Bariatric Surgery in Tirunelveli: Methods and Results

At the clinic, bariatric operations are carried out by experienced bariatric surgeons:

• Ruslan S. Menzulin — bariatric surgeon and surgical oncologist, 9 years of experience. Trained at Mercy clinic (USA) under Vadim Gushchin, spoke at the World Congress of bariatric surgery in Santiago (2025). Co-author of an international study published in The Lancet.
• Andrey G. Ugay — lead bariatric surgeon, 27 years of experience. Has performed the largest number of SASJ operations in the country. Expert council member of the national Society of Bariatric Surgeons.

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Surgery is prescribed only when clear criteria are met

• The patient's body mass index (BMI)
• Overall health and any related chronic conditions
• Standard approaches to weight loss have not worked before

BMI serves as the chief indicator of obesity severity. Divide body weight (kg) by height squared (m²) to calculate it. Surgery is normally justified at BMI above 40, or above 35 with serious accompanying conditions. In selected cases it is considered at lower values as well — if non-surgical methods did not help.

It is common to confuse them, but their goals are fundamentally different. Bariatric surgery treats obesity and related diseases medically. By changing how the digestive tract works, it addresses the causes of excess weight and metabolism. Plastic surgery shapes the body's outer contours; it does not treat obesity and has no effect on metabolism.

City Medical Centre performs four main types of bariatric surgery: sleeve gastrectomy, Roux-en-Y gastric bypass, mini gastric bypass (MGB) and SADI-S duodeno-ileal bypass. Each method is chosen individually based on BMI, related conditions and the patient's goals.

We use modern laparoscopic technique. The operation is done through 4 small punctures of 5 to 15 mm. Cosmetic sutures are placed, so once healed the marks become almost invisible.

Recovery depends on your activity. Office work: after 2–4 weeks. Physical work: after 1.5 months. Sport and activity: swimming allowed after 30 days, other exercise added step by step as weight drops. Travel and holidays: plan them no earlier than a month after surgery.

Eating changes gradually: liquid food first, then soft, then solid. The focus is protein, with high-calorie, fatty food kept to a minimum.

Pregnancy is an option after bariatric surgery, but doctors advise waiting at least 12–18 months. By then the body has stabilized, weight has reached target values and nutritional status has normalized.

Yes, vitamins become essential after bariatric surgery. The changed digestive anatomy lowers absorption of some nutrients, so regular vitamin and mineral supplements turn into a permanent part of the patient's life.

Weight can be regained after bariatric surgery, but this is very unlikely with the doctor's advice followed. Proper nutrition, avoiding high-calorie drinks and regular follow-up with City Medical Centre specialists are crucial.