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.

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).

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.

Although the surgery can be performed in any patient, there are a number of situations in which risks outweigh the benefits. For instance, if the patient has hormonal imbalance involving metabolic hormones they are likely to have poor outcomes. Examples include uncontrolled diabetes and hyperthyroidism. These conditions have to be managed first before the operation is carried out. Gastrointestinal diseases such as peptic ulcers and inflammatory bowel disease may also affect the results.




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