Weight Loss Surgery

Your introductory visit to your surgeon will cover a lot of ground. Before any decision is made about surgery, you will meet a number of the other team members, including dietician, psychologist, and endocrinologist.

For most people, surgery will be performed by a minimally invasive method, usually by means of a laparoscope (keyhole surgery). Some of our surgeons also do robot-assisted bariatric surgery.

The weight loss operations recognised as effective by most surgeons include Roux-en-Y gastric bypass, sleeve gastrectomy and gastric banding (adjustable or non-adjustable). Our bariatric team uses the procedures with the highest long-term success rates.

Weight reduction surgery has been reported to improve conditions such as sleep apnea, diabetes, high blood pressure and high cholesterol. Many patients report an improvement in mood and psychosocial functioning after gastric bypass or gastric sleeve treatment.

Our treatment method is inclusive so you will be involved in every step of the plan. 

We will guide you through the early stages, helping you understand and implement your pre-operative diet.
Our multi-disciplinary team will work with you to ensure that you are physically and mentally ready for your gastrectomy or gastric bypass surgery.
Your hospital team will be multi-disciplinary in approach, with specialist nursing, physiotherapy and consultant supervision throughout.
You will be discharged with a thorough understanding of your post-operative plan -  that is when your work starts.
With our continued support for the next two years, you will learn to embrace and love your new lifestyle.

Your introductory visit to your surgeon will cover a lot of ground. It may take some time, so please prepare for this. You will meet the surgeon and dietitian and undergo a comprehensive medical assessment, covering your general health history and expectations.

The information assimilated will help the surgeon determine whether other tests and specialist consultations are required prior to becoming a candidate for gastric bypass surgery or sleeve gastrectomy. You may progress to meet a number of healthcare professionals in advance of surgery should that prove necessary. 

Please make a list of any questions you may have in advance. You may also benefit from bringing a friend or relative along with you should you wish. 

Following all evaluations, if deemed suitable for gastric bypass or sleeve gastrectomy, a pre-operation plan is arranged, including both pre and post-operative diet education. 

There are numerous different types of bariatric surgery. We have chosen the weight loss procedures which we feel are the most beneficial to our patients, bearing in mind the advantages and disadvantages of each procedure.

When you have been given a positive evaluation for gastric sleeve or gastric bypass surgery, a preoperative plan and dietary regime will be arranged in the lead-up to the operation date.

You will need to follow a low-carbohydrate diet plan for the two weeks preceding your operation. This eating pattern is designed to increase the chance of your surgery being performed laparoscopically (by keyhole).

Most of our patients experience weight loss surgery by minimally invasive techniques (laparoscopic surgery). This allows smaller abdominal incisions, offering the advantages of reduced post-operative pain; shorter hospital stays; fewer wound complications; faster recovery times.

However, for a small number of patients, this method might not be an option. In such a case, your surgeon will choose the "open" method. This may be recommended to minimise the risk of complications in certain circumstances. There are several factors which may contribute towards this decision, such as dense scar tissue caused by previous abdominal surgery.

The Roux-En-Y Gastric Bypass (pronounced roo-on-y) procedure involves dividing the stomach and using part of it to form a small gastric pouch. Then instead of the normal outflow to the duodenum, a direct connection is made between the new small stomach and further down the small intestine. This effectively bypasses 5-8 feet of bowel, meaning less food and nutrients are absorbed. The stomach is not actually removed, just bypassed.

Robotic surgery is a new and exciting development. The surgeon still does your surgery, but the robot drives the instruments in a more precise and efficient manner. The robotic-assisted instruments are usually inserted through small keyhole incisions in the abdomen but occasionally can be used in open surgery.

The Sleeve Gastrectomy involves the removal of at least 75% of the stomach. This changes it from a round, bag-shaped structure, to a shape more like a tube or a banana.

Long term studies show that the gastric band is not as effective as other weight loss surgeries. Patients have been found to require more surgeries and have lower rates of weight loss.

The health benefits of Gastric Bypass include:

• 70 -75% average estimated excess body weight loss 
• Approximately 70% reversal of diabetes 
• 60 % resolution of sleep apnoea
• Improved mobility 
• Resolution of acid reflux 
• Improved fertility for females 

• Reduced post-operative pain 
• Shorter hospital stay 
• Fewer wound complications 
• Return to work 2-3 weeks 

Positive health benefits to sleeve gastrectomy surgery include:

• 60 -70 % average estimated excess body weight loss
• Approximately 70% reversal of diabetes
• 60% resolution of sleep apnoea
• Improved mobility
• Resolution of acid reflux
• Improved fertility in females 

• Reduced post-operative pain 
• Shorter hospital stay 
• Fewer wound complications 
• Faster return to work 

Under current Irish insurance rules, to be eligible for bariatric surgery you should have a BMI over 45 or over 40 with weight-related medical conditions. Current international guidelines stipulate a BMI of over 40 or over 35 with weight-related medical conditions. If you are self-paying, the international guidelines will apply. Surgical, medical, psychological and dietary evaluations are all usually required prior to deciding if you are eligible.

