bariatrische chirurgie India

India erg opkomst
Bariatrische chirurgie in India is erg in opkomst. Sinds 6 jaar, gelijk met landen als United Kingdom, Spanje en Duitsland werd de bariatrische chirurgie gestart terwijl in Nederland, Belgie en Frankrijk de operatieve behandeling van obesitas zo’n 12 jaar geleden echt op gang kwam. Belangrijk voor India is deze chirurgie omdat obesitas en diabetes helaas heel sterk groeiend zijn en nu al meer dan 50 miljoen diabetes patienten en bijna 200 miljoen obesitas patienten al zijn geregisteerd. Dit betekent een belangrijke doorbraak in India.

Veel operaties uitgevoerd in Pune
In 2007 werden er nu al zo’n 1000 operaties uitgevoerd, waarvan de meeste operaties plaatsvinden in Pune, een wereldstad met 5 miljoen inwoners op 160 km van Mumbai. In 2008 wordt minimaal 2.500 tot 3.000 operaties verwacht en voor het komende jaar wordt een explosieve groei verwacht van minimaal 6.000. In Pune is het enige bariatrische centrum van dr. Shashank Shah dat verspreid wordt over 3 ziekenhuizen in Pune, obesityasia, www.obesityasia.com. In Pune werden door dr. Shashank Shah en dr. Jayashree Todkar de laatste 2 jaar veel(meer dan 200) aziatische chirurgen uit India, China, Maleisie, Indonesie, Filipijnen, Pakistan en Bangladesh opgeleid voor deze belangrijke vorm van chirurgie.

Nederlander bij Obesityasia
Vanaf augustus 2008 zal aan zijn centrum de nederlander Jaap Suyk worden verbonden, Jaap Suyk heeft in Nederland en Engeland de laatste 10 jaar veel activiteiten verricht in deze chirurgie en bariatrische patienten begeleid en ondersteund. De ziekenhuizen in Pune van dr. Shashank zijn luxueus en zeer goed uitgerust. Daarnaast is de service in Pune erg goed en vooral ook echt 24/7. Het verblijf in India voor maagband is 3 nachten, gastric sleeve 5 nachten en 7 nachten voor een gastric bypass. De kamers bieden tevens plaats voor de partner die geen apart hotel hoeft te boeken tijdens het ziekenhuisverblijf.

Pune biedt mogelijkheden voor Nederlandse patient
Voor Nederlandse patienten kan Pune ook in de toekomst mogelijkheden gaan bieden via samenwerkende ziekenhuizen. Op dit moment zijn er gesprekken tussen Obesityasia en een aantal Nederlandse chirurgen. Hierdoor zullen patienten, indien zij dit graag willen mee te kunnen werken in deze bijzondere samenwerking. De patient kan haar/zijn operatie sneller laten uitvoeren en de Nederlandse chirurg kijkt mee bij dr. Shashank Shah via een speciale video-internet verbinding.

Kleine groepsreizen Amsterdam naar Pune
Vanuit Nederland worden in de toekomst kleine groepsreizen georganiseerd om dit alles professioneel te stroomlijnen. Ander voordeel voor de patient is: de operatie combineren met een goedkope maar ook luxeuze vakantie in een hotel resort in Lonavala of Khandala.

Armoede bestrijding in Pune
Maar er is nog een ander belangrijk argument voor chirurgie naar India. In de ziekenhuizen van dr. Shah worden ook gratis operaties uitgevoerd bij inwoners van Pune. Zoals bekend leeft 27% van de totale bevolking van India nog steeds op de absolute armoede grens van € 0,60 per dag onvoorstelbaar voor Nederlandse begrippen. Door deze speciale manier van medische outsourcing worden de allerarmste van Pune direct geholpen. De ziekenhuizen van Pune lopen overigens hier wel mee voorop en de Nederlandse patient dient hierbij twee doelen. Ten eerste wordt hij/zij snel geholpen in een groot en vakkundig bariatrisch centrum met behulp van haar/zijn eigen chirurg en draagt deze deze operatie ook werkelijk bij tot de armoede bestrijding in Pune.

Plastische chirurgie Pune
Er zijn in Pune overigens ook prachtige mogelijkheden voor plastische en dentale chirurgie die op dezelfde manier bijdragen aan dit prachtige project. Buikwand correctie of totale dentale make-over voor slechts 10% van de prijs in Nederland.

Will USA use India for outsourcing their bariatric surgery?

Bariatric surgery in USA In USA bariatric surgery, reducing the size of the stomach by gastric band or stapling procedures like Roux en Y gastric bypass, vertical gastric sleeve (Gastrectomy) or duodenal sleeve for many years strongly growth market. In USA in 2007 more 200,000 surgeries took place and for 2008 increase of 50% is expected. More than 2,000 surgeons are trained for bariatric surgery and more and more centers of excellence are created. Being one of the largest obesity countries (India and China are confronted with the same huge numbers) it seems that severe obese patients are really getting good care and the results are enormous. But is this situation ideal at this moment?

