Weight Loss and Bariatric Surgery
Laparoscopic gastric bypass also known as a Roux-en-y-bypass is one of the most popular weight loss operation in Europe. It is particularly effective in patients with type 2 diabetes and usually causes a dramatic improvement in diabetes as well as weight loss. The operation consists of forming a small (20cc) stomach or pouch using surgical staples and joining this directly to the small intestine. The remainder of the stomach and duodenum are "bypassed" by the amount of food consumed.
The operation usually results in three main effects; the small stomach limits what can be eaten at each meal, leaving you feeling full, the bypassed duodenum (small intestine) causes appetite to be altered and has a beneficial effect on type 2 diabetes. By joining the stomach directly to the small intestine, it also reduces the bowel available for absopbtion of nutrients and it is therefore extremely important to follow medical and dietetic advice long term.
The overall resulting effect is significant weight loss in most people, and improvement in type 2 diabetes where it is present.
Sleeve gastrectomy is a laparoscopic operation in which the overall size of the stomach is reduced using staples, so that following surgery, the amount of food which can be consumed at each meal is reduced. This encourages a healthier diet which helps weight loss to occur.
Revision Weight Loss Surgery
For those who have had weight loss operations in the past which are no-longer giving the desired effect or weight loss, revision surgery may be an option. This is done laparoscopically and can be particularly useful where a gastric band has slipped or is no longer maintaining a healthy weight. Gastric band removal, followed by conversion to either sleeve gastrectomy or gastric bypass can be undertaken.
Older weight loss operations such as VBG (Vertical banded gastroplasty), may be converted to a sleeve gastrectomy or gastric bypass and a sleeve gastrectomy itself can be converted to gastric bypass or duodenal switch.
Revision weight loss surgery is more complex than primary weight loss surgery, with operations often taking longer to perform. In addition, the results of revision surgery are not as predictable as primary surgery.
Performed laparoscopically it involves placing a silicon band around the upper part of the stomach. The band has a fluid filled circular balloon inside it which allows the band tightness around the stomach to be adjusted as neccesary.
This limits the amount of food which can be consumed, helping you to maintain a healthier diet than before surgery. It is completely reversible, should removal be required, it leaves the stomach as it was before the surgery. Most patients go home on the same day or day after the surgery and the band is tightened for the first time after six weeks to increase the weight loss effect
Particularly for those with a BMI under 35, who are not eligable to undergo weight loss surgery, I undertake two types of intra-gastric balloons; the Orbera balloon and the Obalon balloon. Both of these work by reducing the space available within the stomach, with the aim of reducing meal sizes.
The fluid-filled Orbera balloon is inserted with an endoscopy and may then remain in place for 6 months, before being removed in the same way. Up to 3 Nitrogen-filled Obalon balloons are swallowed in capsule form and inflated using an xray and may then remain in the stomach for up to three months, at which time they are removed with an endoscopy.
Weightloss surgery is carried out at either The Cobham Clinic, the private wing at The Luton & Dunstable Hospital or Spire Bushey, near Watford.
Weight Loss surgery
All procedures are carried out at either The Cobham Clinic at The Luton and Dunstable Hospital, Luton, Bedfordshire or Spire Bushey Hospital, Watford, Hertfordshire.
At both hospitals as a patient you would be given an initial assessment and supported by a multidisciplinary team from specialist nurses, dieticians and anaesthetist.
There is lots of information in the link 'further reading' at the bottom of this page. It is vitally important that as an individual you understand the risks and benefits of the surgery, join a support network and listen to other patient experiences.