Bariatric weight loss surgery in Aberdeen
Adjustable gastric band
This laparoscopically-positioned device restricts the amount of food entering the stomach. It is placed just below the gastro-oesophageal junction, allowing the formation of a small pouch of about 30 ml volume into which the oesophagus opens.
The inner aspect of the band contains an inflatable silicone balloon that is connected to a subcutaneous port. Over the weeks or months following surgery, this is used to fill or remove fluid, thereby tightening or relaxing the restriction the band causes.
Band insertion carries a lower risk of morbidity and mortality than bypass procedures, but also results in a lower level of weight-loss. It does not suit those unable to significantly change their diet. Close follow-up and several adjustments of the band may be needed to achieve optimum performance.
Roux-en-Y gastric bypass
A more involved procedure than band insertion. The stomach is divided to leave a small proximal pouch. The small intestine is divided about 75 cm from the antrum and the distal part of the intestine is anastomosed to the small stomach pouch. The distal end of the divided proximal small bowel is then anastomosed lower down the small intestine.
The small stomach pouch may have a restrictive effect, but the bypass component results in malabsorption of food. Furthermore, changes in gut hormone release result in a decrease in appetite, hunger and eating behaviour.
This procedure results in better weight loss than band surgery, but malabsorption – for example of vitamin B12 and calcium – is common. There is also more potential for surgical complications, and the ‘dumping syndrome’ is common: lightheadedness, palpitations and diarrhoea within 30 minutes of sugary intake.
Intragastric balloon
This endoscopically-placed device consists of an inert balloon, approximately 300 ml in volume, which severely restricts the amount of food that can be ingested. Such devices can only be placed for a maximum of six months, after which it must be removed. Severe vomiting often occurs in the initial stages after the balloon is placed.
These devices may suit individuals whose medical condition and extreme BMI make laparoscopic surgery very risky. Once they have lost some weight with a balloon, a bypass procedure may become possible.
Vertical banded gastroplasty
This provides a fixed restriction via a band around part of the stomach, and the rest of the stomach being closed off with staples.
Other malabsorptive procedures
The Roux-en-Y bypass procedure is the most common bariatric procedure worldwide, but we also perform various other procedures to achieve greater malabsorption, such as biliary-pancreatic diversion or duodenal switch procedure.
