- General Surgery
Confused about the weight loss surgery choices that may be available to you? Mr Siva Gounder is an experienced Perth bariatric surgeon with experience in a number of effective weight loss procedures.
Our guide to the different types of weight loss surgery will help to demystify your options.
To find out if you qualify for bariatric surgery start by checking your BMI here, or book a consultation with Mr Gounder.
An adjustable gastric band (commonly called a lap band) containing an inflatable pouch is surgically placed around the top of the stomach. After lap band surgery the pouch is inflated or deflated according to the individual’s needs via a ‘port’ in the lower abdomen.
Gastric bands promote the sensation of feeling full by restricting the stomach size, therefore limiting food intake. They do not reduce calorie or nutrient absorption.
Gastric bands are adjustable to suit the individual’s weight loss targets. Most patients see around 40% excess weight loss from adjustable gastric band surgery.
Adjustable gastric bands are approved for people with a BMI over 35, or over 30 with special conditions such as obesity-related illness. Despite its popularity as a weight loss surgery there has been a decline in the instances of gastric band surgery in recent years due to the 15-30% occurrence of revisional bariatric surgery.
Gastric bypass procedures partition the stomach, attaching a portion of the small intestine to the new smaller stomach pouch. There are two types of gastric bypass surgery:
Gastric bypass surgery uses a combination of limited food intake and reduced nutrient absorption (malabsorption) for effective weight loss. Food bypasses most of the stomach and small intestine, meaning the body absorbs less calories. The bypassed sections are still connected however for digestive juices to enter the lower part of the intestinal tract.
Individuals with a BMI over 35 generally benefit from up to 90% excess weight loss. Comorbidities like diabetes and reflux are also brought under control and less than 5% of patients require revision surgeries.
Gastric bypasses are difficult to reverse although a qualified surgeon may do so for medical reasons.
Sleeve gastrectomy reduces the stomach to around 15% of its original size in an effective, though permanent and irreversible, procedure. The curved part of the stomach is removed during keyhole bariatric surgery creating a tube or “sleeve”.
The reduced stomach cannot hold as much food, and production of the appetite-inducing hormone ghrelin is also reduced. Without limiting caloric or nutritional absorption, gastric sleeve surgery greatly reduces appetite for long-term weight loss.
Because gastric sleeve procedures are irreversible this weight loss surgery is suitable for morbidly obese individuals with a BMI over 35. However, BMIs over 30 may be considered suitable if the individual is facing obesity-related health problems such as diabetes.
Single anastomosis duodeno-ileal switch (SADI-S) or Stomach Intestine Sparing Surgery (SIPS) combines gastric sleeve surgery with intestinal rerouting. Starting with a gastric sleeve procedure, the surgeon then bypasses a section of the intestine without relocating it as in duodenal switch weight loss surgery.
SIPS triggers malabsorption as a result of bypassing a section of the intestine. Combined with a lower appetite thanks to reducing the stomach by two-thirds, SIPS promotes effective long-term weight loss. With the right post-surgery lifestyle changes individuals can experience up to 80-90% excess weight loss.
SIPS can be an effective bariatric surgery option for individuals with a BMI over 35. This relatively new procedure is having positive effects for people battling obesity and related health problems through a combination of malabsorption and greatly reduced food intake.
Revisional bariatric surgery alters the type of weight loss method, normally from lap band to a gastric sleeve procedure or a sleeve gastrectomy to gastric bypass. Typically, patients will undergo revisional weight loss surgery due to weight gain or complications with the initial bariatric surgery.
The initial procedure like gastric banding is removed and non-reversible procedure such as gastric sleeve or SIPS is carried out. Long term outcomes are then dictated by the type of surgery and the individual’s lifestyle adjustments post-surgery.
Patients who have experienced weight gain or other complications after gastric banding surgery or reflux from sleeve gastrectomy may find alternative procedures more effective. Consultation and careful selection of surgery such as sleeve gastrectomy, gastric bypass or SADI-S/SIPS is required before undertaking revisional surgery.