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Compare Obesity Surgery Types

Written by Ali Zarrouk on .

Name of Operation  Gastric Banding   Sleeve Gastrectomy Gastric Bypass  
   gastric-banding-clear  sleeve-gastrectomy  gastric-bypass
How is it done? keyhole surgery keyhole surgery keyhole surgery
Modality of Weight Loss Restrictive only Restrictive and Metabolic Restrictive and Metabolic
How does it work? An inflatable band is placed around the top part of the stomach. This limits the amount of food that can be taken by creating a sensation of fullness and degree of discomfort. Tightness of the band is adjusted by injecting and withdrawing fluid from an access port under the skin. Frequent adjustments are needed at regular intervarls. The size of the stomach is reduce to a narrow tube by removing the outer 75% of the stomach. This limits the amount of food that can be ingested without creating a point of obstruction thus achieving a normal sensation of feeling full. Also it lowers ghrelin level (a hungar hormone) thus reducing hungar. The stomach size is reduced to a small pouch and then connected to the small intestine. Another join between the small intestine loops is needed further down. Food bypasses the stomach, duodenum and the first part of the small intestine. Small amount of food can be taken and the ingested food creates a strong hormonal environment that suppresses appetite.
Operating Time  1 hour 2 hours 2-3 hours


Advantages

Removal (though leaves a scar on stomach)
No cutting or stapeling needed
Low risk of early complications
Easy to do

Reduces hungar
Achieves normal sensation of being full rather than obstructed
No or minimal food intolerance
No need for adjustments
No foreign body
Improved quality of life
Improves or cure diabetes
Less follow-up is needed
"Set and forget" type of operation
Easy to live with

Reduces hungar
Best long term data
Rapid intial weight loss
Improves or cure diabetes even before weight loss starts
Fixes acid reflux as well

Disadvantages & Complications

Food interlance
Teaches patients to have the wrong food
Band erosion
Band slippage
Makes further weightloss operations difficult
Tube complications
Frequent reflux

 

Staple line leak
Narrowing
Acid Reflux (rare)

Staple line leak
Narrowing
Ulcers
Dumping syndrome
Serious vitamin defeciency
Risk of internal hernias and bowel twisting
Need close long term follow-up
Risk of developing alcohol or substance abuse

Vomiting Very frequent very rare very rare
Long term need for re-opeartion

About 1 in 5 to 1 in 3 patients will need reoperation

very rare about 5-10% over ten years
Average Hospital Stay 1 Night 2-3 night 3-4 night
Quality of Life

Poor
Many patients can not eat healthy food

Best amonng all weight loss operations

Good
Dumping syndrome can be an issue


Average weight loss (Results may vary from person to person)

30-40% of excess weight.  60-70% of excess weight 60-80% of excess weight

My Recomendation

Avoid this operation!

I recommend this operation for most patients Consider this operation if can not have the sleeve operation or if you have poorly controlled diabetes.

 Reference:
1. Diamantis  T, Apostolou  KG, Alexandrou  A, Griniatsos  J, Felekouras  E, Tsigris  C.  Review of long-term weight loss results after laparoscopic sleeve gastrectomy.  Surg Obes Relat Dis. 2014;10(1):177-183. 

 

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Campbelltown Priv Hospital
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Campbelltown 2560 NSW

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