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We need to consider here what your realistic options are when we choose the type of weight loss surgery together (there are many others but most are now historic and only safer effective options remain).All are laparoscopic (kethole) or robotic. It is very rare to need to do open surgery and in fact in over 2000 surgeries I have not needed to convert to open surgery.Sleeve Gastrectomy – I like to consider thesleeve gastrectomyas our starting point. It is the simplest to understand and most common to perform unless there is a good reason for you as an individual to vary this. It is classically referred to as a type of ‘restrictive procedure‘. I like to explain it that normally when you swallow a meal the stomach distends from being collapsed to like a blown up balloon – for a Laparoscopic sleeve gastrectomy I remove the majority of the stomach organ and turn it into a tube stomach.Everything else essentially stays the same and food still travels the same way through you. If you can imagine blowing up a balloon you can keep blowing this up and up until it becomes huge and can burst. If you blow up one of those cylindrical balloon, (like those balloonsused to twist into shapes) it is much harder to do (the analogy to the sleeve being it is hard to eat a lot and distend this tube stomach). The hunger hormone level of ghrelin also drops after removal of most of the stomach organ.
Gastric bypass – It is the next most common and choice we may choose. I staple the stomach and turn it into a tube (like the sleeve gastrectomy but even smaller) but I also join this small stomach to a different piece of your bowel to food takes a shortcut through you. It classically was considered a ‘restrictive procedure’ and a ‘malabsorptive‘ procedure, but malabsorption is not a strong effect of it and I would consider it more a ‘metabolic‘ effect (leading to changes in hunger hormones and fullness feelings). We may choose this if you have a large amount of excess weight to lose, diabetes (often the single-loop gastric bypass or omega loop gastric bypass type) or reflux (roux-en-y gastric bypass type).Laparoscopic Gastric Band (LAGB) – The final type still performed is thelaparoscopic gastric band (LAGB)which is the classic ‘restrictive’ type of operation. Nothing is stapled or removed from you, rather a plastic inflatable ring is put on the top part of your stomach. This make food hold up there before it passess through (or if you eat too quickly or do not chew well it can be regurgitated). Aside from it ‘restrictive’ effect, it compresses on the vagus nerve as well (which can send a signal to your brain that your stomach is full when it isn’t)I will explain this is more detail during your consultation and answer any questions you may have.
Kind Regards,Dr Phil Le PageUpper GIT, Bariatric and Laparoscopic SurgeonPh 9126 8963Fax 9137 2285