Head - General, MI & Bariatric Surgery, Artemis Hospitals, Gurgaon, India
Part 7 of 9 in Diagnosis and Management of Obesity and Metabolic Syndrome: The Role of Bariatric Surgery
Inside a Safe Bariatric Surgery Program: Team, Technique and Complication Rates
September 6, 2026
A bariatric surgery program is only as safe as the team and technique behind it. Dr. Rakesh Durkhure describes the multidisciplinary approach and safety record built over roughly 560 weight-loss procedures at Artemis Hospitals.
A Team, Not Just a Surgeon
Surgery is only one part of the process. Dr. Durkhure's program includes an endocrinologist for diabetes management, a chest physician for sleep apnea, a dedicated obesity dietician for pre- and post-surgery nutrition, a physiotherapist, and a psychologist to support patients through the psychological side of major weight loss, alongside the surgical team.
A Track Record Built on Technique
Dr. Durkhure reports having performed around 560 weight-loss procedures overall, including roughly 200 sleeve gastrectomies and around 200 bypass procedures for diabetes control, treating patients from 100 kilograms up to 227 kilograms. Surgery typically takes about an hour, blood loss is near zero, the hospital stay runs one to two days, and none of his patients have required ICU admission.
Preventing the Most Feared Complications
Internal hernia and leakage are the two complications surgeons worry about most after bariatric surgery. Dr. Durkhure reports never having seen an internal hernia in his practice, because every site where one could form is surgically closed during the operation, and he runs an intraoperative puncture test to check for leaks before closing, which has kept leakage at zero in his data. He also records video of every surgery and gives it to the patient at discharge, so it can be shown to their own doctor back home.
Deficiency Risk Tracks Diet, Not Geography
The main long-term risk after bariatric surgery is vitamin and protein deficiency. In Dr. Durkhure's experience it is rarely seen in patients who eat non-vegetarian food regularly, and shows up more often in patients following a strictly vegetarian diet, since dietary protein intake is what drives the difference.
← Bariatric Surgery Outcomes: What the Data Shows | Series index | Cost of Bariatric Surgery in India Versus Lifelong Medication →
This article is based on a Jivo Masterclass session conducted by Dr. Rakesh Durkhure, Head - General, MI & Bariatric Surgery, Artemis Hospitals, Gurgaon, India. The article has been summarised with the assistance of an AI tool from the original masterclass recording. Watch the full Masterclass recording
This guide is based on a live Jivo Masterclass: Dr. Rakesh Durkhure taught doctors across Africa on May 4, 2025.
FROM THE LIVE Q&A
Moderator
How does the cost of surgery compare with the lifetime cost of medical management, in terms of return on investment?
Dr. Rakesh Durkhure
Ozempic and Mounjaro cost about $500 a month in India and have to be taken indefinitely. The cost of surgery is recovered within about a year of what that ongoing medication would have cost. After that, the only requirement is vitamins and good nutritious food.
Book a Consultation with Dr. Rakesh Durkhure
Book on WhatsAppOr message us on WhatsApp: +91 98182 98669
Frequently Asked Questions
Beyond bariatric surgery, what other conditions can African doctors refer to your service?▼
The scope goes well beyond bariatric surgery. It includes hiatus hernia, where the stomach moves from the abdomen into the chest, gallbladder stones, particularly complicated cases where a stone has slipped into the bile duct, and problems of the colon and small intestine. It also covers complex abdominal hernias, including inguinal, umbilical, and recurrent hernias that have come back after a local repair, as well as rectal prolapse, complex piles and haemorrhoids, and fistulas near the back passage. All of these can be managed and the patient sent back with a satisfactory outcome.
What are the early signs of obesity?▼
A waistband that keeps needing loosening is the earliest sign. A partner reporting loud snoring at night is another. And marked breathlessness after something as minor as running 100 metres is a third.
How affordable are these surgeries?▼
Door to door, from hospital admission to discharge, the cost runs about $5,500 to $6,000. It varies by roughly $500 to $1,000 depending on the patient's body weight, diabetes management and breathing problems.
What is the relapse rate after the different weight-loss surgeries?▼
Relapse is highest with the intragastric balloon: because it has to be removed after four to six months, about 80% of patients regain the weight. With sleeve gastrectomy, around 40% of patients report weight relapse within two years. With gastric bypass, only 5 to 10% of patients report weight regain, which is why I recommend bypass specifically when a patient's weight is above around 125 kilograms.
Does that cost range apply to all four surgical options, or just the one with the lowest relapse rate?▼
That figure is for the option with the lowest relapse rate, gastric bypass. The other options cost somewhat less, roughly $1,000 less.
Who is on the team behind a bariatric surgery, besides the surgeon?▼
An endocrinologist, a chest physician, a dedicated dietician, a physiotherapist and a psychologist, working alongside the surgeon.
How does Dr. Durkhure guard against internal hernia and leakage?▼
Every potential hernia site is surgically closed during the operation, and an intraoperative puncture test checks for leaks before closing.
In This Series: Diagnosis and Management of Obesity and Metabolic Syndrome: The Role of Bariatric Surgery
- 1.Diagnosis and Management of Obesity and Metabolic Syndrome
- 2.Metabolic Syndrome: The Five Components and the Early Warning Signs of Obesity
- 3.Who Qualifies for Bariatric Surgery? Patient Selection Criteria
- 4.Intragastric Balloon, Sleeve Gastrectomy or Gastric Bypass: Comparing the Weight-Loss Surgery Options
- 5.How Bariatric Surgery Reverses Type 2 Diabetes
- 6.Bariatric Surgery Outcomes: What the Data Shows on Sleep Apnea, Blood Pressure and Quality of Life
- 7.Inside a Safe Bariatric Surgery Program: Team, Technique and Complication Rates
- 8.Cost of Bariatric Surgery in India Versus a Lifetime on Weight-Loss Medication
- 9.Beyond Bariatric Surgery: When to Refer a Patient for General and GI Surgery