Do you know your options for weight loss surgery?
Are you considering your options for weight loss surgery? Surgery may be an option if you’ve found traditional weight loss methods have been unsuccessful and unsustainable.
Surgical weight loss is referred to as bariatric surgery. This area of surgery is growing rapidly around the world, with over 25,000 surgeries performed in Australia each year alone. Bariatric surgery can help you lose weight in a sustainable way in combination with dietary, lifestyle and behaviour changes.
In addition to weight loss, bariatric surgery induces a significant metabolic response. Patients with obesity-related co-morbidities can see improvements, and in some cases remission, of conditions such as:
- Obstructive sleep apnoea
- Type 2 diabetes mellitus
Your journey into bariatric surgery can be overwhelming initially with many different surgical options available, therefore choosing the right one for you can be difficult. This decision is best made with your surgeon as they will assess your personal history, treatment goals, and will recommend a procedure that’s appropriate for your individual circumstances.
What options do you have when it comes to bariatric surgery?
Dr Scott Whiting is a general surgeon with sub-specialty training in Upper GI and Bariatric Surgery. This means that he has all your options for weight loss surgery covered.
Intra Gastric Balloon
Intra gastric balloon is a non-operative, fully reversible device that involves inserting a saline-filled silicon balloon into the stomach either by simply swallowing or placed via gastroscopy. This type of procedure essentially works by reducing the capacity of the stomach. An intra gastric balloon is often used by people preparing for other forms of weight loss surgery by helping them lose initial weight, lower BMI patients and those preparing for an event. Generally, an intra gastric balloon is only inserted for 3-9 nine months.
The sleeve gastrectomy is the most performed bariatric surgery procedure in Australia. The surgery is performed laparoscopically (keyhole) and involves removing approximately 70% of your stomach, leaving behind a small, tubular stomach that can hold between 150-200mls of volume. The sleeve gastrectomy induces weight loss by restricting the amount of food and fluids you can consume and by altering the production of circulating gut hormones that control hunger and satiety.
Roux-en-Y Gastric bypass
Roux-en-Y Gastric bypass, otherwise known as RY gastric bypass, is considered the gold standard of bariatric surgery. The first step involves the surgeon forming a small pouch from your stomach which is then disconnected from the remaining stomach. Following this, the bypass component is performed whereby a section of the small bowel is disconnected and joined (anastomosis) to the pouch. After a measured length, a second anastomosis is made to reconnect small bowel back onto small bowel along the small intestine. The RY gastric bypass restricts the amount of food that can be consumed and absorbed by the small bowel while also inducing a metabolic (hormonal) response and hence promoting weight loss.
One Anastomosis Gastric Bypass (OAGB)
The one anastomosis gastric bypass (OAGB) or mini gastric bypass is a simplified version of the traditional RY gastric bypass. This surgery has a lower operating time. The OAGB involves laparoscopically dividing the stomach and stapling it into a smaller, tube shape. Then the lower part of the small intestine is attached to the stomach, meaning around 2 metres of the intestine is bypassed. This results in most of the stomach and intestines not receiving food. While very effective, bile reflux can result in subsequent conversion to a RY Gastric Bypass
This type of weight loss surgery provides the most weight loss of all the procedures. It involves a sleeve gastrectomy and an intestinal bypass. First, the surgeon will remove approximately 60 to 70 per cent of the patient’s stomach. Then the first part of the small intestine, the duodenum is divided and is attached to a lower section of the small intestine. This bypasses more than two-thirds of the small intestine, much more than in a regular gastric bypass. A second anastomosis is made to reconnect the small bowel containing bile back onto small bowel. While very effective lifelong micronutrient supplementation is required.
Single Anastomosis Duodenal Interposition (SADI)
A SADI surgery is a variant of the duodenal switch and new option for weight loss surgery. Initially, the stomach is reduced in size like in a sleeve gastrectomy. Then, unlike the duodenal switch, only one intestinal bypass is made. This means the surgery takes less time and there is less risk of complications.