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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.

You need to have a discussion with your doctor before choosing between the banding procedure and gastrectomy. Benefits and risks need to be considered for one to make an informed decision. In general, the main similarity between these two techniques is the fact that both can be done by accessing the abdomen through the laparoscopic technique or through the open technique. The main difference is that banding is reversible while gastrectomy is not.

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 the removal of part of the stomach. Up to 80% can be removed in a single operation reducing the organ to just a small pouch. The new shape is similar to a sleeve (hence the name). Most surgeons prefer the laparoscopic technique over the open method due to the lower risk of complications associated with the former technique. The remaining part is usually stitched using surgical sutures or staples.

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.

A reduction in the stomach capacity results in a reduction in the amount of food intake. Related to this is the fact that there is early satiety and suppression of appetite. Removing part of the stomach significantly reduces the surface area that is available for absorption of nutrients. All these changes cause weight loss that begins to be seen within weeks or months.

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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