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Doctors at AIIMS in Delhi were able to give a new lease of life to a 32-year-old patient suffering from severe obesity accompanied by sleep apnea. Due to this condition, his breathing constantly stopped, requiring him to use a CPAP machine every night.

The doctors first performed a tracheostomy—a surgical creation of an opening in the throat for the insertion of a breathing tube. Following this, bariatric surgery was performed to reduce weight. In just thirteen days, Manish's weight decreased by approximately 49 kilograms, and the breathing problem disappeared.

Professor Dr. Manjunath Maruti Paul, a specialist in metabolic, bariatric, and transplant surgery in the Department of Surgery at AIIMS Delhi, told aajtak.in about this case. He noted that the patient, who was only 32 years old, weighed 209 kilograms and had a Body Mass Index (BMI) of 74 kg/m².

The patient suffered from high blood pressure, prediabetes, cholesterol problems, heartburn, depression, knee pain, and most seriously, obstructive sleep apnea (OSA). With OSA, a person's breathing repeatedly stops during sleep, leading to a dangerous drop in oxygen levels in the body. The patient sought help at AIIMS Delhi due to his critical condition and was hospitalized.

During his hospital stay, the patient's weight continued to increase, and his ability to breathe deteriorated rapidly. The CPAP machine proved insufficient, forcing the doctors to perform intubation, followed by emergency tracheostomy. Because of the enormous size of his abdomen, it was impossible to safely place the patient on a standard operating table, so the tracheostomy was performed directly in bed. After this, the patient remained on CPAP support via the tracheostomy for 32 days. During this period, he faced the risk of ventilator-associated infection, which required antibiotic treatment.

Dr. Manjunath explained that excessive weight gain affects almost all organs in the body. This puts stress on bones and joints, increases pressure on the heart, hinders normal lung function, causes mobility difficulties, and significantly raises the risk of respiratory arrest during sleep.

Obstructive sleep apnea is characterized by the periodic closure of the airways in the throat during sleep, leading to brief pauses in breathing. If this happens frequently, blood oxygen levels drop, which can negatively affect the heart. Such patients often use a CPAP machine, which delivers pressurized air to keep the airways open. However, with severe progression of the disease, some patients require a tracheostomy, allowing air to enter the lungs directly.

Before the operation, the medical team conducted special preparation over 32 days. A group was formed comprising surgeons, anesthesiologists, physiotherapists, dietitians, and other experts. The patient was placed on a very low-calorie diet (VLCD). Concurrently, breathing exercises, infection treatment, blood pressure control, and constant monitoring of his condition were carried out.

This meticulous preparation yielded significant results. Following this, the doctors decided to proceed with bariatric surgery. As a result, the patient's weight dropped from 209 kilograms to 160 kilograms, and his abdominal circumference decreased from 198 centimeters to 178 centimeters. The patient was discharged from the hospital and is now healthy, though continuous monitoring will be maintained.