A Mauritian weighing 410kg underwent bariatric surgery at Indore and became the first in the super-obese categ... Read More

INDORE: A Mauritian weighing 410kg underwent bariatric surgery at Indore and became the first in the super-obese category to survive the procedure, said a local hospital on Friday.

Dharamveer, 46, was operated on January 4 at Mohak Hospital , but the centre came out with a statement only on Friday because he has already lost 30kg and walks about unassisted. In March last year, Egyptian Eman Ahmed Abd El Aty became the world’s heaviest woman at 500kg to undergo surgery at a Mumbai hospital but was unable to walk and developed fatal complications. She died in Abu Dhabi.

Dharamveer, too, was turned away by hospitals in Mauritius because they believed the risk was too great. He had to book three business-class seats in Mauritius Airlines to fly to Mumbai in January. An Indian airline operators refused to accommodate him in a flight to Indore and he had to be brought by road in a specially designed car.

Mohak Hospital director and chief surgeon Dr Mohit Bhandari told TOI that Dharamveer had all complications associated with obesity — like type 2 diabetes, hypertension, sleep apnea, pulmonary artery hypertension and acanthosis (thickening of skin).

“He was refused care by federal hospitals of Mauritius as they were concerned about the anesthesia risk. They refused him basic obesity care and referred him to a higher centre,” he said adding that Dharamveer was confined to a bed in his room for 5 years. He had a very rapid weight regain in the last six months before surgery.

“It was one of the most challenging cases of my life as there was a dilemma in considering the patient for surgery. The surgery itself was difficult as a special bariatric table, able to bear 500 kg, extra-long instruments, and special surgical staplers were required,” Dr Bhandari said.

The super-obese, weighing over 400kg, have a high risk of developing cardiac arrest after surgery, so the decision to operate upon Dharamveer was a daunting one, he added. “The torque on hands during surgery was immense and three instruments broke down due to the intense abdominal wall thickness,” said Dr Bhandari.

Dharamveer underwent a gastric bypass surgery that creates a pouch and bypasses a part of the intestine. Usually, gastric bypass patients lose 80% of excess weight in 2-3 years and should be free of all comorbidities.

Dharamveer was discharged three weeks ago, and is doing fine, say doctors. They believe he will lose around 250 kg in 2-3 years. Dr Bhandari said the surgery has post-operative risks. “There is 0.5 to 5% chance of pulmonary embolism and sudden cardiac arrest after the surgery because of the viscosity of their blood and fat content,” he added.

