Sleeve Gastrectomy

Also known as the gastric sleeve resection, or tube gastrectomy, the sleeve gastrectomy is an operation where approximately 90% of the stomach is removed to reduce its capacity to around 100 to 200mL. 

Normally, the stomach is a pouch which can take a large volume of food and fluid and expand while doing so. This allows us to eat a meal which is much larger than required to maintain a healthy weight. Almost all weight loss procedures attempt to reduce the stomach’s capacity in some way. 

The Surgery

The sleeve gastrectomy procedure is performed with laparoscopic (keyhole) technique under general anaesthesia. Five small incisions (between 5 and 15mm in length) are made for the insertion of keyhole surgery instruments. Using these instruments, the size of the stomach is reduced by stapling along the length to form a long tube that looks similar to a banana. The large redundant part of the stomach is removed permanently. 

How does the surgery help you lose weight? 

The sleeve gastrectomy procedure assists patients to lose weight in two ways:

• Reduces the amount of food that can be eaten at one time – the volume of food the pouch can take is greatly reduced which allows you to feel full from a small portion of food. 

• Suppresses appetite - the stomach secretes a hormone call ghrelin, which is involved in appetite stimulation. By decreasing the size of the stomach, the amount of ghrelin produced is also decreased therefore suppressing appetite. 

It is important to remember that surgery is a TOOL for weight loss. It is vital that eating behaviours are modified to get the best result from the procedure. It is important to eat a variety of protein, vegetables and fruit, limit your intake of calorie dense foods and liquids and to slow your speed of eating. If eating behaviours are not adapted after surgery, weight loss will be limited or weight regain can be possible in the future. More detailed information about correct eating behaviours will be covered during your visit with the dietitian.

Expected Weight Loss

The sleeve gastrectomy is quite successful in initial weight reduction as well as maintaining the weight loss. Most patients can expect to lose 60 to 70% of their excess body weight over 6 to 12 months. 

Roux-en Y Gastric Bypass

The Roux-en Y gastric bypass is a weight loss procedure that has been performed for more than 20 years in some parts of the world, particularly in the United States. It has recently become a more popular choice for patients in Australia, in particular those with diabetes. 

The Surgery

The gastric bypass procedure is performed with laparoscopic (keyhole) technique under general anaesthesia. Five small incisions (between 5 and 12mm in length) are made for the insertion of keyhole surgery instruments. Using these instruments, the top of the stomach is stapled to form a small pouch (30mL to 50mL in size). The small pouch becomes the new, smaller, stomach and is completely separate to the rest of the stomach. This stomach is then joined to the jejunum, the middle part of the small intestine, bypassing the first part of the intestine called the duodenum. The rest of the stomach and duodenum remains in the body but is no longer used for food digestion. The operation takes between two and three hours. 

How does the surgery help you lose weight? 

The gastric bypass procedure helps you to lose weight in two ways: 

• Reduces the amount of food that can be eaten at any one time to less than a 1/4 of what you can eat now 

• By decreasing the amount of calories you absorb from your food as a result of bypassing the duodenum (upper part of the small intestine) 

It is important to remember that surgery is a TOOL for weight loss. It is vital that eating behaviours are modified to get the best result from the procedure. It is important to eat a variety of healthy foods, to limit your intake of calorie-dense foods and liquids and to slow your speed of eating to improve food tolerance. If eating behaviours are not adapted after surgery, weight loss will be limited or weight regain can be possible in the future. 

Expected Weight Loss

Most people can expect to lose 60 to 70% of their excess body weight over 6 to 12 months. 

Single Anastomosis Gastric Bypass

This single anastomosis gastric bypass, or mini gastric bypass, is a relatively new procedure that combines some of the properties of a gastric sleeve and a Roux-en Y gastric bypass. The upper part of the stomach is divided into a tube, similar to the top three quarters of a sleeve and then joined to a loop of intestine. It is an operation that combines food intake restriction with some calorie malabsorption, resulting in good weight loss with great quality of life.

The Surgery

The single anastomosis gastric bypass procedure takes approximately 1-2 hours to complete and is performed with laparoscopic (keyhole) technique under general anaesthesia. This involves making several small cuts (between 5 and 15mm in length) into the abdomen where the surgical instruments, including a camera, are inserted. The top of the stomach is then stapled to form a thin tube (30-50ml in size), which becomes the new, smaller stomach and is completely separate to the rest of the stomach. This new stomach is then joined to the middle part of the small intestine (the jejunum), skipping the first 150-200cm of the intestine. The unused part of the stomach and intestine remain in the body but are no longer involved in food digestion.

How does the surgery help you lose weight? 

The single anastomosis gastric bypass assists patients to lose weight in two ways:

• Reducing the amount of food that can be eaten at any one time. The volume of food the new stomach can hold is greatly reduced, causing you to feel full from a small portion of food.

• Decreasing the amount of calories absorbed from food as a result of bypassing 150- 200cm of the small intestine.

It is important to remember that surgery is a tool to assist your weight loss journey and not the whole solution. It is vital that healthy lifestyle behaviours, are practiced to get the best result from the procedure. Eating a variety of vegetables, fruits and lean proteins as well as limiting your intake of high-calorie foods such as sweets, fast food and sugary-drinks will maximise your weight loss after surgery. If eating behaviours are not adapted after surgery, weight loss will be slowed and limited and weight regain can occur. More detailed information regarding healthy eating behaviours will be provided during your visit with the dietitian.

Expected Weight Loss

Most people can expect to lose up 30 to 40% of their total body weight in the first 12 to 24 months after surgery.