Dr. Mohit Bhandari

Operating at Scale: Lessons from Asia’s Largest Bariatric Program

Mohit Bhandari is an Indian bariatric surgeon known for his work in laparoscopic and robot-assisted surgery. He is the first surgeon in Asian sub-continent to perform more than twenty one thousand bariatrics and metabolic surgeries.

Driving Superior Surgical Outcomes in Revisional Surgery for Weight Regain

Bariatric surgery remains the most effective and durable weight loss method available to patients. However, a significant percentage of patients may regain weight resulting in frustration, depression, and return of obesity-related co-morbidities. Revision surgery is the one of the treatment modalities for such weight regained patients. The more you do bariatric surgery, the more you need to prepare for revision surgery.

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Pursuit of Mastery

Leadership is an essential skill in a surgeon. But leadership qualities can be developed during residency rather than waiting until later in your career. The surgical training process in itself requires initiative and motivation and successful residents must begin to develop leadership qualities during their training. Often finding a suitable mentor either within the department or elsewhere can provide essential guidance.

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How I Balance Quantity and Quality in Bariatric Surgery

Obesity is now a global public health issue and has nearly doubled worldwide since 1980. Bariatric surgery is on the rise, but little focus has been placed on the quality impacts of surgery. The purpose of this study is to explore our knowledge with respect to the quantity and quality of bariatric surgery from our last ten years’ experiences.  The main focus of this work is to gain an understanding of the successes and challenges faced before and after surgery with the advances in surgical techniques and technologies available for its treatment. We outline the different options in bariatric surgery and summarize the recommendations for selecting and assessing potential candidates before proceeding to surgery.    Standardization of bariatric metabolic procedures provides patients with better quality of life and a longer lifespan. For the enhancement of quality, a fellowship programme and the Virtual Bariatric University (VBU) have started to provide knowledge on bariatric (weight loss) surgery to all minimal-access surgeons. We constantly provide data on post-surgical outcomes and evaluate the psychosocial and economic effects of bariatric surgery. Uniform measurement is a fundamental requirement to understand the elements in each procedure that correlate with beneficial weight loss and metabolic effects.  Our experiences revealed that standardization and changes to improve care based on the data analysis are key metrics to establish whether the final anatomic configuration following a procedure strengthens bariatric surgical practice, research, and patient outcomes.

Managing a Global Pandemic through International Collaboration

he Covid 19 in India program is designed to update the entire world as to how the country is managing the second wave of this pandemic. Resources were limited in India with lack of ICU beds and meager supply of oxygen.

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Becoming a COE: Appropriate Equipment and Instruments

The number of laparoscopic bariatric surgical procedures is rapidly increasing all over the world, as it has the advantage of improving recovery time and reducing surgical morbidity. Laparoscopic bariatric procedures require appropriate equipment and instrumentation and surgeons are required to have advanced surgical skills. The operating room must be equipped with an adequate bed with a capacity of approximately 400 kg which makes it possible to safely position an obese patient and prevent musculoskeletal injuries. For bariatric procedures is essential: Optical devices: preferably a 30 or 45 degree telescope, provided with a white light illumination source and a video camera of high resolution. A TV monitor is required for reproduction of endoscopic images and the 4K monitors are recommendable. A DVD recorder allows for documentation of procedures performed. Equipment to creatine / maintain the domain: For performing laparoscopy is necessary a high flow CO2 insufflator which can deliver up 20 liters/min, to maintain a level of 12-15mmHg. Instruments for access: the Veress needle is commonly used, it should be appropriate for the size of the abdominal wall.  Operative instruments:  Trocars: available in various diameters and sizes according to requirements. Graspers: Bullet nose grasper and Dorsey intestinal fenestrated grasper are the most commonly used and are completely atraumatic.  Dissectors: like Maryland and bipolar dissector.  Scissors: Hook scissors or dissecting scissors with diathermy are used as required. Bowel and lung clamps: they are not frequently used, but are useful in revision procedures. Energy sources: There’s currently a shift towards the use of bipolar instead of monopolar in bariatric surgery.  Tissue approximation/ hemostasis: Laparoscopic ligating suture delivery system Needle driver Clip applicators Mechanical stapling devices: completely changed the bariatric surgery. A range of staple lengths (2.5-3.8mm) is available depending on the thickness of the tissue to be divided. Miscellaneous: like aspiration/irrigation probes or organ extraction devices. It is also important to set a bariatric unit with adequate entrances and routes, lobbies and waiting areas for obese patients, appropriate bedrooms and bathrooms to improve the quality of attention for these patients. Endorsed by:  [Image]

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