Doctors at the All India Institute of Medical Sciences (AIIMS), Delhi, have performed bariatric surgery on a 32-year-old man weighing 209 kg after a month-long multidisciplinary intervention that reduced his weight, stabilised his breathing, and enabled a procedure initially considered high risk.
The patient, with a body mass index (BMI) of 74 kg/m², suffered from severe obstructive sleep apnoea (OSA), respiratory failure, and obesity-related conditions, including hypertension, prediabetes, and dyslipidaemia. His condition had deteriorated to the extent that he required an emergency tracheostomy and remained dependent on continuous positive airway pressure (CPAP) support for over a month before surgery.
His body size also posed logistical challenges, as an abdominal girth of 198 cm prevented safe positioning on a conventional operating table. A multidisciplinary team comprising bariatric surgeons, anaesthesiologists, intensivists, physicians, infection-control specialists, dietitians, and physiotherapists devised a pre-operative optimisation plan to improve respiratory function and reduce abdominal fat.
“The patient underwent a 32-day very low-calorie diet (VLCD), respiratory physiotherapy, infection control, and nutritional counselling. During this period, his weight reduced from 209 kg to 172 kg, while abdominal girth decreased by 20 cm, allowing safe positioning on a modified operating table fitted with side extensions,” an AIIMS release said.
Doctors then performed a laparoscopic one anastomosis gastric bypass (OAGB), completing the procedure in just over two hours without major intraoperative complications.
Post-surgery, the patient was gradually weaned off CPAP support and, by the 13th postoperative day, was breathing independently, walking without assistance, and able to resume self-care. His abdominal girth further reduced to 155 cm before discharge, and his weight declined to 160 kg, AIIMS officials said.
The treating team said the case shows that patients with “super-super obesity” (BMI above 60 kg/m²), including those requiring prolonged ventilatory support and tracheostomy, can be considered for bariatric surgery with careful pre-operative optimisation and coordinated multidisciplinary care. “Reducing abdominal girth, rather than weight alone, proved critical in making the surgery feasible,” the institute said.
Published – August 07, 2026 01:06 am IST
