With super-obese people, we know that there can be limited success of gastric banding. Often we have found that it is a major struggle just to get the needle to hit the port for gastric band adjustments.
Gastric bypass is well known to be a far more effective weight loss procedure for the super-obese. However, it is much more difficult to perform.
The sleeve gastrectomy was developed as the first stage of the gastric bypass or a bilio-pancreatic diversion. It is relatively easy to perform and often will help the super-obese lose weight on its own. Super-obese is defined as patients with a body mass index greater than 50. For most patients, the sleeve gastrectomy will suffice but in some, a second stage operation to convert to gastric bypass is necessary.
The choice of the appropriate weight loss operation is complex and an individualised approach is best.