Surgery Options

Gastric Balloon (Temporary Weight Loss Procedure)

Sometimes the surgeon may suggest that you have a gastric balloon inserted as a temporary measure. This is often to help you lose weight prior to surgery to reduce your surgical risks or if the surgeons can’t operate due to shape of your abdomen. It will also provide an idea of the expected restrictions with other surgery.

This is a silicone balloon, which is fitted in the stomach via the mouth (endoscopically) as a day case. This is usually under light general anaesthetic or sedation.

As with the other bariatric procedures, you will be expected to follow a special post-operative diet whilst your body adapts to the balloon.

It is only a temporary measure and has a lifespan of 6 months. After 6 months it will be removed, with the aim that a more permanent operation will be possible two months following removal of gastric balloon.

 

Benefits

  • You can expect to lose 20 – 30% of your excess bodyweight in 6 months provided you adhere to a healthy lifestyle and dietary guidelines
  • Losing weight should reduce your medical and surgical risks, thereby making further surgery easier and safer
  • It gives you an impression of the lifestyle changes expected for all other bariatric surgery without undergoing the risks involved with these
  • You are expected to return to ‘normal’ textures and healthy eating within 2 weeks of insertion

 

Drawbacks

  • The weight and presence of the balloon can cause the stomach to become irritated causing nausea and vomiting, which can last for 7-10 days depending on how strictly you follow instructions
  • Usually it takes a few days for nausea and vomiting to reduce
  • It is only a temporary solution
  • You still need to make healthy eating and lifestyle choices
  • The balloon can rupture, but it is filled with a blue dye. If this happens your urine will turn a blue / green colour. If this occurs, please contact us urgently.
  • Oesophagus, stomach or duodenum rupture is a rare (1;10,000) complication caused by the endoscopy or balloon itself. It this occurs it may require an emergency operation.

 

Gastric Bypass

During this surgery, the surgeon creates a pouch similar in size to an egg therefore restricting the volume that can be eaten.

However, this pouch is detached from the main part of the stomach. The lower part of the small bowel is then cut, moved up to and attached to the pouch.

The bowel that has been bypassed is then attached to the small bowel, thereby allowing the digestive juices from the pancreas to be mixed with the food coming from the small pouch.

 

The bypass works in two ways:

It restricts the amount that can be eaten and the by-passing of some of the small bowel means that there is a reduction in the amount of calories, protein, vitamins and minerals absorbed.

To try to prevent vitamin and mineral deficiencies, you will be required to take a daily vitamin and mineral supplement for life.

You will be expected to have regular blood tests to ensure nutritional adequacy, which may require further supplements such as iron, calcium, Vitamin D, Zinc etc.

 

Benefits

  • You can expect to lose 60 – 70% of your excess body weight after 2 years
  • Average initial weight loss is quick
  • Evidence suggests that gut hormones can be altered which affects appetite
  • Has a high-resolution rate of diabetes (75%)

 

Drawbacks

  • Has a higher mortality rate (1;250 chance) and more serious complications than other operations
  • It will be necessary to take multivitamin and minerals for life. You may need to take extra supplements based on your dietary intake and blood tests
  • ‘Dumping syndrome’ can occur after eating foods with too much sugar or fat, with symptoms including; nausea, sweating, faintness, vomiting and potentially diarrhoea
  • It is effectively irreversible. For example, if it were deemed an medical emergency, it could be reversed
  • Medication needs to be reviewed to ensure adequate absorption
  • You may not lose or maintain weight loss if you do not stick to healthy eating and lifestyle guidelines
  • It is recommended you avoid alcohol for 1 year after surgery. It may be limited after this, as the side effects of alcohol can occur more rapidly after the bypass

 

Sleeve Gastrectomy

Originally, this surgery was suggested to patients as a ‘halfway’ house, in order to reduce weight and surgical risks.

This was then converted to a full bypass once the patient had lost a significant amount of weight.

Due to its success, this surgery is now available as a ‘stand alone’ treatment or as an operation prior to a full bypass.

During this surgery, the surgeon removes ¾ of your stomach, leaving a small narrow tube.

It works by reducing your stomach size and therefore restricting the amount of food that can be eaten.

It can also affect the hormones which regulate your appetite, making you feel less hungry.

 

Benefits

  • You can expect to lose 50 – 60% of your excess body weight after 2 years
  • It can be converted to a full bypass if needed
  • Evidence suggests that gut hormones can be altered which affects appetite
  • Compared to the bypass, less likely to suffer nutritional deficiencies unless the diet is unbalanced. However, with such a relatively new procedure, please note this may change as new evidence is collected

 

Drawbacks

  • It is a relatively new procedure as a ‘stand alone’ treatment, so long term data is not yet available
  • It is non-reversible as 75% of the stomach is removed from your body
  • You may not lose or maintain weight loss if you do not stick to healthy eating and lifestyle guidelines
  • Its effects on appetite may only be temporary
  • It is recommended you avoid alcohol for the 1st year after surgery. Alcohol intake may still be limited after this

 

Please note: Lifelong vitamin and mineral supplements are expected with both the Gastric Bypass and the Sleeve Gastrectomy and you will need regular bloods tests to monitor your nutritional status.