WLS. Which Operation should I have?

Some clients see me in clinic, knowing which procedure they are best suited to and some come with an open-mind asking me, which operation is the best. Perhaps disappointingly, there is not a best operation; each operation has pluses and minuses, but there is usually an operation which best fits, each client.  


My aim in a consultation, is to help the patient choose the operation, that best fits their needs, to give them the best chance of long-term success. Having said that, I prioritise the patient’s wishes and expectations above everything else. For example, if a client really wants a LAGB, even if I don’t think it is the best operation for them and I’m concerned they won’t get the result they want, after explaining my concerns, I will follow their wishes. I would not want the patient to go elsewhere, because I wouldn’t listen to their wishes, where they might get a less good operation and outcome.


A consultation with me, is quite structured. First, I listen to the patient, to find out why they’re interested in weight loss surgery, which procedure they favour and what they hope to achieve with surgery.  Often ladies want to lose as much weight as possible, while some men are concerned that they might lose too much weight.


I then take a detailed medical history, taking note of any previous operations, past illnesses and medication the client takes. I am especially interested in illnesses the patient, might have related to their weight, which could be improved by weight loss surgery, such as diabetes.


I am interested in the patient’s current diet and past diet; honesty really helps! Often a dietician will support me with this phase of the consultation. Knowing a patient’s average daily calorie intake can be useful. Different patients, have different eating patterns, some are structured in their eating behaviour, some lack structure, always hungry, grazing through the day. Some patients have a sweet tooth, favouring chocolate, sweets, sugary drinks, some have more savoury tastes, carbs, bread, cheese. I’m interested in past success dieting, a person who loses weight well with a moderately low calorie diet, such as weight watchers, may suit a laparoscopic adjustable gastric band, whereas someone who struggles to lose weight with weight watchers or slimming world and only loses weight well with very low calorie diets, such as lighter life may be better suited to a sleeve gastrectomy or a gastric bypass. 


The dietary information, with the medical history, helps me build a profile of the person.

Informed by this dietary and medical profile, I can then discuss each of the procedures with the client, explaining how their diet and lifestyle, are likely to fit with each of the procedures and  the weight loss they are likely to achieve with each procedure. 


I will then move on to a more detailed explanation of usually, the one or two procedures, the client is best suited to. I will explain how I do the procedure, how it works, the usual hospital stay, the recovery period, the risk of complications in the short and long-term. In addition, clients will receive detailed information booklets, which cover everything discussed, about the procedures in the consultation.

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© Guy Slater