Types of Surgery & Guidelines for Revisional Surgery
Types of Surgery offered at Bedfordshire Metabolic Institute
- Sleeve Gastrectomy
- Roux-en-Y Gastric Bypass (RYGB)
- One Anastomosis Gastric Bypass (OAGB)
- Duodenal Switch
In some circumstances we can offer a gastric balloon or gastric band for patients that may not be clinically suitable for surgery.
Revisional Surgery on clinical grounds
Although bariatric surgery is the most effective long-term weight loss solution for people living with obesity, there are occasions when patients can develop complications from a previous operation. In most cases the problem can be simply addressed with changes to diet and lifestyle.
Where it is not possible to address these problems through lifestyle changes, we can offer revisional surgery in certain scenarios. In some cases, exceptional funding may be required.
The examples of revisional surgery covered by the NHS include:
Some of the common complications following Gastric Band surgery are vomiting, difficulty swallowing, band slippage, failure to lose weight or infected bands. The NHS will cover patients to have their gastric band removed irrespective of whether the band was placed in the NHS, in the UK privately or abroad privately. However, it does NOT cover private patients who want the Gastric Band adjusted or the Gastric Band inflated with fluid to give more restriction. Following the band removal, if private patients would like to be considered for other bariatric surgery such as Sleeve Gastrectomy or bypass, they would have to go the usual Tier 3 and Tier 4 referral pathway. Removal of the band in our service, does not automatically enter the patient into the Tier 3 pathway, nor does it enter the patient onto a waiting list to have a sleeve or bypass. The patient would not be covered for any other follow up under our services.
If a patient experiences symptoms from a gastric balloon (typically abdominal pain, nausea, vomiting) or if the balloon has burst, the NHS will cover the patient to have it removed (irrespective of whether the balloon was inserted in the NHS, privately in the UK or abroad) but it will not fund re-insertion of the balloon or follow up for patients.
Some patients suffer from acid reflux after sleeve gastrectomy. If acid reflux is not settling with medication, there may be a need to convert the sleeve gastrectomy to a Roux-en-Y Gastric bypass which is effective in treating the symptoms of reflux. Some patients may suffer from severe bile reflux into the stomach or oesophagus after a ‘mini bypass’. If the bile reflux is not settling with medication, there may be a need to convert the mini bypass to a Roux-en-Y bypass. The NHS will cover all patients who have had a sleeve gastrectomy or ‘mini bypass’ (either NHS, UK privately or abroad privately) to have a conversion to a Roux-en-Y Gastric Bypass to treat the reflux. However, it does not cover follow up for the patient after surgery. Also, please note that a conversion to a bypass does not result in any significant weight loss and the operation is purely to treat reflux symptoms.