Weight Loss Surgery Options

Introducing Allurion – a gentle, ingestible balloon designed to reside in your stomach without the need for surgery, endoscopy, or anesthesia. This groundbreaking gastric balloon aims to support your journey towards a healthier lifestyle by curbing your food intake.

Experience an average weight loss of 10-15% of total body weight over 16 weeks, thanks to the balloon and an accompanying comprehensive lifestyle program.

How does the Allurion Balloon function?

The balloon occupies space in your stomach, fostering a sense of fullness that diminishes hunger and promotes reduced food consumption during meals.

Key benefits include:

1. Rapid satisfaction, prompting smaller portions.
2. Inducing a prolonged feeling of fullness, potentially decreasing cravings.
3. Extended retention of food in the stomach, potentially reducing snacking.

The placement of the balloon is a swift, 20-minute procedure during a consultation with your doctor. By swallowing a capsule containing the deflated balloon, attached to a thin tube, there is no need for surgery, endoscopy, or anesthesia. A simple X-ray ensures accurate capsule positioning.

During the procedure, the surgeon fills the balloon with liquid using the attached tube, confirmed by a second X-ray. Subsequently, the tube is gently removed, allowing you to eat less without experiencing hunger.

Approximately 16 weeks later, a time-activated release valve opens, enabling the balloon to naturally empty and pass through your digestive system when you use the toilet. This convenient and safe method jumpstarts a healthier lifestyle. In rare instances, the empty balloon may be expelled through vomiting (2% chance), although such occurrences have not been linked to any reported adverse events to date.

For more information, visit www.allurion.com.

Surgeon: Dr. William Braun
Location: WMSA Clinic

Laparoscopic Sleeve Gastrectomy, commonly known as Gastric Sleeve Surgery, represents a restrictive surgical option offered at our weight loss surgery clinic, ideal for achieving substantial weight loss without necessitating significant anatomical alterations.

Procedure for Gastric Sleeve Surgery:
This technique involves reducing the amount of food intake by diminishing the size of the stomach. A thin vertical sleeve or tube is created using a surgical stapling device, and the remaining portion of the stomach is then removed and discarded. The entire process is conducted through keyhole surgery. The resulting sleeve can accommodate approximately 50-100 ml, roughly 1/10th of the stomach's usual capacity. Despite the significant reduction in size, the stomach continues to function normally.

Advantages of Laparoscopic Sleeve Gastrectomy Surgery:
Key benefits of this procedure include limiting mealtime food consumption, ensuring the full absorption of vitamins and nutrients through the usual digestive tract order, and eliminating the need for postoperative adjustments.

This surgery is particularly suitable for patients with a lower body mass index (BMI). In our Brisbane weight loss surgery clinic, patients typically experience an average weight loss of 70% of their excess weight within the initial 9 to 12 months post-surgery.

Surgeon: Dr. Justin Greenslade
Hospitals: Brisbane Private (Spring Hill), Greenslopes Private (Greenslopes)

Roux-en-Y Gastric Bypass Surgery, commonly referred to as Gastric Bypass Surgery, integrates both restrictive and malabsorptive elements into the procedure.

In a restrictive aspect, adjustments are made to the stomach capacity, while the malabsorptive component alters the structure of the digestive tract, thereby reducing the absorption of calories. This widely performed procedure is recognised as the gold standard in laparoscopic weight loss surgery by the American Society of Bariatric and Metabolic Surgery.

Gastric Bypass weight loss surgery yields early sensations of fullness and satisfaction, contributing to a reduced desire to eat, among other beneficial effects.

Procedure for Gastric Bypass Surgery:
This surgery involves stapling to create a small stomach pouch. The remaining portion of the stomach is then stapled shut and separated from the newly formed pouch in the lower stomach. The resulting pouch directly empties into the jejunum, bypassing calorie absorption in the duodenum. This occurs by dividing the small intestine just after the duodenum and establishing a connection with the smaller stomach pouch, creating two distinct channels in the intestinal tract—one for food and the other for digestive juices.

Advantages of Roux-en-Y Gastric Bypass:
Post-Gastric Bypass surgery, the average excess weight loss tends to be higher compared to procedures solely focused on restriction, reaching up to 80% body weight loss. Another significant benefit is the restriction on food intake due to the smaller stomach pouch created during the procedure. Additionally, this surgery induces 'Dumping Syndrome,' discouraging sugar consumption by causing discomfort after sugar consumption. While unpleasant, Dumping Syndrome is not dangerous and proves effective in modifying behavior and reducing sugar intake. This procedure is particularly beneficial for cases of uncontrolled diabetes and significant reflux disease.

Medical Professionals:
Surgeon: Dr. Justin Greenslade
Hospitals: Brisbane Private (Spring Hill), Greenslopes Private (Greenslopes)

Mini Gastric Bypass Surgery, also recognized as Single Anastomosis Gastric Bypass or the Omega Loop Gastric Bypass, serves as an alternative to the traditional Gastric Bypass Surgery.

