Tuesday, May 31, 2016

Facts On Lap-band And Laparoscopic Sleeve Gastrectomy

By Catherine Howard

The number of weight loss surgical procedures being done in New York has continued to increase tremendously. Part of the reason for this is the fact that the techniques that are employed have been greatly improved and the procedure is now not only safe but also very effective. Lap-band and laparoscopic sleeve gastrectomy are two of the most commonly performed bariatric operations. It is important that one first tries out lifestyle changes before turning to surgery for weight loss.

The two operations work by reducing the functional capacity of the stomach. The stomach tends to fill faster than before hence there is a reduction in the amount of food eaten. Most of the food that is consumed undergoes metabolism to produce energy and very little is converted to fat. With time, there is net weight loss. The fundamental difference between the two is the fact that while lap-band surgery is can be reversed while sleeve gastrectomy is permanent.

The lap band procedure is usually done using an instrument called a laparoscope. The exact procedure involves minimal access of the abdomen using three small incisions. A silicon band is usually placed on the upper region of the stomach where it causes compression. With the organ now converted into a small pouch, only a small amount of food can be held at any one time.

There are a number of side effects associated with this surgery. They include bleeding (usually minimal), vomiting, nausea and aversion to food. The compression force from the band can be increased or reduced to minimize the symptoms. This is can be achieved by injecting or withdrawing water from a plastic tubing attached to the band. When water is injected the compression increases and when it is withdrawn, it reduces.

In sleeve gastrectomy, surgical resection of the stomach helps to reduce it by as much as 80%. The resultant stomach takes the shape of a sleeve (hence the name). Due to the reduction in capacity there will be early satiety and generally a reduction in consumption of food. The other benefit of this transformation is the fact that transit time is greatly reduced and so is the absorption of nutrients.

Generally, surgical weight loss surgery is most beneficial in persons with a body mass index (BMI) of more than 40. In case they have weight related complications such as diabetes, hypertension, sleep apnea and gastro esophageal reflux disease, a lower BMI may be considered. Bariatric surgeries have been shown to reduce the symptoms associated with these conditions.

There are a number of situations in which bariatric surgery is deemed inappropriate. One such situation is when there is a high risk of complications. Underlying hormonal problems such as hypothyroidism are among the reasons why the procedure may be cancelled or postponed until the problem has been managed. Other examples include gastrointestinal tract diseases such as inflammatory bowel disease, peptic ulcers and esophagitis.

This surgeries are usually done as day cases hence once can be discharged from hospital on the day that they are operated. In a few cases, there may be a need for one to be retained for 24 to 48 hours for observation. You will be instructed to take a liquid diet for about two weeks as the wounds heal. This is especially important in the case of gastrectomy.

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