopic Surgeons. 

Part 1.Selection of a patient.- 1.Selection guidelines for bariatric surgery.- 2.Bariatric surgery in adolescents.- 3.Selection of bariatric surgery procedures in special circumstances.- 4.Preoperative evaluation and contraindications to bariatric surgery.- Part 2.Preoperative predictors of outcomes.- 5.Definition of outcomes after bariatric surgery.- 6.Preoperative predictors of weightloss after bariatric surgery.- 7.Preoperative predictors of Diabetes control following bariatric surgery.- Part 3.Technical considerations.- 8.Standardization of technique in sleeve gastrectomy.- 9.Technical considerations in gastric plication with or without a band.- 10.Standardization of technique in roux-en-Y gastric bypass.- 11.Technical considerations of duodenal switch and variants.- Part 4.Specific situations in bariatric surgery.- 12.Gastroesophageal reflux disease and bariatric surgery.- 13.Ventral hernia repair in the morbidly obese.- 14.Gallstone disease before and after bariatric surgery.-  15.Polycystic ovarian disease, pregnancy and bariatric surgery.- 16.Nonalcoholic fatty liver disease and effects of bariatric surgery.- 17.Outcomes of diabetic microvascular complications after bariatric surgery.-  18.Role of bariatric surgery in end-organ failure.- Part 5: Postoperative pathways.- 19.Peri-operative venous thromboembolism prophylaxis after bariatric surgery.- 20.Peri-operative management of  medical comorbidities  after bariatric surgery.- 21.Peri-operative management of  obstructive sleep apnea after bariatric surgery.- 22.Enhanced recovery after bariatric surgery.- Part 6.Surgical complications after bariatric surgery.- 23.Post Sleeve gastrectomy leaks.- 24.Detection and management of internal hernias.- 25.Prevention and management of marginal ulcers.- 26.Prevention and management of gastro-jejunostomy strictures.- 27.Management of leaks after gastric bypass.- 28.Prevention andmanagement of bleeding after sleeve gastrectomy and gastric bypass.- Part 9.Revisional bariatric surgery.- 29.Revisional surgical options after laparoscopic adjustable gastric banding.- 30.Revisional surgical options after laparoscopic sleeve gastrectomy.- 31.Revisional surgical options after laparoscopic roux-en-Y gastric bypass.- Part10.Nutritional management in bariatric surgery.- 32.Perioperative diet management in  bariatric surgery.- 33.Importance of proteins after  bariatric surgery.- 34.Anaemia and related deficiencies in  bariatric surgery.- 35.Calcium and vitamin D deficiencies  in  bariatric surgery.- 36.Other micronutrient deficiencies in bariatric surgery.