While maintaining a restrictive nature, this procedure is comparatively simpler and can be completed in less time than the Roux-en-Y Gastric Bypass option. Theoretically, Mini Gastric Bypass Surgery may lead to fewer complications.

Experiencing a recent resurgence after its popularity before the 1970s, this procedure has regained prominence thanks to advancements in keyhole surgery, offering a swift and efficient gastric bypass alternative. It proves to be more effective in weight loss as it eliminates the food channel, albeit at the potential cost of biliary reflux.

Procedure for Mini Gastric Bypass Surgery:
During this procedure, the stomach is divided with a stapler, resulting in a substantial portion of the stomach no longer being attached. The newly formed, smaller stomach will bypass between 2 to 7 feet of intestines.

The detached larger portion of the stomach will continue to produce digestive juices, aiding digestion, but it will no longer come into contact with food. This procedure involves less re-routing of intestines compared to regular gastric bypass surgery, with one fewer anastomosis (intestinal connection).

Benefits of the Omega Loop Gastric Bypass:
This procedure yields significant weight loss results comparable to or even surpassing those of traditional gastric bypass surgery. The likelihood of complications is lower due to the technically simpler surgical process for the surgeon.

Since the original stomach remains in the body and functional, this procedure is easily reversible if necessary. Recognizing the numerous benefits it offers, our weight loss clinic in Brisbane presents this procedure as a valid and advantageous option for weight loss.

Surgeon: Dr. Justin Greenslade
Hospitals: Brisbane Private (Spring Hill), Greenslopes Private (Greenslopes)

In certain instances, a revision may be necessary due to clinical reasons and weight regain.

We offer various options and are happy to provide our recommendation and assessment for undergoing a secondary procedure. Positive transformations from a Gastric Band to Roux-En Y Gastric Bypass (RYGB) include:

- Outstanding results, with over 85% excess weight loss, even in patients who have only experienced minimal weight loss with the gastric band.
- Enhanced sense of fullness (satiety) compared to band patients due to a reduction in stomach size and capacity.
- Superior appetite suppression.
- Possible laparoscopic completion in a single step (Band to Bypass).
- Comparable recovery time to a primary procedure.

As the popularity of this approach to surgical weight loss has grown in Australia, so have the associated problems and complications. Issues such as band slips, erosions, inadequate weight loss, or weight regain have become prevalent concerns that weight loss surgery practitioners must address. An overlooked yet crucial issue is the long-term complication and failure rate of these devices.

Reports in the literature indicate that 10 years after surgery, up to a 25% explantation (removal) rate, a 10% rate of re-operation to address complications or technical problems, and a 40% failure rate (not achieving sufficient weight loss) were observed in Gastric Band patients. With over 400,000 adjustable gastric bands implanted worldwide, this presents a significant problem.

Our approach to converting a Band to a Gastric Bypass:

Due to the unique issues with the gastric band, forward-thinking bariatric surgeons have implemented strategies and algorithms to manage failures and complications. Substantial evidence suggests that converting a failed band to a bypass is somewhat superior, yet sleeve gastrectomy is our preferred initial surgical option. However, the choice of operation is ultimately yours, provided you understand all the risks, benefits, advantages, and disadvantages.

Interestingly, a high incidence of patients complaining of "troubled eating" (pain with swallowing, regurgitation, heartburn, or reflux) was observed, even in those who successfully lost weight with the band. These symptoms often disappear when converted to RYGB or VSG.

For 'banded' patients unsuccessful in losing an adequate amount of weight, many reported discomfort with consuming dense foods (chicken, steak, and broccoli), leading them to opt for "soft" calories such as mashed potatoes, cookies, ice cream, and pasta, making it essentially impossible to reach their surgical weight loss goals.

What to expect when converting a Band to Roux-En Y Gastric Bypass:

We have been performing revisions from the adjustable gastric band to RYGB since 2011. The results in terms of %EWL, reduction of appetite, and overall sense of satiety have been comparable to internationally accepted levels, essentially mirroring patients undergoing RYGB as a primary procedure.

Most of our patients have found that RYGB produces little or no episodes of "troubled eating," such as pain and vomiting, and is universally superior in terms of satiety and appetite suppression compared to their Band.

Given that every patient is unique, our surgeons customise a team-approached post-operative plan. Our multidisciplinary team implements a strategy to guide you on the path to success in Making Change Real.

Additionally, we provide the following options:

- Band to One Anastomosis Gastric Bypass (OAGB)
- Band to Sleeve Gastrectomy (Two Steps)
- Sleeve to Bypass

Surgeons: Dr. Justin Greenslade
Hospitals: Brisbane Private (Spring Hill), Greenslopes Private (Greenslopes)

Surgeon: Dr Justin Greenslade
Hospital: Brisbane Private (Spring Hill), Greenslopes Private (Greenslopes)