Tuesday, September 13, 2016

Understanding Lap-band And Laparoscopic Sleeve Gastrectomy

By Timothy Brown

Bariatric weight loss surgery is a procedure that has continue to grow steadily in recent times in New York. There are three main types of bariatric surgeries that are performed. These include gastric banding, sleeve gastrectomy and gastric bypass surgery. While some differences exist among these procedures, the manner in which they work is similar. Lap-band and laparoscopic sleeve gastrectomy have the best outcomes hence are the most commonly performed.

Surgical options for weight should only come in when all the other methods have been exhausted. The general recommendation is that conservative options should be tried out for at least 6 months. Dietary modification is one of the approaches that have been shown to be quite effective in achieving weight loss. One should strive to reduce their consumption of fats and carbohydrates and increase that of vegetables and fruits. Regular physical exercise also has a role to play.

The decision to undergo either lap band surgery or sleeve gastrectomy is made by the doctor in consultation with the patient. The choice is made after carefully considering the benefits of each of them. Both can be performed through the open technique or through laparoscopy. One of the major differences between the two is the fact that banding is reversible while gastrectomy is a permanent procedure.

To perform the banding procedure, the abdominal cavity is first opened either through a large incision or by making smaller incisions to be used for the placement of the laparoscope. The next step is to place a silicone band around the upper part of the stomach. This band has a compression effect that squeezes the stomach and reduces its size considerably. The force of compression can be increased or reduced as needed.

Gastrectomy is simply the cutting and removal of a segment of a stomach. In a single operation, between 75 and 80% is usually removed. What is left behind is a small pouch that takes the shape of a sleeve (thus the name of the operation). The laparoscopic method is preferred over the open technique. Once the required part has been cut off, the rest is stitched back using sutures or stitches.

A number of complications may occur following these operations. Excessive bleeding, injury to internal organs and post-operative infections are among the most commonly encountered. In rare circumstances, the staples or stitches used during the operation may come off. Leakage of foods and acids may then ensue and cause chemical injury to other organs. Nausea and vomiting will be experienced if the squeeze of the band is too much.

Reduced stomach capacity translates into reduced intake of food. This is not only due to the smaller quantity of food that can be held at one time but also due to the associated early satiety. A reduction in the surface area of the stomach also reduces the amount of food absorbed. Weight loss begins to become evident within weeks or months depending on the magnitude of the problem.

There are a number of conditions that may increase the risk of these operations. Patients with hormonal imbalance (such as hyperthyroidism) and metabolic conditions (such as diabetes) need to have these problems solved first before they have the operation. Apart from the systemic conditions, diseases that affect the stomach may delay healing and lead to poor outcomes. Examples include inflammatory bowel disease and peptic ulcer disease. These too have to be managed beforehand.

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