Weight Loss Surgery
In the last 20 years weight loss surgery in Australia has come a long way. In the early 2000’s Lapband surgery was for most people looking for weight loss surgery the only option available. While the initial results for many people were promising the long term results were not always great largely because of the issues associated with a foreign body and longterm issues such as reflux and food intolerances. Since 2010 Sleeve Gastrectomy has largely replaced lap banding as the most common procedure performed not only in Australia but world wide.
Dr France was one of the first surgeons to introduce Sleeve Gastrectomy in Australia and whilst initially people were concerned about removing part of the stomach, the results both in terms of weight loss and low complication rates soon convinced many patients that this was a better option than gastric banding.
Today Sleeve Gastrectomy is still the most common procedure performed but other procedures particularly gastric bypass have evolved and gained popularity. The reality is that there is no one perfect procedure for all patients, mainly because no 2 patients are the same and different procedures suit different individuals based on their individual characteristics and circumstances.
Dr France is a great believer in tailoring the procedure to the patient and as such he performs all of the currently recognised weight loss procedures including Sleeve Gastrectomy, Gastric Bypass (Roux en Y and Single Anastomosis) and the SADI procedure which combines a Sleeve Gastrectomy with Bypass of the small intestine.
Traditionally surgeons have classified operations into those that work by restricting the amount of food and hence calories consumed such as gastric banding, and those that cause malabsorption of food such as Bilio-pancreatic diversion. Laparscopic gastric bypass combines both restriction and an element of malabsorption although this is mild. More recently research has revealed that some operations such as laparoscopic sleeve gastrectomy and laparoscopic gastric bypass also alter hormones involved in appetite control. These changes mean that patients can better control their diets and lose weight without feeling like they are starving to death and are probably as important as restriction and malabsorption components.
No matter what any surgeon might tell you there is not one single perfect procedure, but nor should their be as obesity embraces a wide range of patients, and certainly a super obese 300kg patient with a BMI of 80 and multiple obesity related diseases is completely different from a relatively fit 110kg patient with a BMI of 35.
Deciding which procedure is best for an individual patient is a complex process, but includes assessment of a patients dietary pattern, their obesity related diseases and risks, as well as patient wishes. Patients need to understand the advantages and disadvantages of varying procedures and the reasons why a certain procedure maybe a better fit for them in the long-term.
