There are a number of options available to you should you wish to have weightloss surgery. The type of surgery you have will depend on a number of factors such as your BMI, pre-existing medical conditions that may be life-threatening, and the results you are trying to achieve. The first step is to speak to your doctor and ask for a referral to a specialist surgeon. The surgeon will discuss the options available to you and make recommendations.
1. Gastric balloon insertion
The gastric balloon is probably the least invasive weight loss surgery you can experience. The procedure involves inserting a deflated balloon into the stomach via the mouth or nose (no surgery required). Once in place, it is filled with sterile saline through a catheter attached to the balloon. Once filled, the catheter is removed, and the balloon remains floating in your stomach.
The gastric balloon is temporary and can only be left in the stomach for a maximum of 6 months.
The gastric balloon should give you a “full” feeling, which helps you to eat less and to lose weight. It trains your stomach to expect less food and to shrink. It is hoped that while the balloon is in place, you will have adjusted your eating habits enough so you will be able to maintain a smaller volume of food intake once the balloon is removed.
2. Gastric band surgery
Gastric (lap) band surgery is performed via key hole surgery whilst under general anaesthetic. The surgeon will make a few small incisions in your abdomen, then fill the abdomen with carbon dioxide to inflate the area to give them room to operate. A laparoscopic camera is inserted into one of the holes so the surgeon can view the procedure on a monitor. The other key holes are for the surgeon’s operating tools. The surgeon places a saline-filled ring around the top of the stomach. This creates a new small stomach pouch above the band, with the remaining larger part of the stomach sitting below the band.
As you eat, the flow of food from the new upper stomach through to the lower stomach is restricted by the size of the ring. This makes you feel fuller sooner, and for longer periods, resulting in less food intake and weightloss.
Over time, the band/ring may need to be adjusted for comfort and effectiveness, and can be adjusted by your surgeon via a port under the skin. The surgeon will add or remove saline as required.
The gastric band is designed for long-term use, however it can be removed/reversed if needed.
3. Gastric sleeve surgery (Sleeve Gastrectomy)
Gastric sleeve surgery is generally performed via key hole surgery under general anaesthetic. Like gastric band surgery, a number of incisions are made in the abdomen, the area filled with carbon dioxide to create a space for the surgeon to work, and a camera and operating tools inserted through the incisions.
The surgeon will remove 2/3rds of the your stomach using a stapling device. The stapling tool staples and cuts the stomach into two pieces at the same time. This surgery basically leaves you with a stomach tube/sleeve instead of a stomach sack. It also removes the part of the stomach that produces the hormone that makes you feel hungry (ghrelin).
Once the stomach is separated, the surgeon will pump water into your abdomen to check that there aren’t any leaks in the stomach. The cut away part of the stomach is then removed via a tube inserted into one of the incisions.
This procedure is not reversible.
4. Gastric bypass surgery
This operation is performed laparoscopically under general anaesthetic, following the same procedure as lap band and gastric sleeve surgery above. This is the most difficult of the weightloss surgeries.
The surgeon will create a small thumb-sized pouch from the upper stomach using the stapling device mentioned above. The stomach may be partitioned or totally divided into two parts. The larger section of stomach separated away remains in the body. The small intestine is then attached to the base of the new small stomach, allowing food to bypass the stomach all together. This restricts the volume of food which can be eaten.
Gastric bypass surgery is not reversible.
Before deciding which path is right for you, please consult your doctor and seek a referral to a specialist surgeon. As with all medical procedures, please discuss the full procedure, risks and benefits with your preferred surgeon.