The Avenue Hospital
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Bariatric Surgery (for weight loss)

Obesity is a major health care problem and one of the most frequent causes of preventable death in Western countries in the 21st century. Bariatric surgery is the only current treatment that has been shown to achieve major and durable weight loss, which can lead to total or partial control of a wide range of common and serious diseases, such as diabetes, heart disease and hypertension according to a Medical Journal of Australia report.

Our hospital performs more than 1,000 bariatric procedures every year, with many patients resolving or significantly reducing obesity-related issues after surgery.

We are committed to providing high quality, personalized care for patients who undergo bariatric surgery. Our highly experienced surgeons work closely with our team of skilled nurses to deliver high quality care. An individual plan of management is developed for each patient’s hospital stay, including prior to admission, whilst in hospital and through to discharge.

The Avenue Hospital has one of the longest established and most reputable bariatric surgical programs in Australia.

Click here to view our Bariatric Specialists

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)

Here are some common bariatric procedures we perform at The Avenue Hospital.

Laparoscopic Adjustable Gastric Banding

The gastric band consists of a ring of silicone which is placed around the very top of the stomach. It has an inner balloon which compresses this area to control the appetite. The balloon is connected to a port lying deep to the skin. By injection or removal of saline into the port the appetite can be increased or decreased. It is a very safe day procedure which leads to good long-term weight loss. It is fully reversible.

Laparoscopic Sleeve Gastrectomy

The Sleeve Gastrectomy procedure involves removing approximately 3/4ths of the stomach leaving behind a narrow tube of stomach. This restricts the amount of food eaten before the sleeve distends, creating a feeling of fullness. This is currently the most frequently used bariatric procedure in Australia and offers good early weight loss. The procedure is not reversible or adjustable.

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. It is not reversible or adjustable.

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). “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 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
  • Your weight is limiting simple activities of daily living and quality of life
  • You are concerned about missing out on those extra years of life

Calculate your BMI here

  • Find out your BMI and gain an understanding of what it means
  • Find out the health consequences
  • Get practice weight loss information
  • 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 30 to 40kg.
  • You will feel better about your appearance and self-confidence.

Frequently Asked Questions

If you have significant problems with excess weight, of course, you should at least consider weight loss surgery. You only get one pass through life and you must not reduce your quality or quantity of that life by ignoring a possible solution to this chronic and disabling problem. You should know what options are available and have some estimate of the benefits they could bring to you and the costs and risks that go with each option.

The first step is decide if you have a significant problem. Let’s ask you some questions:

Is your obesity severe enough?

We usually discuss the levels of obesity by referring to the body mass index (BMI) which is calculated by dividing your weight in kg by the square of your height in metres. You need to have a BMI greater than 30 to be considered for gastric banding and it should be above 35 to be considered for the stapling procedures.

Is your obesity associated with health problems?

Obesity causes or makes worse more than 30 different diseases. The common ones include diabetes, high blood pressure, sleep apnoea, heartburn, back pain, asthma, anxiety states, infertility, hip or knee pain and depression. And there are many others.

Is your obesity limiting you physically and socially?

Do you find you have difficulty doing the simple activities of daily living such as tying shoe laces, attending to personal hygiene, buying clothes and getting in and from your car?

Do you feel embarrassed by your appearance and tend to avoid social activity except with your close family?

Are you concerned that your obesity is likely to reduce your life expectancy?

We know that, across the community, people who are obese will die earlier than those with normal weight. We cannot easily predict what will happen to any individual but we know that, if you are obese, you are at increased risk.

Have you tried and failed to control your weight with the lifestyle treatments?

The lifestyle treatments should always come first. These include the various measures to get you to eat less and do more such as the never-ending list of diets plus exercise programs, diet pills, and Jenny Craig or other commercial weight loss groups.

If your BMI is greater than 30, if you are concerned about missing out on those extra years of life, if the quality of what life you do have is being reduced by the health problems or physical and social restrictions that your obesity places on your life and if you have given the lifestyle measures enough of a try to know they will not solve your problem then, yes, you should consider weight loss surgery.

Weight loss surgery is serious therapy. It is not like going on another diet. It is a commitment to a life-long change and significant risk which must be balanced against the rewards of substantial and durable weight loss and its associated improvements in your health, your physical and social status and in your length of life. All procedures can have complication which at their worse could lead to death. The risk of death is around one in 500 for the stapling procedures, such as sleeve gastrectomy and gastric bypass and a much lower risk for gastric banding. If this risk sounds high, remember it is much less than the risk of dying prematurely from obesity.

The complications which concern us the most will occur after the stapling procedures and include leaks from the staple line, bleeding and pulmonary embolism. These problems are rarely an issue after gastric banding. Leaks are of major concern as they can lead to a prolonged period in hospital with the need for multiple additional procedures.

It depends very much on how much excess weight you are carrying, what procedure you have and when we measure it. The excess weight represents the excess fat you have and for the typical person having weight loss surgery there would be around 60 kg of excess fat present at the start. By two years, we would expect you to have lost between 35 and 40 kg if you have a sleeve gastrectomy or gastric bypass and around 30-35 kg after gastric banding. There tends to be some weight regain from there and, by 10 years from operation, you are likely to be at 30-35 kg weight lost after gastric bypass, 30 kg after gastric banding and sleeve gastrectomy. Be aware that this represents the average. Many do better than this and an equal number do worse, so for any one individual, we cannot provide a firm estimate. And much, but not all, of the variation reflects the effort of the person to comply with the aftercare program. Better follow-up achieves better outcomes.

After weight loss surgery the most prominent effect that you will notice is a reduction of your appetite. You notice that through the day you are just not that hungry nor interested in eating. When you do eat you will feel satisfied after a small amount of food. This enables you to follow the guidelines regarding eating. On average, your energy intake per day will fall from around 2,500 kcals to about 1,000 kcals. This is a huge reduction, made possible by the reduced appetite. It leads to an initial weight loss and then to weight maintenance at your new weight level. But you must do your part. The surgery does not force you eat less; it just makes it easier for you to decide to eat less. And you can still enjoy the food. You can eat the very best foods. The quality of the food can increase as the quantity decreases.

With the weight loss, your activity level should increase. The more you do, the better you will feel and the better will be the weight loss.

Weight loss is the most powerful treatment we have in medicine today. Every disease that is caused or made worse by obesity is either reversed or made less troublesome by weight loss. People find they can cease most of the tablets they are taking, they might be able to defer the thought of needing a knee replacement and those who have been seeking pregnancy can be rewarded. A problem that had dominated their lives through years of frustration with failed lifestyle options has become controlled through the substantial and durable weight loss of bariatric surgery. This so often leads our patients to express their joy at deciding to seek weight loss surgery – “it is the best thing I have ever done”.