Operations for Obesity
We can divide surgery for obesity into procedures that limit intake of calories, such as stomach stapling and gastric banding and procedures that work to disrupt metabolic pathways that lead to obesity such as sleeve gastrectomy and Roux En Y Gastric Bypass. The operations that limit intake are referred to as restrictive procedures and the other procedures are called metabolic procedures.
It is important to remember that surgery is an aid to weight loss and that ultimately it still needs to be combined with lifestyle changes. I am a firm believer that you must develop an addiction to exercise. Primitive man moved all the time and so should you. Our practice has a specialist exercise physiologist to help you start your exercise programme.
I could have called this section “my band doesn’t work anymore” as this is inevitably the patient we see who requests revision.
It is important to realize that revision is not always an option and some people may just need better adjustment of there band to succeed. Further surgery can be a risky business and needs a lot of thought before proceeding.
I have a lot of experience with revision and along the way learnt a lot about what works best for the individual. Sometimes I still arrange a second opinion if it is really tricky and often operate with a second surgeon.
I also have an interest in very complex Revisional surgery and am happy to see you and explain possible solutions to your problems. I have extensive experience in Reversal and revision of gastric stapling and can offer help if this is your problem.
Even if another surgeon has put your band in or done your previous surgery I am happy to offer an opinion.
Band to Sleeve
- Not always an option
- Tends to be associated with more reflux and food intolerance than conversion to RYGB
- Perhaps there is less weight loss but this is debatable.
- Not a good operation with any evidence of reflux disease and esophageal dilatation.
- Not a good idea for multiple band patients.
Band to RYGB
- I believe this is the gold standard and offers the best chance of success
- Great option if reflux is an issue
- Can work if there is persistent esophageal dilatation
- Mostly done through keyhole surgery