TREATMENT OPTIONS
We offer a range of treatment options, and careful discussion with our weight-loss specialists ensures that together we will find the weight loss solution most appropriate to your individual and personal needs
- The care that you will receive here is about much more than just the surgical procedure, and it is this which distinguishes us as one to the leading providers of bariatric care.
- The weight loss journey begins with your first consultation, as an antecedent to surgery, where your surgeon will discuss with you your medical and personal history. Surgery is followed up with long-term aftercare, which we consider to be crucial to significant and sustainable weight loss.
- All will undergo psychiatric evaluation and have access to metabolic medicine and dietetic expertise.
- All surgical weight-loss procedures act by limiting the amount of food that gets into the body through the digestive system. Bariatric surgery can be either restrictive, malabsorptive, or a combination of the two:
- Restrictive: restrictive measures work by reducing the size of the stomach so that satiety is reached with eating only very small meals.
- Malabsorptive: malabsorptive measures work by bypassing the part of the small intestine so that there is less opportunity for the calories from food eaten to be absorbed.
- Our surgeons are all highly competent at performing these procedures laparoscopically (by passing minimally invasive operating instruments through a small incision and performing the operation with the use of a telescope and camera).
- Procedures and hospitalisation vary in duration, but you can expect to be hospitalised for at least one night following surgery.
- Each procedure is of course associated with different benefits and side effects. As with any surgery, there are some risks attached. However the risk of staying obese or morbidly obese is much higher than the risk of surgery. The decision as to which procedure will be made jointly by you and your surgeon, and this is part of the purpose of your pre-operative assessments. You shouldn’t hesitate to ask your surgeon for advice or a clearer explanation of anything that you have not fully understood!
GASTRIC BAND
Also known as the “Laparoscopic Adjustable Gastric Band”
- This is a restrictive procedure whereby a small synthetic ring is placed around the top portion of the stomach to create a small pouch, which will fill very quickly and leave you feeling satisfied after only a very small meal.
- Because this is a restrictive procedure, it does require a certain level of effort from the patient in following pre- and post-operative diets and exercise guidelines, with the care and support of our multi-disciplinary team.
- The band is adjustable, and follow-up appointments are part of your weight loss success.
- This procedure is reversible as the band can be removed and the body anatomy is left intact.
PROXIMAL GASTRIC BYPASS
- This procedure is a combination of restrictive and malabsorptive measures. The stomach is divided and stitched using very small staples to produce a smaller stomach pouch. The rest of the stomach remains in the body. The intestine is rearranged so that food enters it directly, bypassing both the rest of the stomach and the initial length of intestine. These are reconnected to the remaining intestine lower down (sometimes referred to as the “Roux-en-Y” procedure).
- The operation strongly reduces the amount of food that can be eaten. It mildly reduces the amount of fat that can be absorbed from the food that is eaten by making patients intolerant to the high-fat and high-sugar foods that they should be avoiding anyway. It has a direct effect that reduces appetite. These effects particularly improve Type II Diabetes.
- This procedure is more appropriate for those patients at the higher end of the weight spectrum, with a BMI of >50. However this is not automatically the case as surgery is matched to the individual needs of the patient following close patient-surgeon discussions.
- Because this operation works by limiting absorption, you will be required to take vitamin and mineral supplements daily, and have blood tests every 6 months to ensure that you have not become deficient in any of them. You will also have an annual check-up to ensure that all is functioning as it should be.
- This procedure is irreversible.
LAPAROSCOPIC SLEEVE GASTRECTOMY
- The bulky part of the stomach is separated from the rest with a long staple line and removed, leaving a narrow tube of stomach connecting the gullet to the first part of the intestine.
- Normal digestive continuity is preserved, but the capacity for solid food is seriously limited.
- The part of the stomach that is removed is the part that produces the signalling chemical called ghrelin that is responsible for making people feel empty, so this operation usually also produces a reduction in appetite.
- Long-term weight loss is often significant, but if not, a further conversion procedure can be added later.
- This procedure can be regarded as a single-step procedure or as stage 1 of a more complicated operation in heavier patients.
- This procedure is irreversible.
BILOPANCREATIC DIVERSION BY DUODENAL SWITCH
- The intestine is divided twice and re-connected so that food only passes through a very short section of the duodenum (first section of the small intestine) before reaching the lower intestine.
- The bowel is reconnected so that bile and pancreatic juices are also diverted to enter the intestine lower down.
- As a result there is a fixed limit to absorbing carbohydrate (starch) and fat. This imposes a fixed calorie intake capacity and so fixes the final weight.
- It allows a relatively normal volume intake capacity later on and weight loss occurs however much is eaten.
- Although the risk at the time of surgery is higher than for the simpler operations, the risks of remaining overweight may be even greater.
- The procedure is irreversible.
