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The Procedure

Defining Weight Loss Surgery

Weight loss surgery is now also known as bariatric surgery

Weight loss surgery is now also known as bariatric surgery. The word bariatric comes from Greek origin and is broken down as 'baros' – meaning weight 'iatrikos' – meaning the art of healing.

Weight loss surgery is a treatment option for people living with morbid obesity, that is, those who have a body mass index (BMI) = 40 or who have a BMI of 35 – 40 and who also have associated co-morbidities. It is especially relevant for those who have not had success with other weight loss programs, exercise and/or medication. If a patient presents with a BMI between 30 – 35 with significant medical issues, following consultation with all team members and the surgeon, may be considered eligible for surgery.

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Restrictive Weight Loss Surgery

During these procedures, the surgeon creates a small stomach pouch, which limits the amount of food patients can eat at any one time. The smaller pouch fills quickly and this helps the patient feel satisfied with a smaller amount of food. The two types of restrictive procedures are:

  • Laparoscopic Adjustable Gastric Banding
  • Laparoscopic Sleeve Gastrectomy
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Laparoscopic Adjustable Gastric Banding

The gastric banding procedure is performed by key-hole surgery (laparoscopic) which is minimally invasive and involves 5 small incisions in the abdomen. The silicone band is placed around the upper part of the stomach to create a small pouch above the band.

This allows only a small amount of food to be held by the stomach at any one time, and slows down the passage of food from the small pouch to the rest of the digestive tract which enables you to feel full for longer and helps reduce the urge to have large helpings and to eat between meals. Food is no longer the focus it once was. You are in control of your eating, rather than eating controlling you.

The inner surface of the band contains a small balloon which is connected by tubing to a reservoir which is placed under the skin in the abdomen during surgery. This makes the band adjustable. Adjustments are usually performed in the rooms by a medical practitioner. They use a needle to inject saline into the band through the port (reservoir). When saline is added, this increases the amount of restriction provided by the band.

The gastric band is intended for long term use. There is no evidence at this stage, that the band will need to be replaced except in the event of a complication. Gastric banding is a reversible procedure as the anatomy of the stomach is not permanently changed. However it is important to note that reversal surgery is not simple and weight gain has been observed in patients who have had their bands removed.

 

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Laparoscopic Sleeve Gastrectomy

This restrictive procedure is performed by keyhole (laparoscopic) surgery.

This restrictive procedure is performed by keyhole (laparoscopic) surgery. The surgeon creates a small, sleeve shaped stomach (approximately 200 mls capacity or the size of a banana). This procedure is not reversible and is also not adjustable.

The sleeve gastrectomy procedure would be considered the procedure of choice following failed gastric banding. Also, when a patient lives in a remote location and is unable to have band adjustments a sleeve gastrectomy may be considered more suitable surgery.