Surgery
At the Cape Town Bariatric Clinic, we offer two types of bariatric/metabolic surgery:
Laparoscopic Roux-en-Y Gastric Bypass (also known as a Gastric Bypass)
Laparoscopic Sleeve Gastrectomy
Who Qualifies for Surgery?
Bariatric surgery is indicated in people with a Body Mass Index (BMI) of 35-39 who have one or more specific weight-related comorbidities, and people who have a BMI greater than 40, with or without comorbidities. In exceptional cases, we might consider surgery on patients with type 2 diabetes who have a BMI of greater than 30, although generally most medical aids would not cover this.
A person’s BMI is calculated by dividing their weight in kg by their height in metres squared.
What Types of Operations Are Available?
At the Cape Town Bariatric Clinic, we offer two types of bariatric/metabolic surgery:
Laparoscopic Roux-en-Y Gastric Bypass (also known as a Gastric Bypass).
This is considered the gold standard of bariatric operations worldwide. The operation is performed through five small incisions (keyhole surgery) to create a small stomach pouch. The stomach pouch is joined to the small bowel in such a way that a portion of the small bowel is bypassed. The Gastric Bypass is associated with significant changes in hormonal secretion by the intestine, which in turn increases a person’s metabolic rate, improves the way our bodies metabolise nutrients, and has significant effects on the satiety centre in our brain. This causes us to feel full after small meals, and burn up energy more rapidly. One can expect remission of type 2 diabetes from 24 hours to 12 weeks post operatively.
Laparoscopic Sleeve Gastrectomy
Another excellent option for bariatric surgery. This operation is also performed through five small incisions (keyhole surgery). About 90% of the stomach is stapled off and removed, leaving a thin stomach sleeve (gastric sleeve). The surgery works by restricting the amount of food that can be eaten and stored in the thin stomach sleeve.
Both of these operations take about 100 minutes to complete, and patients typically spend three nights in hospital after surgery.
In deciding upon which of these two operations to choose, we would consider a patients BMI, comorbidities, as well as the patient’s choice of procedure.