Life-saving surgery on 2-year-old weighing 45kg
NEW DELHI: City doctors performed a life-saving bariatric surgery on a two-year-old baby whose 45kg weight left her incapable of walking or crawling and posed a serious health risk. A healthy weight for a child her age is between 12kg and 15kg.
The doctors said that as per medical literature, the toddler, Khyati Varshney, is the youngest child to undergo weight loss surgery in the country.
The doctors from Max Hospital in Patparganj, where the toddler Khyati has been undergoing treatment for over a year, were unable to pinpoint the reason why she was putting on excess weight that caused sleep apnoea, a condition where the breathing stops and restarts repeatedly during sleep.
A sleep test conducted by her doctors, days before her surgery, showed that her oxygen saturation dropped to 75% in her sleep. Normally, people maintain oxygen saturation between 95% and 100%. Covid-19 patients with oxygen saturation below 94% are encouraged to go to a hospital.
Khyati’s parents started noticing excess weight when she was three months old. “People dismissed it saying that she is from a well-to-do family. At six months, she weighed over 15kg. Before the surgery, she was 45kg when her mother weighed 50kg,” said her father Rahul Varshney.
Doctors said they were unable to find any hormonal or genetic reason for her obesity, adding that it had nothing to with her diet as she started putting on weight even when she was on mother’s milk.
“It could be a genetic condition that we still do not know of. She doesn’t eat any junk food, she doesn’t like sweets too much – so it is not a case of food making the child obese,” said Dr Vivek Bindal, head of Max Institute of Minimal Access, Bariatric, and Robotic Surgery.
Doctors said Khyati is the youngest child to get a bariatric surgery. “There is a case of a 2.6-year-old child of 36 kg [undergoing weight-loss surgery] that is reported in medical literature. As far as we know, this is the youngest child to get the life-saving surgery. She may have died without it,” said Dr Bindal.
Worried about the excessive weight gain, the parents encouraged doctors to try bariatric surgery on her even though it is not usually considered for children below 12 years old because of the lifestyle changes it entails.
Among the challenges faced by doctors were a lack of medical equipment for bariatric surgery on children and no fixed guidelines to decide doses of medicines, anaesthetics or even ventilator settings.
“If the ventilator settings were set for a 45kg person, her lungs would not have been able to deal with the pressure. But if we gave it according to a twoyear-old, it would not have helped as her chest is heavy. We had to plan for all eventualities,” said Dr Rajiv Uttam, paediatric intensive care specialist.
Dr Arun Puri, the anaesthetist, said that five days after the surgery, Khyati’s sleep apnoea started improving and her snoring, one of the symptoms of the condition, stopped completely. “This could pave the way for the surgery becoming available for other obese children in the future,” he said.
It could be a genetic condition we still do not know of... She may have died without a surgery
Max Hospital