Weight Loss Surgery
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Overweight and obesity effect more than 700 million people worldwide and in Australia effects more than one third of adults. Obesity is associated with a higher incidence of serious health conditions such as heart disease, liver disease and diabetes mellitus, amongst others. For patients unable to lose weight through other means, weight loss surgery has been shown to improve quality of life, exercise tolerance and associated medical illness.
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There are many different types of weight loss surgery. Weight loss surgery can be divided into those procedures that restrict how much food can be consumed during a single sitting, those that cause malabsorption of food or those that result in both restriction and malabsorption. In Australia, the most commonly performed procedures are sleeve gastrectomy (SG) and gastric bypass (GBy).
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Sleeve gastrectomy: SG is considered to be a restrictive procedure. It is usually performed as a laparoscopic ("key hole") procedure that involves 4-5 small incisions (port sites). In the adult, the stomach normally has a volume of approximately 1500ml to 2000ml. During surgery, the outer margin of the stomach is stapled off and removed, to reduce the volume of the stomach to approximately 200ml. Surgery also has the added benefit of removing the cells in the stomach that contribute to the sensation of hunger.
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Gastric bypass: GBy is considered to be both a restrictive and malabsorptive procedure. It is also usually performed as a laparoscopic ("key hole") procedure that involves 4-5 small incisions (port sites). During surgery, the stomach is divided in its middle section to create a new smaller stomach pouch (neo-stomach). The newer stomach has a volume of approximately 30-40ml. The small intestine is then joined to the stomach pouch so that food can bypass some of the intestine, thereby not being absorbed as much as it normally would.
