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Laparoscopic Obesity Surgery

"Obesity" means severely overweight. "Morbid" means causing illness or disease.  "Morbid obesity" means severe obesity to the point when the excessive fat stores cause or aggravate serious, life-threatening illnesses such as type 2 diabetes, high blood pressure, heart disease, arthritis and cancer.   The most common cause of death in obese people is a heart attack.
 

Your body mass index determines whether you are obese.  Morbid obesity is defined as a BMI greater than 40.

 

  BMI kg/m2
Normal 18 to 25
Overweight 25 to 30
Obese more than 30
Severe obesity more than 35
Superobesity more than 50
Body mass index
(BMI) = weight (kg)
divided by height2 (m)

Obesity is more common in the UK than in any other European country; 2% of the population (21% women & 17% men) have a BMI >35 and obesity-related disease.  15% of school children are obese.   Severe obesity reduces life expectancy by an average 9 years.  Put another way, patients have only a 1 in 7 chance of a normal life.

Once patients attain a BMI of >35, behavioural modification and exercise alone do not achieve weight loss. The only strategy that is proven to produce weight loss is surgery. Once a patient has reached severe obesity every other means to produce weight loss is doomed to fail.  Weight loss surgery however, is not a quick fix, and it’s not suitable  for everyone.  However, when combined with a life-long commitment to proper nutrition and exercise, bariatric surgery can help you lose those excess pounds and maintain a healthy weight, offering you a second chance at life. 


WHAT OPERATIONS ARE AVAILABLE?

  • Restrictive operations cause weight loss by reducing the amount of food that can go into the stomach. This makes a patient feel full very quickly, removes hunger and reduces the need to eat.
  • Operations that cause malabsorption reduce the amount of food that can be digested by the intestine and the operation is combined with restriction of the stomach.

Overall, the risks of bariatric surgery are low, and most patients experience few, if any, complications.  However, this is major surgery and serious, even fatal, problems may arise.  Bariatric surgery should be considered only after all other weight loss solutions have been exhausted.

The safety of bariatric surgery varies considerably, depending on several factors, particularly the type of operation and the experience of the surgeon and the hospital.  A general rule of thumb is that the longer and more complicated the surgery, the higher the risk.

Lap-Band surgery, which does not involve cutting and suturing of the stomach and intestines, is considered to be much safer than Roux-en-Y gastric bypass surgery, biliopancreatic diversion (BPD), or biliopancreatic diversion with duodenal switch (BPD/DS).  In general, the risk of mortality with the Lap-band is about 1 in 2,000, while the risk of mortality with a gastric bypass is about 1 in 100.  The mortality rate of BPD and BPD/DS procedures are somewhat higher.

No matter which operation you ultimately choose, it is vital to have it performed by a highly experienced team.  Simply put, the more experience, the better the outcomes.


 

HOW MUCH WEIGHT COULD YOU LOSE WITH SURGERY?


With gastric banding approx. 40-60% excess weight is lost within 18 months. This is enough to result in a completely changed body image and improved quality of life. After this, the weight tends to reach a plateau.  Weight loss varies between patients depending on dietary habits.  After gastric bypass patients can expect to lose about 70% of their excess weight.



Obesity Surgery

NICE guidance on obesity
Health problems associated with morbid obesity
Adjustable Laparoscopic Gastric Band Surgery
After Laparoscopic Gastric Band surgery
Sleeve gastrectomy
Gastric Bypass Surgery
Side Effects of Bariatric Surgery
Risks of weight-loss surgery
Costs of private obesity surgery
UK Bariatric Surgeons

Avon Obesity Service

Who are AOS

NICE recommendations

The National Institute for Clinical Excellence (NICE) 2006 guidelines recommend that surgery be available as a treatment option for those people with;

  • Severely Obese (BMI 35-39.9) with co-morbidity e.g. type 2 diabetes, high blood pressure, osteoarthritis, metabolic syndrome etc.
  • Morbidly Obese (BMI 40-50), no co-morbidity required.
  • Super Obese (BMI > 50), no co-morbidity required.

We require a referral letter from a medical practitioner, which should be addressed to a Consultant, before an appointment can be made.

You will only be considered for restrictive or malabsorptative bariatric surgery if:


  • You are fit enough to have an anaesthetic and surgery

  • You are aged 18 or over

  • You are receiving treatment in a specialist clinic at a hospital

  • You have suffered form obesity for more than five years;

  • You have tried all other appropriate non-surgical treatments (for at least 6 months) to lose weight but have not been able to maintain weight loss;

  • You fully understand the procedure, the need for long-term follow-up and are prepared to change your eating habits;

  • You are not dependent on alcohol or drugs

  • You have no untreated endocrine disorder

  • There is no specific medical or psychological reasons why weight loss surgery should not be performed



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    SPIRE Hospital, Bristol. 
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    Contact: Claire Trenberth - 0117 9804051
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