Understanding Lap-band And Laparoscopic Sleeve Gastrectomy

By Timothy Brown


Bariatric surgeries are becoming a preferred mode of weight loss all over the world include New York City. The reasons behind this are the increase safety and effectiveness of these procedures. Three main types of weight loss surgeries are performed: gastric banding, gastric bypass and sleeve gastrectomy. Both similarities and difference exist among these techniques. Lap-band and laparoscopic sleeve gastrectomy are associated with better outcomes than the bypass procedure.

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.

To choose between banding and gastrectomy, one has to fully understand the benefits and risks associated with each of them. One of the major similarities is that both of them can be effectively performed using the open technique or laparoscopy. The major difference is that in gastrectomy the stomach has to be cut surgically while no cutting is involved in banding. For this reason banding is reversible while gastrectomy is not.

During the open procedure, a large incision running from the epigastric area to the pubic region is made. The surgeon can visualize the stomach through this incision and place the band directly. When the laparoscopic option is used, on the other hand, very small incisions are created in the anterior abdominal region. These incisions (also known as ports) are used for the entry of instruments.

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.

These surgeries are associated with various complications. These include blood loss, internal organ injury, nausea, vomiting and infections in the postoperative period. Loss of stitches or staples using in closing the stomach has also been reported in rare cases. Whenever the staples or stitches are displaced, there is a huge risk of acid leakage and subsequent chemical injury to organs (peritonitis).

When the size of the stomach is reduced, the amount of food that can be consumed by an individual is also reduced. Smaller stomachs tend to fill faster hence the individual will experience early satiety. When 80% of the organ is removed, a significant size or the surface area is also removed meaning that the absorptive capacity is reduced. The end result of all these is steady weight loss whose effects will become evident within weeks and 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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