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Bariatric surgery
Gastric band| | Gastric bypass| | Laparoscopic sleeve gastrectomy| | Who is suitable?| | Benefits and risks| | Specialists| | Contact us| | Oxfordshire Banding and Bypass Organisation (OBBO)|
Bariatric surgery is the generic term for three different types of surgery which are performed for the treatment of morbid obesity.
The operations performed most commonly are:
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the laparoscopic gastric band
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the open and laparoscopic 'roux en y' gastric bypass
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the laparoscopic sleeve gastrectomy.
Each operation has advantages and disadvantages. The medical team will identify which one will be most appropriate for each patient.
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The gastric band is a 'restrictive' procedure. This means that it restricts the amount of food that the patient can eat. It reduces feelings of hunger by pressing on the surface of the stomach and can be adjusted by adding or removing fluid.
This procedure is relatively safe and the recovery time is short. The patient is admitted to the hospital on the morning of surgery and stays overnight. The band can be removed with a second keyhole operation if necessary, and the weight loss it supports can be considerable.
A commitment to follow-up care is essential, and for the best results patients must commit to a permanent healthy diet and lifestyle. If they work hard they can expect to lose around 50 percent of excess body weight.
The gastric bypass is the most common weight loss operation worldwide. It is usually performed by keyhole surgery, and the patient will need to stay in hospital for five days.
This operation helps weight loss in three ways:
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it restricts the amount of food patients can eat by reducing the size of the stomach
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it bypasses part of the stomach and intestine, reducing the amount of food the body is able to absorb
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it reduces the appetite, especially for sweet foods.
It is particularly suitable for patients with type 2 diabetes.
A gastric bypass will not require adjustment, but patients need to commit to regular monitoring, lifelong six-monthly blood tests and daily multivitamin and mineral tablets. Patients can lose up to 70 percent of excess body weight with this procedure.
This is a restrictive procedure similar to the gastric band. It can be performed as a definitive operation or before a gastric band if expected weight loss is not achieved. The sleeve gastrectomy reduces the size of the stomach by 75 percent and is not reversible.
Following the procedure the remaining part of the stomach will have the shape of a banana. This means that, although smaller, the stomach function remains unaltered and the food will follow its natural pathway.
Patients should expect to lose 40-60 percent of excess body weight following a sleeve gastrectomy, and a similar improvement in diabetes to the gastric band. The results of this operation in the long term (over five years) are not yet well known.
Specialist consultants at Oxford Radcliffe Private Healthcare follow the guidance for surgery issued by the National Institute for Clinical Excellence (NICE).
NICE state that people with morbid obesity should have surgery to aid weight loss only after they have had a full assessment by the specialist and other healthcare professionals involved in their care. In addition, counselling and support should be arranged for people before and after the surgery.
Other treatments for weight loss
Currently other treatments for obesity include advice on diet, exercise and lifestyle, drug therapy, referral to specialist weight loss clinics, low and very low calorie diets and therapy designed to modify behaviour.
The benefits of weight loss surgery are:
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increased life-expectancy and improved quality of life
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a significant improvement in type 2 diabetes
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a significant improvement in blood pressure control, if not a return to normal blood pressure
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a rapid return to normal blood cholesterol levels in more than 70 percent of patients
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elimination of sleep apnoea in a significant number of patients The risks
The risks of weight loss surgery are similar to the risks of any surgery for patients with complex health problems. These problems would be discussed with patients prior to any decision about surgery being made.
Bariatric surgery can cause side effects both at the time of the operation and in the long term. These can include:
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nausea and vomiting
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diarrhoea
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heartburn
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vitamin deficiency
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infections in the wound
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the band or staples breaking or bursting
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ulcers forming around the band or staples.
After the operation, care is available to deal with any side effects or complications: patients will receive advice to help change their eating habits to prevent complications.
Mr Nick Maynard – consultant surgeon
Mr Maynard underwent medical training at Oxford University, Exeter College before spending three years at Guy's Hospital in London completing the clinical phase of his training.
Following a brief spell as a junior doctor at the Radcliffe Infirmary|, Mr Maynard spent a year in Australia completing some of his specialist surgical training. He completed specialist training in oesophageal and gastric surgery at Guy's hospital, working for Bill Owen and Bob Mason, which has been one of the best training grounds for oesophageal surgery in the country.
Mr Maynard was appointed a consultant in Oxford in 1997.
Mr Bob Marshall – consultant surgeon
Mr Marshall has been a consultant upper gastrointestinal surgeon in Oxford since 2001. He is one of three consultant surgeons now offering specialist bariatric surgery.
Mr Marshall completed his MBBS in 1988 and graduated to the Fellowship of the Royal College of Surgeons after four years at St Thomas' Hospital. He was granted his Master of Surgery (London) qualification in 1999.
Special interests: gallbladder surgery, anti-reflux surgery, hernia surgery, gastroscopy, colonoscopy and oesophago-gastric cancer.
Mr Bruno Sgromo – consultant surgeon
Mr Bruno Sgromo is the Lead Consultant Bariatric Surgeon at the Oxford University Hospitals, Oxford, UK. He earned his MD in Italy in 1998 and completed general and laparoscopic surgery training in Italy and in the Netherlands. Prior to his posting in Oxford, he served as a Senior Surgical Fellow at the Ninewells Hospital in Dundee, Scotland, with concentration in advanced laparoscopic surgery of the stomach and oesophagus.
He joined the Upper Gastrointestinal Unit of Oxford in 2007 as senior clinical fellow and then was appointed as Consultant Surgeon in 2009.
Mr Sgromo has been performing weight loss surgery since 2004, with focus on gastric bypass and revisional bariatric surgery in collaboration with Mr Shaw Somers, one of the leading bariatric surgeons in the UK. He specialised in laparoscopic gastric band, gastric bypass, sleeve gastrectomy and revisional bariatric surgery as a part of his higher surgical training. To date, Mr Sgromo has performed over 200 keyhole surgeries for weight loss.
Despite working on a very high risk patient group, he has achieved a zero mortality rate and ananastomotic leak rate well below the national average.
Mr Sgromo's research interests lie in the changes of stomach hormones and their effect on dumping syndrome post gastric bypass. He has produced several publications in the field of laparoscopic and upperGI surgery and regularly attends the British Obesity and Metabolic Surgery Society (BOMSS), the International Federation for the Surgery of Obesity (IFSO) and the American Society of Metabolic and Bariatric Surgery (ASMBS).
Mr Sgromo lives in Oxford with his wife Alessandra and daughter Caterina.
If you want to know more about weight loss surgery visit www.oxford-surgery.co.uk|.
To arrange an interview please contact:
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Vicki Baxter or Peter Bredenkamp
Tel: 01625 506444.
For further information contact:
OBBO is a small, friendly group based in Oxford who have all had, or are planning to have, weight-loss surgery. The group is open to both NHS and Private patients, and also to those having surgery elsewhere in the UK. It meets once a month, offering a relaxed, confidential environment for members to discuss their concerns and support each other. It also aims to provide a 'buddy' system for those about to have surgery.
There is a small fee of £1.00 to pay, to cover costs, but the first session is free and helpers are also free.
OBBO meetings 2012
Meetings are held 6.00pm - 8.00pm at:
There is an underground car park.
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Monday 19 March 2012
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Tuesday 17 April 2012
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Monday 21 May 2012
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Tuesday 19 June 2012