Weight Loss Surgery
Weight Loss surgery is surgery designed to cause long-term weight loss. This type of surgery has existed for about 50 years, and has evolved tremendously since the early days of "stomach stapling." One of the most important innovations in the last decade has been the development of the laparoscopic approach to weight loss surgery which Mr Steven Karametos regularly uses in Melbourne Australia. Most operations can now be performed laparoscopically, reducing the amount of postoperative pain and length of hospitalisation.
Bariatric surgery works by multiple mechanisms:
- Restriction: The operation reduces the size of useable stomach; therefore one feels full more quickly after a meal. Most operations reduce the stomach to the size of a small cup.
- Decreased absorption: The gastric bypass is an operation which "bypasses" a significant amount of the stomach and small intestine, causing a limitation in the amount of calories absorbed from food.
- Hormonal effect: The bariatric operations alter the expression of hormones made in the body, particularly ones made by the gastrointestinal tract. This can lead to an alteration in the feeling of hunger. In addition, this hormonal effect is thought to also effect the regulation of metabolism in the body. This is thought to be why bariatric surgery has a profound effect on the resolution of Diabetes and High Blood Pressure. In addition, Bariatric surgery has been shown to improve other obesity - related disorders such as obstructive sleep apnea, gastroesophageal reflux (GERD), and degenerative joint disease. In recent studies, patients undergoing bariatric surgery have also been shown to have improved survival over obese individuals not having surgery.
Weight loss surgery is not a miracle; rather, it is a powerful tool to help you lose weight. In order to achieve the best results, one must also participate in regular exercise. Surgery will help to restrict the amount of calories that one takes in, but it has no effect on the number of calories burned. Successful weight loss surgery requires a lifelong commitment to exercise and fitness to keep the weight off.
Candidate For Weight Loss Surgery
Weight loss surgery is not for everyone. The decision to undergo weight loss surgery is one of the biggest decisions you will ever make in your life. The decision should not be taken lightly. If you have not tried a formal, doctor-supervised dietary regimen, you should join an out-patient weight loss program, or consult with a registered dietitian or nutritionist, or discuss using medications to help you lose weight with your doctor. If these approaches have failed, then weight loss surgery may be an option for you. Before making an appointment to see Mr Steven Karametos who is one of the experienced weight loss surgeons in Melbourne, You should discuss your weight loss options with your GP.
Insurance & Cost
Please note Mr Karametos only accepts privately insured patients for weight loss surgery at present. The out of pocket fee is dependant on many factors however patients do find our fees very fair, often much less than they would have thought. At your initial consultation with Mr Karametos, full financial consent will be provided to you for consideration.
Early Super Release For Weight Loss Surgery
Because it is recognised that morbid obesity and the medical problems associated with it will reduce a person’s life expectancy, and that weight loss surgery is not yet readily available in the public hospital system, the Australian Government allows early access to your or another family member’s superannuation to cover the costs involved in weight loss surgery.
The application for early super release is processed by Centrelink- you will need to fill out an application form, and obtain a written letter of support from both your GP and Specialist. (Mr Karametos will provide his letter of support to you upon request after your initial consultation). The processing time by Centrelink generally takes around 3 weeks, and allow a further 4-6 weeks for your superannuation fund to release the funds to your personal bank account. For more details on the early release of Super to pay for medical expenses click HERE. To download the application form HERE.
Laparoscopic sleeve gastrectomy (SG) also known as laparoscopic gastric sleeve surgery is a procedure in which a portion of the stomach is surgically removed. The procedure is typically performed laparoscopically and is an irreversible procedure. The stomach size can be reduced to as little as 15% of the original size. As a result of this surgery, a person feels fuller upon eating a relatively small amount, body metabolism is altered and the craving for food is reduced.