Downside in USA With the information that 1/3 of the total population of USA is suffering for obesity, at this moment 0,2% of obese patients are having surgery. It is a start if the numbers of obesity are not raising more than surgery can help it would. For these patient groups more than 80% will have good result. After 20 years of bariatric surgery worldwide this is one of the outcomes of surgery. But 0,2% is hardly any effect on obesity in USA, for real results like taking down diabetes, sleeping apnea, heart & vascular diseases caused by obesity the effect should be raised at least to 5% of the total obesity population. This means 5.000.000 surgeries/yearly. Is that realistic figure?

The downsides in USA is that most insurance companies will pay based on information on the Internet but the procedures can be quite long, sometimes 1-2 years, and not every company pays for surgery. Some companies pay only for gastric band surgery because of the costs.

Loans for financing surgery Another negative effect of the situation in USA is that when patients for what kind of reasons need to finance (or are uninsured for this type of surgery or uninsured at all) their own surgery they are forced to pay a high price for surgery in USA. Based on the Internet average price for gastric band surgery is 10,000 – 15,000 USD and after care is most cases separate and can add some thousands of dollars to this investment. Prices for gastric bypass are even much higher to 20,000 – 30,000 USD. A lot of people are creating financial problems for themselves to finance their surgery with loans. It is the reality at this moment.

Medical tourism for surgery? Is medical tourism the future for bariatric surgery to Americans? Medical tourism is for some type of surgery like cosmetic or dental surgery combined with nice and luxury stays at resort on an exotic island or country a nice way to undergo surgery, but is this the case for bariatric surgery too? Bariatric surgery what requires an intensive after care and check-ups to get the good results is not the most ideal scenario for medical tourism. Patients are not sure about the good quality of the surgeon, high or low expertise? These are not something like an international database for bariatric surgeons. And a lot of exotic countries have other hygiene guidelines and infection prevention than USA. For these reasons US surgeons are not very happy to perform after care to patients who underwent surgery abroad.

Outsourcing to India by bariatric surgeons

If medical tourism has his negative arguments, how about medical outsourcing of bariatric surgery to India? Outsourcing to India is in many sectors an interesting option like ICT, Financial business and Telecommunication. Would this be the help we are looking for to a large group of patients in USA, insurance companies and bariatric surgeons in USA? With this type of outsourcing US surgeons and medical insurance companies have full control to their patients in pre-op and post -op care and financially. But cheaper options for everybody, India can offer the same surgeries for less than half the cost in USA. If surgeons in USA would use this extra option to avoid medical tourism to some less experienced countries the patients would be the winners. In India bariatric surgery started since 2000 and with the high medical knowledge and expertise of good group of surgeons it would a very good option for outsourcing bariatric patients also in most private hospitals the video-conference options are THE method for the US surgeons to keep in touch with their patients and to see the surgery themselves. It saves money and higher volume of patients is possible. We see at Obesityasia, www.obesityasia.com, in the last year a strong growing interest of US surgeons and insurance company for this unique concept of outsourcing.

Lecture for bariatric surgery in India

Since 15 years in a lot of countries all around the world bariatric surgery has been an effective way to lose high percentage of people’s overweight, to let medical complications disappear and to give people a chance to start living again. Obesity is probably the worldwide biggest medical problem what causes so many co-morbidities like hypertension, diabetes, joint problems, sleeping apnea, fertility problems, depression, heart and vascular diseases and so much more. A very long list. Since several years alos childhood obesity is causing huge medical problems to our children. Figures in USA speak over more 10% of children under 15 year medical treated for hypertension and diabetes. And this is just the beginning. More and more people,companies and governments realize the daily effect of obesity. Soon to be our number disease and number 1 death cause. Bariatric surgery is not only to IFSO (International Federation for Surgery Obesity) the world organization for bariatric surgeons with more than 2,000 members the only realistic way to lose weight and not be become overweighted again.

After 50 years of thousands of different diets, change of lifestyle, new and old medications to the market we don’t know how to stop obesity, surgery can help obese patients should be consider by large public more and more. Physicians worldwide must consider bariatric surgery as real medical treatment to help their obese patients. There are thousands of medical papers since 15 years show the good results of bariatric surgery. Despite a small percentage of patients who regain weight again for most of the patients surgery is the final solution and most bariatric surgeons are seen as their friends for life.

In 2007 in Asia, USA and Europe more than 350,000 surgeries were performed and especially in USA we see that a very small effect to obesity. Is bariatric surgery the ideal method? This is related to the patient and medical professionals but in most situations it is a very good help to solve comorbidities.

In several countries in Europe and in USA more and more medical insurance companies refund or finance the surgery what can give patients back their life. Is bariatric surgery an ideal method and is it safe? Since 15 years we know that surgery to obese and morbidly obese patients can be high risk in respect to anesthesia and good information and lecture is probably one way to reduce the medical risks. In India, now fast start in bariatric surgery worldwide these lectures makes a part of the whole procedure. India is now heading to be number 1 in obesity and diabetes with USA and China as quicker followers. For that reason bariatric surgery can be very helpful to reduce obesity in India. In Pune free lectures we as Obesity asia started as standard for bariatric surgery in India. With help of many organizations and medical industry we hope to start at many other locations in India. For the sake of the obese patients in India. www.obesityasia.com