Use our simple body mass index (BMI) calculator for an overview of whether you qualify for weight loss surgery. 

A thorough multidisciplinary evaluation to determine if you are a candidate for sleeve gastrectomy or gastric bypass surgery, which includes nutritional, psychological and consultations from other medical specialists if deemed necessary. In addition, you are required to quit smoking prior to surgery.

In a small number of patients, the laparoscopic method cannot be performed. Factors that may increase the possibility of choosing or converting to the "open" procedure may include a history of prior abdominal surgery causing dense scar tissue, inability to visualise organs or bleeding problems during the operation. When the surgeon feels that it is safest to convert the laparoscopic procedure to an open one, this is not a complication but rather a sound surgical judgment. The decision to convert to an open procedure is strictly based on patient safety.

You will arrive at the hospital on the morning of the operation. Preparation for surgery includes changing into a hospital gown. Pre-operative medications may be necessary including a blood thinning injection to reduce the risk of clots. You will also meet the anaesthetist in advance of your surgery.

The success rate for weight loss is reported as being slightly higher with the gastric bypass than the sleeve gastrectomy but both techniques have shown excellent results. Most reports show a 50% or greater excess weight loss after one year. Weight loss generally continues for all the procedures for 18-24 months after surgery. Some weight gain is common about two to five years after surgery.

Bariatric surgery can produce a sudden positive change in your fertility. Women who become pregnant after any of these surgical procedures need special attention from their doctors and clinical care team. To protect women and their babies from potential malnutrition, doctors recommend that women not get pregnant until 18 months after sleeve gastrectomy or gastric bypass surgery.

Typically, you will remain an inpatient for 2-4 days after gastric sleeve or gastric bypass, during which you will participate in breathing exercises and chest physiotherapy. It is important that you continue with these exercises when you return home. 

You will receive pain medication when you need it, although pain after laparoscopic surgery is generally mild.

Prior to going home, you will begin a three-week course of subcutaneous injections of a blood thinner to protect you from clots.

When you leave the hospital, you will be encouraged to walk and engage in light activity. You will probably be able to resume most of your normal activities within one to two weeks, such as showering, driving, walking up stairs, work etc.

You will receive a comprehensive diet plan for the weeks after your operation, and it is essential that you stick to the guidelines. You will also be given information regarding vitamin and mineral supplements which you must take as part of your new regimen. 

The procedures available are proven to be safe, although complications can occur in the short or longer term. You will leave the hospital with all the information and contact numbers you need, along with a follow up appointment date. 

Endocrinology is the study of medicine relating to the endocrine system, controlling hormones. As well as overseeing your care relating to diabetes, the endocrinologist covers a wide range of bodily functions including respiration, metabolism, fertility, sensory perception and movement. 

A dietitian will be with you at every stage of your gastric bypass or gastrectomy treatment. You will be educated in your pre-operative diet, and staged post operative eating requirements, along with essential vitamin and mineral supplementation.

After surgery, you will need to participate in breathing exercises and chest physio. A chartered physiotherapist will visit you soon after surgery and begin a course of exercises. You will be tutored on how to continue the exercises at home.

Excess weight gain will have added stress to your heart and vascular system, and you will probably be suffering from conditions such as high blood pressure, high cholesterol and "venous stasis". This is a medical condition in which veins are unable to pump enough blood back to the heart and is a risk factor for forming blood clots. Our cardiovascular team is one of the strongest in Ireland and will be a constant presence during your gastric bypass or gastrectomy treatment.

The risk of chronic respiratory diseases increases with excess weight gain. COPD, asthma and obstructive sleep apnea are common associations. Our respiratory physician will oversee your recovery and ensure your well-being throughout. 

Your decision to enter into weight loss surgery has enormous implications for your future lifestyle. Your understanding, your strengths, and any weaknesses will be assessed so that we may guide and support you in your choice to undergo gastric bypass or sleeve gastrectomy treatment.

You will need a referral letter from your GP or consultant before you make an appointment

Under current Irish insurance rules, to be eligible for bariatric surgery a patient should have a BMI over 45, or over 40 with weight-related medical conditions. If you intend to apply to your insurer for cover, this is one item they will use in their pre-authorisation process. Your surgeon will present your medical case to your insurance company, allowing them to assess and pre-authorise your cover for sleeve gastrectomy or gastric bypass surgery.

All facilities are available to patients with health insurance, on a self-paying basis, or a combination of both. It's important to consider that patient shortfalls are waived on many plans. 

If you want to find out how you are covered, discuss the pre-authorisation process, or talk to us about self-funding gastric sleeve or gastric bypass prices, please contact us at the details below.

If you do not have health insurance or your health plan does not cover the full cost, you will need to pay the balance due before your treatment or procedure. You may be able to claim back some fees on your insurance. To pay an excess not covered by your insurance or any other inpatient fees, please visit our payment page. If you have any queries about paying for your care, please contact the finance team in your hospital.