Bariatric Surgery (for weight loss)

Obesity is associated with a number of serious health conditions including:

• Musculo-skeletal problems
• Cardiovascular disease & stroke
• Some cancers
• Sleep apnoea
• Type 2 diabetes (one of the six National Health Priority areas)
• Hypertension (High blood pressure)

Australian Gov Dept of Health (2009)

See what the journey is for a bariatric patient.

Here are some common bariatric procedures we perform at Westmead Private Hospital.

Laparoscopic Sleeve Gastrectomy (Tube Gastrectomy)

A Sleeve Gastrectomy procedure involves removing the lateral 2/3rds of the stomach along the inner curve and leaving behind only a sleeve (much smaller than the natural stomach). This restricts the amount of food eaten before the sleeve distends, creating a feeling of fullness. This is the most rapidly growing bariatric procedure in Australia and offers long term results with minimal complications. The procedure is not reversible.

Laparoscopic Adjustable Gastric Banding

An adjustable gastric banding procedure, a hollow band made of special material is placed around the stomach near its upper end, creating a small pouch and a narrow passage into the larger remainder of the stomach. The band is then inflated with a salt solution. It can be tightened or loosened over time to change the size of the passage by increasing or decreasing the amount of salt solution.

Laparoscopic Gastric Bypass

In Gastric Bypass procedure, a small stomach pouch is created to restrict food intake. Next, a Y-shaped section of the small intestine is attached to the pouch to allow food to bypass the lower stomach, the duodenum (the first segment of the small intestine), and the first portion of the jejunum (the second segment of the small intestine). This bypass reduces the absorption of nutrients and thereby reduces the calorie intake.

Revision Surgery

For people who underwent obesity surgery in the 80s and 90s and who have not managed to achieve or maintain their weight-loss goals. It is also performed in patients who experienced previous complications from weight-loss surgery. Revision surgery converts one procedure to another procedure which may be more suitable for the patient. In 95 per cent of cases this can be done laparoscopically (keyhole surgery) or robotically. “Re-do” surgery is typically more complicated and involves more complications. For this reason cautious assessment and consultation is required for all patients considering this option.

• By 2025 more than 80 per cent of Australians will be overweight or obese according to the Monash Obesity and Diabetes Institute.
• As a result of the obesity epidemic, the number of Australians undergoing bariatric surgery has increased from 500 in 1988 to 17,000 per year in recent decades

Australian Gov Dept of Health (2009)

Speak to your doctor about surgery if:

• Your BMI is more than 30
• You have a BMI between 25 and 30 plus health problems linked to weight such as sleep apnoea, asthma, high blood pressure, high cholesterol and arthritis
• Your BMI or waist circumference is increasing in between GP visits
• You have a waist size of 80cm or more for women and 94cm or more for men
• You have diabetes related to obesity. In more than 80 per cent of cases this can be resolved or reduced post-surgery

• Your risk of premature death and obesity-related illness reduces dramatically.
• Obesity surgery reduces and often resolves symptoms of obesity-related sleep apnoea, arthritis and diabetes.
• Cancer risk reduces too, with obesity now a significant risk factor for many cancers.
• You will embark on a healthier lifestyle with regular follow-up, improved diet and exercise programs.
• You will lose significantly amounts of weight, commonly 60 to 70kg.
• You will feel better about your appearance and self-confidence.