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Weight Loss Surgery

Sleeve gastrectomy, also known as a Gastric Sleeve, is a laparoscopic or keyhole surgical operation in which the overall size of the stomach is reduced in size by dividing it vertically from top to bottom using a line of staples. This leaves a much smaller stomach, roughly around 30% of its original size. The excess stomach is removed and therefore a sleeve gastrectomy is an irreversible operation. By reducing the size of the stomach, it reduces the amount of food that an individual can consume, leaving you feeling full after eating less. Rapid weight loss follows. After surgery it is important that you follow a sensible healthy diet and lifestyle including exercise. While surgery will help control the amount of food you consume the type of food you eat will remain your personal choice. A Sleeve Gastrectomy is performed Laparoscopically avoiding any large incisions enabling a faster recovery. Five small incisions are made into the abdomen allowing five surgical ports to be inserted, one for a camera and the others for surgical instruments. Rates of weight loss will vary and are most rapid in the first twelve to eighteen months after surgery, after two years weight loss will plateau. It is important that you follow a healthy diet and lifestyle and form better habits to prevent weight regain. After the first year you can expect to lose around 60-70% of your excess body weight. Gastric Sleeve Surgery Criteria You will have a Body Mass Index (BMI) of 35 or a BMI of 32.5 or over with associated health problems, such as type 2 diabetes, high blood pressure, sleep apnoea, high cholesterol to name a few. As an individual it is important that you are aware of the commitment you must make to diet and lifestyle changes including exercise. You don't have to become a marathon runner but a recommendation of a minimum of thirty minutes walking a day along with some resistance training each week should be a goal. To find out more about gastric sleeve surgery please click on the heading text sleeve gastrectomy above.

Also known as Roux-en-Y-bypass is one of the most popular weight loss procedures in Europe. It is particularly effective for individuals who have chronic long term health problems associated with a high body mass index (BMI) such as Type 2 diabetes, sleep apnoea and metabolic syndrome, a combination of type 2 diabetes, high blood pressure and high cholesterol. It is also highly effective for weight loss when there are no other medical problems. Gastric Bypass is always performed Laparoscopically using five small incisions to allow three twelve and two five-millimetre ports to be inserted into the abdomen. This avoids any major scaring and post operative recovery is faster than if the operation was done by traditional open surgery. Because gastric bypass alters the anatomy of the gut and digestive pathway it cannot be reversed and is permanent. The operation consists of forming a small pouch of stomach, from the existing stomach reducing it in size from approximately 1500ml to 30ml. This is done using surgical staples and then joining this directly to the small intestine. The remainder of the stomach and duodenum are bypassed by food that is eaten. This results in a stomach with a much smaller capacity meaning less food can be consumed at a meal. A Gastric Bypass normally results in three main effects. The small stomach limits what can be eaten at each meal leaving you feeling full and unable to eat anymore. The bypassed small intestine (duodenum) causes the appetite to be altered and has a beneficial effect on type 2 diabetes. By joining the stomach directly to part of the small intestine, it also reduces the intestine available for absorption of nutrients and it is extremely important to follow medical and dietetic advice long term. The amount of weight loss post-surgery tends to happen during the first eighteen months to two years after which time your weight will begin to plateau. The rate of weight loss varies but an initial loss of 1-2 kg per week is usual. At two years an individual can expect to have lost on average around 70% of excess weight. The weight loss will reduce the risk of health problems associated with a high body mass index such as metabolic syndrome (Type 2 diabetes, high blood pressure and high cholesterol combined are referred to as metabolic syndrome), sleep apnoea, osteoarthritis affecting joints, degenerative disease of the spine, polycystic ovarian syndrome, chronic pain syndrome and fibromyalgia. Gastric Bypass Surgery also has a significant improvement on Type 2 diabetes, high blood pressure and raised cholesterol as individual health issues. Once you have fully recovered from the surgery and are established in a healthy eating pattern involving exercise and increased physical activity you may expect to have increased energy levels and self-confidence. Gastric Bypass Surgery criteria You will have a Body Mass Index (BMI) of 35 or higher. You have a BMI of between 32.5 and 35 with a serious health condition that would be improved by Gastric Bypass Surgery such as sleep apnoea, type 2 diabetes, or metabolic syndrome. You must also be willing to commit and adopt to the permanent changes Gastric Bypass Surgery will make to your diet and lifestyle and agree to long term follow up. To find out more about gastric bypass surgery please click on the heading text gastric bypass above.

For those who have had previous weight loss operations which are no longer giving the desired weight loss outcomes, gastric revision surgery can be an option. Gastric revision weight loss surgery is performed to improve the outcome of previous weight loss surgery or to overcome complications or side effects of a previous weight loss operation. Revision weight loss surgery can be divided into two main groups. Gastric revision surgery where the original or primary weight loss operation has not led to the expected weight loss or that weight lost after surgery has been re-gained. Gastric revision surgery where the original or primary weight loss operation has caused significant unwanted side effects or an individual has developed complications. Choosing the correct gastric revision operation for you The gastric revision operation which is best suited to your situation can only be decided with a detailed discussion of your previous surgery, current symptoms and weight loss or weight regain experience. It is then a carefully individualised decision made by you in consultation with your weight loss surgeon. It will depend on which primary surgery you've had or indeed if you've had more than one previous surgery and what those surgeries were. Gastric bands can be easily converted to gastric bypass or sleeve gastrectomy or one-anastomosis gastric bypass (mini gastric bypass). These operations all have slightly different characteristics in terms of further weight reduction, erdaication of reflux and subsequent weight loss. To find out more about revision weight loss surgery and the different types please click on the header link above revision weight loss surgery

The Laparoscopic Gastric band is an adjustable silicon band placed around the top of the stomach just below the food pipe (oesophagus). The band forms a small pouch at the top of the stomach about the size of a large golf ball. By creating the pouch, the amount of food that can be taken in at any one time is restricted. The band is connected to narrow tubing which exits just under the skin on the left side of the abdomen and is connected to a filling port which allows saline/water to be injected into the band either increasing or decreasing the band restriction dependant on the degree of restriction the individual requires to ensure weight loss. The main advantages of a Gastric Band are that it does not involve a change in the anatomy of the stomach and intestine and is therefore reversible. The Surgery is carried out laparoscopically under general anaesthetic normally as a day case and takes about an hour. The amount of weight that can be lost is most rapid during the first year after insertion and maximum weight loss will happen after eighteen months to two years, after which weight loss will plateau. Patients can expect to lose approximately 40% of their initial body weight. This will also depend on the life changes individuals make to their diet and lifestyle and it is imperative that you work with the band. The Gastric band can be adjusted to an individual optimum restriction in order for them to successfully lose weight. The long-term success of a Gastric Band depends on the individuals and is not a quick fix to weight loss, it still requires consideration of intake, following a healthy diet and commitment to follow a healthier lifestyle and increasing physical activity. Failure to do so will result in disappointing weight loss results. Around 10% of patients with a gastric band fail to lose weight and go on to have further gastric revision procedures such as a gastric sleeve or a gastric bypass.

Gastric Balloon

A Gastric Balloon is useful for individuals who are over weight but but have a lower BMI, usually under 35. Balloons work by reducing the space available within the stomach with the aim of reducing food intake and calories. The balloon is inserted endoscopically and then 550mls of fluid is inserted into the balloon. There is no general anaesthetic. The balloon can stay in place for up to a year before being removed. Youwill be given strong anti enetics prior to the balloon insertion as individuals can feel quite nauseous immedicately afterwards. Patients normally go home on the day of the procedure and fluids and foods are slowly re-introduced.

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