Weight loss
If you're reading this, you've probably already tried everything else. The first thing worth knowing is there's no single right procedure. There's a right procedure for you, and finding it starts with a proper conversation about your health, your history and your goals.
A lot of people come in wanting the quickest fix. That's completely understandable. Dr Esh's job is to slow things down for a minute, understand the actual problem you're trying to solve, then match you to the option that works best for the long run. Sometimes that's surgery. Sometimes it isn't. Either way, you'll leave knowing your options and why one suits you.
All weight loss surgery carries risk, and Dr Esh will talk you through that as part of your consult.
Gastric Sleeve
A gastric sleeve reduces the size of the stomach so you feel full sooner and eat less. But there's more to it than removing most of the stomach. Done well, it's about removing the part of the stomach that stretches, while keeping the pressure inside as low as possible.
Dr Esh explains it like plumbing. If you create a high pressure environment, you get problems, reflux being a common one. So the way the sleeve is formed matters, and there are ways to take that pressure off. If a sleeve done elsewhere has caused problems, here are often ways to fix it.
Gastric Bypass
A gastric bypass changes both the size of the stomach and the way food moves through the digestive system. It's often considered when reflux is part of the picture, or when a bypass is likely to suit your goals better than a sleeve. Dr Esh performs the main bypass types and will talk you through which, if any, fits your situation.
SADI-S
SADI-S is a more involved procedure Dr Esh may recommend in select cases of severe obesity, where other procedures aren't likely to achieve enough on their own. Whether it's appropriate is something Dr Esh works through with you carefully.
Had surgery before and hit problems? You're in the right place.
Weight loss surgery doesn't always go to plan, and that's not a reflection on you. Dr Esh takes on revision cases regularly and enjoys this work. That includes:
Whatever's going on, Dr Esh will work out what's going on and talk you through the options to put it right.
Reflux after weight loss surgery
Reflux after a sleeve is common, and it's fixable. It doesn't mean you have to just live with it.
Dr Esh investigates why it's happening. Sometimes there's a narrowing in a particular spot that was too tight when the original surgery was done. Sometimes it's mechanical, sometimes it's anatomy and sometimes it's just bad luck. The cause guides the fix. In many cases, converting to a bypass resolves it.
If reflux has been making life miserable since your surgery, it's worth a proper look.
Non-surgical and other options
Surgery isn't the only path, and Dr Esh is happy to talk through the alternatives, including medical options and the gastric balloon.
He'll be straight with you. People often ask about the balloon because they've heard it's a quick, easy fix. Dr Esh will explain what the evidence says about it, and why he reserves it for particular cases rather than using it as a default option. He's not there to talk you into anything. He's there to give you the full picture so you can make a decision you're confident in.
Every option has trade-offs. The point of your consult is to understand them before you choose.
Not sure where to start?
Know exactly what you need, or just got a problem you want sorted? Book a consult and Dr Esh will help you work out where to go from here.