Weight Loss Surgery
With almost 60% of Australia’s adult population suffering from some type of weight problem, weight loss surgery may serve as their only hope of maintaining and controlling their weight over long periods of time. Obesity related diseases cause the death of thousands of Australians every year while hundreds of thousands more are left suffering serious medical, physical and social disabilities. As such, bariatric surgery performed by our expert weight loss surgeon here in Sydney can be especially useful for those particular individuals.
Severe obesity sufferers are at risk of numerous additional obesity-related health conditions. Most commonly, these include:
- Type 2 diabetes
- coronary heart disease
- high blood pressure
- sleep apnoea
- impaired fertility
- gastro-oesophageal reflux
- fatty liver disease
Obese patients are also at a higher risk of developing colonic, uterine and breast cancers.
However, treatment options are available: our weight loss surgeon specialises in
- Laparoscopic Gastric Bypass
- Laparoscopic Adjustable Gastric Banding (LAGB)
- Laparoscopic Sleeve Gastrectomy
Is weight loss surgery the right solution?
Body Mass Index (BMI) is a simple way to measure excess body fat based on height and weight. BMI is usually a good indicator to determine if you are significantly overweight. Someone is likely to be morbidly obese if he is:
- More than 45 kg over his ideal body weight, or
- Has a BMI of over 40, or
- Has a BMI of over 35 with any associated co-morbidities such as high blood pressure or diabetes
- Is unable to achieve a healthy body weight for a sustained period of time, even through medically supervised dieting.
Lifestyle modifications that include regular exercising and drastic change of eating habits are the first steps to weight loss and health improvement. Unfortunately, the more obese a person is and the more likely he/she will regain weight in a relatively short timeframe. This weight cycling or so-called “yo-yo” phenomenon may on some occasions lead to depression and low self-esteem.
The development of minimally invasive (keyhole surgery) approach to bariatric surgery has revolutionised the management of obesity worldwide, as it is the only recognised modality of treatment that can offer sustained long-term weight loss.
The most efficient, but also most challenging procedure is the Gastric Bypass that circumvents part of the stomach and small bowel thus creating intestinal malabsorption. Its main disadvantages are higher operative risks (as compared to sleeve gastrectomy or gastric banding), the necessity to take ongoing nutritional supplements and vitamins post surgery, and sometimes experiencing daily foul-smelling flatulence and/or loose bowel movements.
Over the last 5 years, Sleeve Gastrectomy has rapidly gained in popularity worldwide mainly due its relative safety and the fact that it is technically simpler than Gastric Bypass. This restrictive procedure consists of creating a narrow gastric “tube” after removing around 80% of the stomach. Patients will experience rapid weight loss within the first 2-years. Unfortunately, not enough long-term data are currently available to confirm long-term efficacy and it seems that after 5-years follow up a certain percentage of patients will regain weight due to gastric tube dilatation.
LAGB is by far the least traumatic and safest option of all. It is also adjustable and totally reversible. This purely restrictive procedure consists of placing an inflatable low-pressure soft band around the upper most part of the stomach, creating a very small pouch and a narrow passage that limits the amount of food intake. Inflating or deflating the gastric band with sterile saline solution will control the level of restriction (overeating prevention), but also allow the patient to feel full with smaller meals (early satiation). Compared to Gastric Bypass and Sleeve Gastrectomy, weight loss occurs at a lower pace following LAGB and is not as radical. But it is probably more physiological and less stressful on the body.
Laparoscopic Adjustable Gastric Banding (LAGB)
This procedure has a long and proven track record for safety in Australia and overseas. It is the safest surgical option available for those eligible for bariatric surgery. A real advantage of LAGB is that no part of the stomach is either, stapled, cut or removed, and as a result food absorption remains exactly the same as it was before surgery. Furthermore, the gastric band can be easily and safely removed if needed, thus allowing the stomach to go back to its normal shape and physiological function.
Prof. Berney, Safe Surgery’s weight loss surgeon believes that it should remain the first line of treatment and gastric bypass being reserved for those suffering from extreme obesity (BMI>50), or as a revisional surgery after failed LAGB. Before deciding on LAGB surgery it is very important to fully understand the life-long commitment and responsibility to lifestyle modifications, as inability to do so is more likely to lead to long-term failure of LAGB surgery and weight regain.
How LAGB is performed?
- Prior to surgery a strict low-calorie diet is introduced for a total of two weeks.
- The procedure is performed under general anaesthesia and the patient stays in hospital overnight.
- The treatment of choice is laparoscopic (keyhole) as it offers the best post-operative outcome with minimal discomfort and excellent cosmetic result.
- Preference is to perform the procedure via 4 small skin cuts.
- The aim of this procedure is to safely place the gastric band (Midband) around the upper most part of the stomach and to fix the adjustable titanium reservoir (port) into a small pocket created under the skin, through one of the previously made incision.
- This adjustable port is attached to the gastric band via a narrow silicone tube.
- At the end of the procedure no drain is necessary and the patient can start limited clear fluids after 6 hours post-operative.
- Once discharged home, the small waterproof dressings covering the wounds can be safely removed 5 days later and there is no need to remove the stiches as they spontaneously dissolve within few weeks.
- The patient generally remains on a clear fluids diet until first follow-up appointment 2 weeks after surgery.