Bariatric Surgery in Pakistan

Bariatric surgery is a group of weight-loss surgeries that involves making changes to the digestive system, some of which are non-reversible. The idea behind these types of surgeries is to help patients lose weight by either limiting the amount of food they can consume/digest at any one time or reducing their body’s ability to absorb nutrients. Some procedures do both. 

Bariatric surgeries should only ever be the final option when diet and exercise have proved inadequate and there are now serious health concerns caused by a person's weight. In general, these surgeries can only be an option for patients whose body mass index (BMI) is 40 or higher (extreme obesity). In certain cases, patients whose BMI is 30 to 39.9 may qualify for certain types of bariatric surgery if they have serious weight-related problems, such as type 2 diabetes.

The three most common types of Bariatric Surgeries are as follows:

1. Gastric Sleeve – The most common surgery, in which about 80% of the stomach is irreversibly removed, resulting in a sleeve or tube-like structure. This smaller stomach will not be able to hold as much food and produces less of the hormone that regulates appetite (ghrelin), which can lessen the patient’s desire to eat. 
2. Gastric Bypass – A more complicated procedure in which the stomach is divided into two parts; a small upper pouch and a large lower ‘remnant’ pouch. The small intestine is rearranged to bypass the large pouch. As a result, the volume of the stomach is significantly reduced. This causes food to go into the small upper pouch of the stomach and then directly into the small intestine. The small upper pouch can only hold around an ounce of food. Gastric Bypass is typically not reversible. 
3. Gastric Band – Involves an inflatable silicone device that is fitted around the top portion of the stomach to create a smaller stomach pouch. This procedure causes the patient to feel fuller with less food but still allows the body to digest food as usual, without malabsorption. The device can be removed when the patient reaches their desired weight.

The bariatric surgeries mentioned above are typically performed laparoscopically, in which the surgeon creates around one to five small incisions in the abdomen to insert a laparoscope (a long narrow tube with a camera) and surgical tools. The patients are usually given a general anesthetic, so they will not feel anything throughout the surgery.

How Long Should I Stay in Pakistan?

After bariatric surgery, an overnight stay in the hospital is usually required. In some cases, you may need to stay longer (around 3 to 5 days). However, it is not advisable to leave Pakistan as soon as you are discharged from the hospital. Stay at least 10 to 14 days following your surgery for initial recovery and follow-up checkups. During the follow-up checkups, your surgeon will remove your stitches and check your overall condition.

What's the Expected Recovery Time?

The recovery time may take around 3 to 6 weeks until you are allowed to go back to your normal activities, including work, with some restrictions. You must avoid heavy work and strenuous activities, such as lifting, pushing, or carrying heavy loads for at least the first three months after surgery. You should also avoid sitting and standing without moving for long periods to avoid blood clots forming in your legs.

What Aftercare is Required?

You will be given a special diet plan immediately after your surgery, as well as detailed post-operative instructions. Make sure to follow the diet plan and instructions to avoid complications and speed up your recovery. In order to maximize and maintain weight loss, it is important that you commit to healthy eating and regular exercise. There may be restrictions on how much food you can consume. You may also need to change your eating habits, such as eating 6 small meals instead of 3 large meals each day. You should take vitamins and mineral supplements to ensure proper nutrition. 

What's the Success Rate?

The success rates vary for each of the different types of bariatric surgery. In general, within the first six months following the surgery, most patients lose around 30% to 55% of their excess weight. Then, as early as 12 months after surgery, most patients lose over 70% of their excess weight. Patients could also maintain a 50% to 60% loss of excess weight for 10 to 14 years after their bariatric surgery. Although the success rates are high, there are risks associated with bariatric surgery, such as bleeding, deep vein thrombosis, infections, spleen injury, stenosis, and infections.

Are there Alternatives?

There is a non-surgical Bariatric procedure, known as the Gastric Balloon. This involves an inflatable device that is temporarily inserted into the stomach via endoscopic placement. A sizable area of the stomach is obstructed by the balloon or balloons, thus reducing the amount of food it can contain at any one time, leading to eventual weight loss. The balloons are usually removed after 6 or 12 months. 

If you cannot or do not want to undergo any surgery or medical procedure, you may be able to work with a doctor who is experienced in treating extreme obesity and a dietician as the alternative. They may recommend you to change your diet, adding physical activity, and prescribe medications.

Bariatric Surgery in and around Pakistan

Introduction

The Islamic Republic of Pakistan is a country located in South Asia and it is the fifth-most populous country of the world, with a population exceeding 207.8 million. Although the country has plenty of natural and historical riches, this country is off the radar for most tourists due to political instability. Those who are curious enough to visit the country will find that it is filled with beautiful, from Mughals and mountains to the mighty Karakoram. 

A large number of ultra-modern medical centers are available, and they are equipped and facilitated with the most advanced medical technologies. Numerous doctors and surgeons at these medical centers are normally foreign qualified. Large numbers of patients from neighboring countries and the Middle East have traveled to Pakistan to undergo various medical procedures, mainly for organ transplants or fertility treatments.

Popular Cities and Regions in Pakistan

The capital city of Pakistan is Islamabad. This city was built as a planned city to replace Karachi as the country’s capital. Islamabad is known for its safety, high standards of living, and plenty of green spaces. Here, tourists can admire the symmetry of the Pakistan Monument, check out the Daman-e-Koh viewpoint, visit the Lok Virsa Museum, and stroll around the Faisal Mosque. Karachi, the original capital of the country, is a sprawling metropolis. Most visitors usually come to check out the Quaid Mausoleum and the Tuba Mosque. Another popular city for tourism in Lahore, which is filled with beautiful architecture and interesting museums. The most popular attractions in this city are the Badshahi Mosque, the Lahore Fort, the Sheesh Mahal, and the Delhi Gate. 

Transport in Pakistan

The busiest airport in Pakistan is the Jinnah International Airport, which is located in Karachi. It serves both domestic and international flights to and from several cities in Europe, Asia, and the Middle East. Taking domestic flights can be a great way to travel around. The rail network is also extensive and comfortable. Taxis and Uber are also available.

Visas in Pakistan

Citizens of 5 countries, including Maldives, Nepal, Samoa, Tonga, and Trinidad and Tobago, can visit Pakistan without a visa. Several countries, such as Austria and the UAE, may obtain a visa on arrival if they possess ETA. Citizens of 15 countries, including Armenia and India, are eligible to apply for an online visa. 

Weather in Pakistan

Summer (March – October) is hot and dry in the northern regions. However, July and August can be rainy, making the weather hot and humid. The temperatures can range from 9°C to 38°C. Winter (November – April) can be really severe and most cities will get frost. Also, the northern part of the country experiences heavy rainfall during this season. The average temperature ranges from 3°C to 25°C.

Additional Info

1. Local Currency: The official currency is the Pakistani rupee (PKR). 1 USD will get you approx. 154.4 PKR.
2. Money & Payments: ATMs are readily available. Pakistan is a cash-based society, and credit cards are only accepted in a few establishments. Tipping is not expected.
3. Local Language: The official language is Urdu and English. Punjabi, Pashto, Sindhi, Saraiki, and Balochi are also spoken by a number of people. 
4. Local Culture and Religion: Islam is practiced by more than 90% of the population. Hinduism, Christianity, Ahmadis, Sikhism, and other religions are also practiced. Always avoid wearing body-revealing clothes in public places.
5. Public holidays: Some of the most celebrated holidays are Holi, Pakistan Day, Eid ul-Fitr, and Eid ul-Azha.