1. Intragastric Balloon

• An endoscope implants an air-filled balloon into the stomach.
• Thirty minutes is all it takes for this procedure takes.
• This surgery is done under general anesthesia or IV sedation.
• Expected weight loss averages 13-24kgs in six months.
• Patients with a very high BMI can lose weight before deciding on permanent surgical procedures.
• Patients that don’t qualify for other surgery options can take advantage of this procedure.
• Intragastric balloons can cause nausea and vomiting in a few patients, so they might not be able to use them for more than a few days.

2. Laparoscopic Gastric Banding

• Keyhole surgery is performed to place an inflatable band is placed around the stomach.
• The inflatable band will have tubing attached through an access port, which is placed on the stomach muscle.
• The purpose of the port is for inflation of the small balloon which is inside the band and placed on stomach muscle. This causes a feeling of fullness so the patient doesn’t eat as much.
• This is a minimal risk procedure that is the least invasive option, with a mortality rate of 1 in 2500. This compares to gall bladder surgery at 1 in 1000.
• The shape of the stomach or bowel is unchanged with this procedure.
• Deflation or removal of the band is possible at any time and the stomach returns to normal.
• During pregnancy, the band doesn’t interfere with development of the baby.
• Academic publications have indicated effectiveness for more than 10 years.
• 50-60% of excess weight has been reported with the band.
• Vitamin and mineral supplements should be taken regularly to avoid nutritional deficiencies that can occur with Gastric banding.
• Slippage has occurred in 0.66% of our patients, while Gastric Band Erosion incidents are less than 1%, although in our series of these procedures. Other side effects include a 5% occurrence in our series of Tubing problems and less than 1% experienced Conversion of laparoscopic surgery. We have never had an occurrence of leaking band complications.

3. Laparoscopic Sleeve (Tube) Gastrectomy

• This operation is a keyhole surgery that reduces the size of the stomach from 1000mls to less than 200mls. Also, known as stomach stapling, it involves removing 2/3rds of the stomach’s capacity. 60-70% of excess weight is lost within a year or two by most patients.
• This operation allows patients to eat things like steak, sausages and bread, which is not possible with gastric banding. Once you have the surgery, no further adjustments are necessary.
• A three day hospital stay is required.
• Leaking from the staple line is a complication that has occurred in 1% of patients. A longer hospital stay might be required if this happens.

4. Biliopancreatic Bypass

• A long intestinal bypass is combined with removal of 2/3rds of the stomach. The absorption of fat is substantially reduced, but it can cause side effects like several foul smelling bowel movements daily and long term skeletal or metabolic problems can occur.
• Complications and mortality percentages increase because it is usually done as open surgery.
• Long term results are impressive with 80-90% excess weight losses possible in 2 years.