What is the safest form of weight loss surgery - Healthier Weight

What is the safest form of weight loss surgery?

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We can confidently say that all of the bariatric procedures that we offer are safe and the gastric band, being the least invasive, is the safest weight loss surgery of all.

In fact, bariatric surgery is one of the safest forms of surgery today with very low mortality rates across the country. The mortality rate for the gastric band among Healthier Weight patients is 0%. Indeed, that’s the same for all of the weight loss procedures that we offer.*

The first gastric band was implanted over 25 years ago when the two predominant weight loss procedures were the open vertical banded gastroplasty (VBG) and Roux-en-Y gastric bypass (RYGB). At the time, these two were associated with high morbidity and mortality, whereas the gastric band offered the prospect of a safe and effective alternative.

Each weight loss procedure has its own unique benefits. The gastric sleeve helps people lose weight by changing their appetite and changing gastric emptying. The gastric bypass is the most powerful procedure, patients can expect to lose about70% of their excess weight in a two year period and maintain this in the long run. It also has the most profound effect on people who are suffering ill-health as a result of their weight. The ESG is is a younger non-surgical procedure, with low complication rates. The main benefit of the gastric band is that it is reversible, minimally invasive, effective and boasts lowest complication rates of any of the surgical options.

Your success with the band depends on how well you are able to adapt to the diet and eating regime required for success. As a guide, you can expect to lose 50-60% of your excess weight over the first 2 years although many patients will do much better than this (see before and after photos and stories from successful gastric band patients here).

This weight loss would normally be a little higher with the sleeve and bypass, but one has to remember that the gastric band is fully reversible and a much less invasive option.

The statistics

We like to be totally transparent with our surgical outcomes and for this reason, we publish them in peer-reviewed publications. We’re proud of the results we achieve which compare favourably to the best centres around the world. Here’s a summary of Healthier Weight complications data, based on a study of 2,246 gastric band patients followed over a 9 year period.

  • Operative mortality – 0% (this means no-one died)
  • In-hospital returns to theatre – 0 (no-one returned to theatre whilst in hospital)
  • Rate of all complications requiring re-operation – 4.2% (over 9 years)
  • Slippage or pouch dilatation re-operation rate – 1.5% (over 9 years)
  • Band removal rate – 0.5% (over 9 years)

Gastric banding in the NHS

The number of bariatric surgery procedures done by the NHS has been declining each year. Back in 2007, the NHS carried out 12,000 weight loss procedures, however, in 2018 that figure has significantly reduced to 4,500. That’s the number across all types of weight loss surgery! The latest data shows that an average of 5,000 procedures are done each year on the NHS. Read our article ‘Can I get weight loss surgery on the NHS‘ to understand why.

The gastric sleeve is the fastest growing weight loss procedure around the world, and it accounts for more procedures on the NHS than any other. The primary reasons for this are that it offers significant and rapid weight loss, relatively short operating times (its simpler surgery than a bypass|) and the aftercare requirement is less onerous than that for the band. It is also effective in controlling weight-related health problems such as type 2 diabetes and sleep apnoea (even though the data show that bypass is even more effective).

Video: How my health improved after weight loss surgery

The truth is that out of all the weight loss procedures, the gastric band requires the most aftercare. You benefit from a lower risk procedure but to get the best from it you really need to engage with the diet and aftercare programme.

What are the risks of bariatric surgery in general?

When compared to the risks of living with obesity, for most people the risks of bariatric surgery are minimal. Obesity can cause major health problems and disease including diabetes, coronary heart disease, some types of cancer and ultimately increase the likelihood of premature death.

Losing weight can also have a hugely beneficial impact on quality of life, improving mood and reducing depression. It can help women who are struggling to fall pregnant due to PCOS (polycystic ovarian syndrome) and it is proven to reduce reliance on blood pressure and asthma medication. Many will also see improvement or resolution of their liver disease and dyslipidaemia (abnormal blood fats).

Patients who undergo bariatric surgery, and make a commitment to it, see a significant improvement in their overall health – leading to a longer, happier and healthier life.

Perhaps the question shouldn’t be “how safe are gastric bands?” but “how safe is not having a gastric band?

All of the weight loss procedures that we offer are done laparoscopically (via keyhole surgery), which massively reduces the risk of complications when compared to open surgery. This significantly benefits recovery times and means that scarring is kept to an absolute minimum.

Below is a table that compares the complication and re-operation rates of all of the weight loss surgery procedures that we offer.

What is the safest form of weight loss surgery? Table comparing complication and re-operation rates of all weight loss procedures.

The safest weight loss procedure is widely regarded as being the laparoscopic gastric band. It’s certainly true to say that if we are considering mortality and complications during surgery and in the period immediately after it. This is partly because of the nature of the procedure itself.

Unlike the sleeve and bypass, it does not require the stomach to be cut. This alone removes those risks that are associated with stomach contents leaking from staple lines. The other factor is that the band is generally favoured for the smaller and lower-risk patients.

Patients who are in very poor health due to their weight or who have higher BMI (50+), are generally recommended to have sleeve or bypass. By comparison therefore those people who have bands tend to present a lower surgical risk regardless of the procedure.

If we look a little further ahead the picture differs slightly. There will be a proportion of band patients who struggle with the eating regime it requires for success. This can lead to an over tightening of the band to compensate which in turn can lead to later complications such as the pouch becoming stretched or symptoms similar to those associated with reflux. Both can lead to the band needing to be removed. 

Even with later complications included its fair to say that the band is the safer procedure, not least because most band complications can be treated with a scheduled revision procedure. That is not the case with some of the later complications that can occur with sleeve and bypass, such as staple line leakage and internal hernia.

One of the newer procedures that is also very safe is the ESG, the ‘non-surgical sleeve’. Although it is not strictly speaking surgery, because it’s done endoscopically (the stomach is accessed by packing a tube through the mouth into the stomach), it is nonetheless done in an operating theatre under general anaesthetic. The initial results for this procedure are very encouraging and like the band, it doesn’t require the stomach to be cut.

So, if you are looking for the safest procedures for significant weight loss, they are gastric band and ESG.

Ultimately, risk varies from patient to patient. No two patients are the same. Therefore, the best way to get an understanding of the surgical and non-surgical procedures that are available is to schedule a consultation with a surgeon. They will take account of your medical history and make a recommendation that takes account of your personal circumstances.

Martyn Berrett, former Healthier Weight Managing Director

If you’re thinking of having weight loss surgery but aren’t sure which procedure is right for you, why not call the Healthier Weight team on 0800 313 4618 to get some information on the surgical and non-surgical treatment options available to you, or click the button below to get a quote.

*Healthier Weight statistics correct as of 22/09/20

Article by Mr Rishi Singhal MBBS, MRCS, FRCS, MD

Last review: 22/09/2020. All content on this page is reviewed by a multi-disciplinary team lead by Mr Rishi Singhal.

Picture of Rishi Singhal

Rishi Singhal

Rishi is an expert bariatric surgeon based in the West Midlands and also Medical Director at Healthier Weight

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