Streamline's specialists offer a full range of procedures to suit individual patients' needs. Before a choice is made, it is vital that the patient is fully assessed and informed by a specialist.

In addition to the standard procedures, Streamline surgical specialises in revision (re-do) surgery for failed or complicated previous procedures.

A brief summary and comparison table shows the main differences between the operations performed.

GASTRIC BALLOON

A plastic balloon is inflated in the stomach to give the feeling of being full. The procedure is carried out using endoscopy. After 6 months the balloon must be removed to avoid injury to the stomach. The procedure can be repeated at a later date. Although the procedure is usually safe, it is not permanent and weight gain after removal of the balloon is not unusual.

LAPAROSCOPIC AJUSTABLE GASTRIC BAND

This is classed as Intermediate internal surgery. The procedure requires a general anaesthetic and keyhole surgery. A plastic inflatable 'ring' is placed around the stomach and is attached to an access port placed under the skin. When correctly tightened the band causes a feeling of fullness after eating and restricts food intake. Dietary discipline, patient commitment and good follow up are needed to achieve good weight loss. In the 'right' patient weight loss at three years can be similar to gastric bypass. Of the surgical procedures, it is the safest, with the shortest recovery period and is fully reversible with laparoscopic surgery.

SLEEVE GASTRECTOMY

This is classed as major internal surgery. The procedure requires a general anaesthetic and keyhole surgery. The stomach is cut and approximately 80% is removed leaving a narrow stomach tube to carry food. Although the recovery is usually short, there is greater potential for complications than with laparoscopic adjustable gastric banding. Long term, the tube may stretch and weight gain can be an issue. If this happens, it not possible to convert a sleeve gastrectomy to a roux-en Y gastric bypass; instead a duodenal switch procedure would need to be performed. Fat-soluble vitamin deificiency and osteoporosis are potential long term complications of the duodenal switch procedure. It is not not adjustable or reversible..

GASTRIC BYPASS

This is classed as major internal surgery. The procedure requires a general anaesthetic and keyhole or open surgery. Not all patients are suitable for keyhole surgery. The stomach is made smaller by stapling and the first part of the small intestine is 'bypassed' by a short circuit of the small intestine. Regular follow-up, with dietetic counselling, is needed for at least a year. Worldwide, roux-en-Y gastric bypass remains the most commonly performed obesity operation. In terms of good long-term weight loss without nutritional deficiency it remains the gold standard, which other procedures try to match. Although usually safe and straightforward, the risk of death and post-operative complications is greater than for laparoscopic adjustable gastric banding. It is not easily reversed and long-term recurrent abdominal pain and intestinal obstruction due to adhesions or internal hernias can be a problem.

REVISION SURGERY (RE-DO OPERATIONS)

Unfortunately, not all bariatric procedures are successful and some need to be revised. Our extensive experience of bariatric surgery has enabled us to specialise in revision surgery for patients with failed or malfunctioning obesity surgery procedures. Revision operations can be complex and require individual assessment and discussion.