Alternatives to Gastric Band Surgery

08 May 2023
gastric band surgery

When you’re considering weight loss surgery, the most common procedure that comes to mind is lap-band, also known as gastric band surgery.

This procedure involves placing an adjustable silicon band around the upper part of the stomach, forming a small pouch. This restricts the volume of food and produces early satiety.

A few years ago, this was the most popular surgical options and the most common bariatric operation in Australia.

However, with emerging technology and procedure advancements, it is becoming outdated in preference for other surgeries and has gradually declined in use, primarily due to the higher risk of long-term revision and complications.

So, when you’re considering surgery, here are a few options to educate your journey.


Alternative Surgical Procedures

Gastric Bypass

A process to partition the stomach into a smaller size pouch and re-route the small bowel.  In the banded gastric bypass, a fixed silastic ring is placed around the gastric pouch.

Advantages include long-term use, up to 90% excess weight loss, and diabetes control, as well as significant cancer and coronary risk reduction and reflux control.

Like many bariatric surgeries, patients will require close monitoring and nutritional supplementation to avoid deficiencies.


Gastric Sleeve

Known as laparoscopic sleeve gastrectomy, part of the stomach is stapled to form a narrow tube (sleeve) and 80 to 90% of the stomach removed.

This surgery is irreversible and permanently effects the entire gastric system and how the body processes food, as well as the volume of the stomach to approximately 15% of its original size.

The benefits of which are less ongoing maintenance and dietary restrictions along with up to 70% weight loss and diabetes control. Supplementing vitamins and minerals are required post-surgery.



Single anastomosis duodeno-ileal switch (SADI-S) or Stomach Intestine Sparing Surgery (SIPS) involves a sleeve gastrectomy being performed along with a reroute of the small intestine, restricting stomach volume and creating malabsorption to reduce calorie absorption.

This procedure results in 95% control for diabetes and other obesity-related illnesses, up to 90% weight loss, and a low risk of complications.

Post-surgery, lifelong supplementation of protein, minerals, and vitamins is required, along with long-term monitoring.


SASI-S surgery

Single Anastomosis Stomach-Ileal Bypass (or SASI-S Bypass) combines a sleeve gastrectomy with an intestinal bypass to join the bottom part of the stomach to the small intestine.

This results in half of all food consumed bypassing the first part of the small intestine, reducing the absorption of fats and sugars. Slow digestion stimulates the release of intestinal hormones, signalling satiation.

This can offer greater weight loss benefits as well as less risk of nutritional deficiencies compared to the sleeve surgery alone.

Although, it may not offer the same level of weight loss and is a newer procedure option without longitudinal outcome studies.



While Gastric Band surgery may still be the most effective and safest option for certain patients, your trusted professional surgeon will be able to help you assess all available options for your situation and health outcomes.

Each individual’s overall health picture, including mental health, will be considered to assess safety and suitability for surgery.

One of the primary eligibility considerations is Body Mass Index (BMI). Both national and international standards require patients to have a BMI of more than 30 for surgery to be considered as a viable option.

Other considerations include a history of tried unsuccessful attempts at weight loss that only offer short-term gains at best, current or assistance to become a non-smoker, or reliance on other drugs or alcohol.


For a comprehensive and personalised information, please book a bulk-billed consultation with Perth’s most trusted bariatric surgeon, Dr Siva Gounder. He and his dedicated, holistic team support people looking for long-term weight loss and health improvement.

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