Surgical Procedures
In addition to the Gastric Balloon Procedure, our clinic also offers the surgical procedures the Laparoscopic Gastric Band and Laparoscopic Tube Gastrectomy.
Laparoscopic Adjustable Gastric Banding
The Laparoscopic Gastric Band is the most common surgical weight procedure performed in Australia.
The device is a inflatable silicone ring that is placed and secured around the upper part of the stomach by keyhole surgery. This ring creates a smaller 'pouch' at the top of the stomach, which limits the amount of food that is consumed. This also slows the foods movement through the stomach, reducing and suppressing the appetite.
The inflatable silicone ring has a small port attached, that is placed in the abdomen. Fluid can then be inserted or removed to control the amount of food that can be consumed. These adjustments, 'band-fills' are performed regularly at our clinic, taking approximately 10 minutes.
Although the Gastric Band can be removed, it is designed to be placed permanently.
Advantages:
- Keyhole approach .. Less scarring or wound problems Earlier return to work (1-2 weeks)
- Adjustable : by filling port the outlet size can be reduced
- Reversible: By removing fluid or the band.
- No malabsorbtion
- Lower risk
Disadvantages
- Easy to cheat .. if chocolates or sweets taken.
- Mechanical problems:
- prolapse
- pouch dilatation
- food bolus obstruction
- slippage of the stomach through the band erosion
- infection of the band or port leak
- Revision rate ? 5 -10%
- An entree portion forever.
Optimal pouch capacity 30 mls
Usual weight loss With Lap Band 50-60% of excess weight lost in 2 yrs
Tube Gastrectomy(Sleeve Gastrectomy)
This is a relatively new approach, where the outer part of the stomach is removed, turning the upper part into a tube like section. As only a small portion is left at the base of the stomach, eating capacity and food absorption is limited.
This procedure is not reversible and is sometimes used as the first stage prior to a Laparoscopic Gastric Bypass.
Sometimes it is offered to patients as part of a two stage Bypass operation particularly if they are super obese ( BMI>60) because it allows good weight loss until the patient gets down to a safe weight and the more radical bypass can then be offered laparoscopically when they are at a safer weight.
The residual stomach capacity is about 200mls so a generous entree should be possible.
The weight loss seems to be a little better and more rapid than the lap band (60-70% EWL) over two years but it is not adjustable.
It might also be a good option if patients have a problem with their lap band requiring revision, have already lost a lot of weight and don't want a full bypass.
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