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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.

Lap band surgery is typically performed laparoscopically. This involves entry into the abdomen through minimal access. Three small incisions (ports) are made in the anterior abdominal wall and used for the insertion of a camera and instruments. A silicon band is fixed to the upper stomach portion so as to cause compression. This converts the entire organ into a small pouch capable of holding just a small amount of food.

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 When water is injected the compression increases and when it is withdrawn, it reduces.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.

Experts recommend that the ideal candidate should have a body mass index (BMI) of at least 40. However, if they have some conditions that may have been contributed or worsened by excess weight, then a lower value of BMI may be considered. The reason for this is that bariatric surgeries may help slow the progression of such conditions. Examples include sleep apnea, gastro esophageal reflux disease, diabetes and hypertension among others.

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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