Saturday, May 21, 2016

What One Should Know About 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 When water is injected the compression increases and when it is withdrawn, it reduces.

Sleeve gastrectomy reduces the size of the stomach to between 20 and 25% of the original. The shape becomes tubular and closely resembles a sleeve. With a reduction in the capacity, the amount of food that one can eat also reduces markedly. In addition, there is a reduction in the transit time of food within the gut hence less absorption of nutrients.

The ideal body mass index, BMI, of a potential candidate should be more than 40. For persons that are already suffering from conditions believed to be caused or aggravated by excessive weight, a lower BMI is usually considered. Examples of these conditions include sleep apnea, esophageal reflux disease, hypertension and diabetes among others. Research has shown that surgery helps reduce the severity of these conditions.

There are some situations in which these operations are deemed unsafe. In case one has hormonal imbalance (as is the case of hypothyroidism), the surgery is usually postponed until the condition has been treated. Other high risk situations include the presence of gastrointestinal diseases such as peptic ulcers, esophagitis and inflammatory bowel disease among others.

Typically, the surgery is done as a day case which means that one can be released from the hospital on the same day. In a few cases, one may be kept on the hospital for between 24 and 48 hours for observation. A liquid dies is recommended for the first two weeks after the operation so as to allow for proper healing of the stitched regions on the stomach (in the case of gastrectomy).




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