In this operation, the stomach is cut into a long, thin tube, or a "sleeve." This operation acts mainly by restricting the amount of calories ingested. In addition, since a large portion of the stomach is removed, it alters the expression of hormones in the gastrointestinal tract, leading to an earlier feeling of fullness. Whilst this has proven to be a highly effective and sustainable weight loss surgery, the decision should be considered seriously. Mr Steven Karametos will discuss in detail with you at your initial appointment. Please call our Melbourne office to book an appointment at either Knox Private Hospital or North Balwyn rooms.
The Orbera gastric balloon is a non-surgical, temporary device designed to boost your current weight loss efforts. While it isn’t a permanent device, it allows you to learn portion control and develop healthy changes in your eating habits that can last well beyond the 6 month balloon placement.
Placement of the balloon generally takes around 20 minutes during which you will be lightly sedated. The deflated balloon is inserted into your stomach through your mouth, endoscopically. Immediately after the balloon is placed and filled with sterile salt water, you will regain complete awareness and remain in the clinic for observation until the doctor discharges you. The balloon is removed through the mouth in a similar manner, under the same supervised conditions
The procedure is performed via gastroscopy under light sedation, in which the balloon is inserted into your stomach via your mouth, and usually takes around 20 minutes. After 6 months, the intra-gastric balloon is removed and your support team will continue to guide you toward making healthy lifestyle choices.
In this operation, an adjustable silicone tube is placed around the "neck" of the stomach. When inflated, this tube constricts around the stomach and restricts the amount of food ingested. It is the simplest bariatric operation. The band is adjusted by accessing a device implanted underneath the skin of the abdomen to "inflate" or "deflate" the stomach.
No Gap Lap Band Removal
For privately insured patients, Mr Steven Karametos offers No Gap for Lap Band removal. It means he does not charge patients any out of pocket fees for the Lap band removal, however please note insurance excess may apply.
Weight Loss After Surgery
The average Excess Weight Loss (%EWL) at 3 years after sleeve gastrectomy is 60%. This means that half of the patients will lose less than 60% and the other half will lose more than 60% of their excess weight.
Most of the weight is lost in the first 6 months then weight loss slows down and stabilizes between 9 and 12 months. There will be a normal weight regain of 1-5 kg after the first year due to the expected adaptation. Losing all the excess weight (that is %EWL of 100%) is achieved by only a small percentage of patients and, therefore, is a not realistic goal.
Patients considering weight loss surgery often have unrealistic expectation of the amount of weight they are going to lose. About two thirds of patients considering surgery report that they would be disappointed if they lose only 50% of excess weight, although this level is considered successful outcome. It is therefore important to think about your own goals from having surgery and set achievable goals and manage your own expectations.
The success of Weight Loss Surgery are measured by the following:
- Weight loss alone (as measured by kilograms lost) should not be the sole reason to undergo weight loss surgery.
- Resolution, improvement or prevention of obesity related health conditions (such as type II diabetes, hypertension, sleep apnoea, metabolic syndrome, etc.) is as important as weight loss.
- Even a modest weight loss of 5% of total body weight can improve metabolic factors and health risks.
- Ask yourself this question "What is lowest amount of weight you hope to lose to not feel disappointed?"
- It is important to pay attention to quality of life after surgery. Frequent vomiting or inability to eat good quality food is not worth looking skinny.
- Patient weight loss results vary widely due to many factors as will be discussed during your consultation with Mr Karametos.
Recovery after Weight Loss Surgery
The recovery timeline largely depends on what type of weight loss surgery you have had, Mr Karametos will discuss in details with you before the operation. A general guideline is as follows:
Gastric Sleeve patients:
- Timeline: Hospital Stay: 1 to 3 days. Return to Work: 1 to 3 weeks
- Pain: Managed with pain medication, which is typical for any laparoscopic surgery
- Diet: Slow transition from clear liquids to solid foods
- Activity: Slow transition back to regular activity and exercise
Gastric Band patients: Hospital Stay: up to one day. Return to Work: 1 to 2 weeks.
Gastric Balloon patients: Go home the same day. Return to Work within 3 days.
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