procedures we offer in the uk
Laparoscopic Adjustable Gastric Band
The adjustable gastric band (sometimes known as lap banding) is a restrictive procedure.
A silicone band is placed around the upper part of the stomach, creating a small pouch above the band, about the size of a golf ball and a large pouch below the band.
This creates an hourglass appearance and it functions by limiting the amount of food you can eat to feel full and by controlling the rate at which the food is allowed to empty out of the pouch into the rest of the stomach. This is at a slower rate than normal and therefore you should feel satisfied on smaller amounts of food and feel full for a longer period of time.
The gastric band can be tightened or loosened and will need adjusting from time to time. An adjustment reduces the size of the opening into the rest of the stomach below the band this is done via the port (button like) which is connected to the band by a small thin tube and positioned under the skin and fat. This is not visible.
Gastric band adjustments are fairly pain free and will be carried out by our own team of specialists until the right restriction for you is established, this can be different for every patient.
The operation takes approximately 1 hour, will require an overnight stay in hospital and is reversible.
Over eating and poor eating habits can cause nausea and vomiting, this may jeopardise your potential to maximise weight loss and may result in band slippage.
Average weight loss
50%-60% of excess weight within 2 years (British Medical Journal)
Risks and complications
Like any surgical procedure there are possible risks and complications, they are rare and everything possible will be done to prevent them from happening. This procedure is reversible.
The most recognised and documented are:-
- Haemorrhage
- Infection
- Anaesthetic reactions
- PE/DVT
- Death
- Port/tubing problems
- Band Slippage
- Band Erosion
- Wind/Constipation
Laparoscopic Gastric Bypass
There are several variations of a bypass, the most common procedure in the UK is the Roux-en-Y, also known as RYGB. It is a combination of restrictive and malabsorptive procedures, therefore has a two way weight reducing effect.
A small pouch is created by stapling off a section of the upper part of the stomach.
Below the staple line the stomach will remain but no food will enter here.
The stomach will still produce gastric juices and enzymes essential for digestion and absorption of nutrients.
The bypass part of the operation is the reconstruction of the small intestine limiting the absorption of calories from food.
The attraction to this surgery is that it is considered to be permanent, weight loss is experienced from the day of surgery and there are no adjustments required, however, it is a higher risk procedure. The surgery takes approximately 2 hours, with up to 3 nights stay in hospital.
Weight loss is dramatic at first and then stabilises to 2-3 lbs per week.
You must also take daily nutritional supplements for the rest of your life and vitamin B12 injections are also recommended every 3 months to prevent Pernicious Anaemia in later life.
Over-eating and poor eating habits can still jeopardise your success and you are also likely to experience 'dumping syndrome' if you consume foods high in sugar or fat. The side effects include diarrhoea, stomach cramps, sweating and dizziness.
Average weight loss
66-80% of excess weight within 2 years
Risks and complications
Like any surgical procedure there are possible risks and complications, they are rare and everything possible will be done to prevent them from happening.
The most recognised and documented are:-
- Haemorrhage
- Infection
- Bowel perforation
- Anaesthetic reactions
- PE/DVT
- Anastomotic leak
- Death
- Wind/constipation
- Dumping Syndrome
- Nausea and vomiting
Laparoscopic Sleeve Gastrectomy
The sleeve gastrectomy is a restrictive procedure.
Two thirds of the stomach is resected and removed, leaving a smaller stomach in the shape of a sleeve.
The portion of the stomach removed produces a hormone that stimulates appetite and hunger, removing this results in a significant reduction in appetite.
This procedure allows the consumption of normal food in much smaller quantities, therefore fewer calories are absorbed and weight loss is experienced and long term weight loss maintained.
This procedure, like the bypass, is suitable for those who have more weight to lose and whose health is in particular risk because of their weight and obesity related diseases.
The surgery takes approximately 2 hours (depending on your medical condition) with up to 3 nights stay in hospital.
Unlike the gastric band, a sleeve gastrectomy is not reversible, it does not require the implantation of any device around your stomach or frequent adjustments.
Long term commitment to follow-up and vitamin supplements will be required.
Average weight loss
50% of excess weight within 2 years
This procedure can also be performed on super obese or high risk patients with the intention of performing either a gastric bypass or duodenal switch at a later date.
Risks and complications
Like any surgical procedure there are possible risks and complications, they are rare and everything possible will be done to prevent them from happening.
- Haemorrhage
- Infection
- Dilation of the sleeve (which allows for more food intake)
- PE/DVT
- Death
- Anaesthetic reactions
- Nausea and vomiting
- Wind/constipation
Intragastric Balloon – non surgical treatment for weight loss
For many patients with a BMI (body mass index) of 27-35 surgical intervention is not always available or recommended according to the NICE guidelines, as patients with a lower BMI do not qualify.
For many the outlook does not look positive, following years of yo-yo dieting and failed attempts at maintaining weight loss, patients return to old eating habits and unhealthy lifestyles.
Balloon placement constitutes a therapeutic attempt for the treatment of obesity, primarily was used to reduce patients weight prior to having surgery for morbid obesity.
We at have looked at the specific treatment of obesity and why some patients fail on supervised weight control programmes.
We have found that along with the insertion of the intra-gastric balloon and a professionally supervised “behavioural modification” program, successful weight loss can be achieved and maintained.
The balloon is a silicone sphere that holds 500cc volume of saline or air. The balloon stays in place for approximately 6 months and is radiopaque (can be seen easily under X-ray) and complications are extremely rare.
The feeling of satiety and fullness is achieved by the Baroceptor and the brain passing messages to each other that the patient is full; there is a delay in gastric emptying resulting in reducing the amount the patient can eat and a constant feeling of satiety.
Pre insertion
All patients will follow our pre screening assessment and complete a patient information profile, have a dietary evaluation and psychiatric consultation if clinically indicated.
An X-ray of the oesophagus, stomach and duodenum may be required if clinically indicated.
Routine blood tests, chest X-ray and ECG may also be required if clinically indicated.
All patients will commence a liquid diet 24 hours prior to midnight pre admission, then nil by mouth until insertion.
Insertion of the balloon
Most patients have the balloon inserted under sedation, unless there is a specific clinical reason.
The balloon is inserted endoscopically and placed in the stomach, then inflated with saline or air (depending on the type used).
The balloon can easily be deflated and removed, if required, at any time.
All patients will be required to stay one night in hospital.
Removal technique
The balloon will be removed endoscopically, under sedation, following 6 months treatment and behaviour program.
All patients will commence a liquid diet 3 days prior to removal.
Patients may be discharged following removal within a few hours.
Risks and Complications
With any surgical or medical intervention there are always going to be risks and some complications and although many are very rare and every effort is made to reduce or prevent them, you need to be fully aware of their existence, to make an informed decision.
- Nausea and vomiting
- Bloating
- Peptic ulcer
- Diarrhoea
- Reactions to sedation
- Aspiration Pneumonia
- Oesophageal/gastric perforation
- Gastro-Oesophageal reflux
- Deflation of the balloon and intestinal obstruction
Post Insertion
For the first 3-5 days following positioning, you may feel uncomfortable and nauseated, this will pass and every effort will be made to reduce these side effects. You may be offered some medication to settle your stomach and relieve the nausea.
All patients will commence a liquid only diet for 1 week and slowly progress to a semi solid diet, resuming normal textured foods within 2 weeks.
All patients will be informed about the behaviour modification program and will be aware of the compliance, attendance and content that is paramount to weight loss success – this runs for 12 months (6 months whilst the balloon is in place and 6 month after removal)
All patients will have access to our helpline and expert advice.
After the first 12 months all patients enter a maintenance follow up programme for a further 12 months (24 months aftercare in total) which during this time telephone contact will be made to help 'protect' the weight you have lost.
Revision surgery
Surgery patients are not always successful in reaching their weight loss goals.
Reasons for post operative weight loss failure can include problems with the original surgery, as well as patient inability to comply with necessary life style changes.
We specialise in working with patients who have already had weight loss surgery but are looking for another solution as their original surgery has not been a success, for whatever reason.
Preventing complications, managing complications and managing patients post operatively are all equally challenging aspects of care to us at the WLS group.
We can offer one to one consultations to patients with post surgery weight loss failure to discuss revision surgery further.
Patients are screened carefully to determine cause of failure and are medically evaluated prior to any further surgery taking place.
We also ensure you receive comprehensive guidelines for post surgical compliance appropriate to the procedure you have chosen to have.
Costs
- We understand the cost of surgery is important to you, especially if you are working to a budget.
- We aim to give you a quality service that is affordable
- Our costs are fixed with no hidden extras and includes an intensive aftercare programme.
See our price lists page for a breakdown of costs for procedures
Weight loss surgery here in the UK is currently not covered by private medical insurance. You will need to pay for your surgery in full by cash, cheque or credit card 7 days before your procedure takes place.
Please call free on 0800 78 79 029 for further information.
If you are looking to finance your surgery we have an independent financial advisor that may be able to help - call us on 0800 78 79 029 for more information
