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Important Aspects Of 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.

These two surgeries are slightly different in the way in which they are done but their effect is the same; they all reduce the size of the stomach. As a result the amount of food that can be eaten during a single meal is markedly reduced. Most of what is consumed is used for energy provision and very little ends up as stored fat. Over time, there is net weight loss. The main difference that exists is that lap band is temporary (reversible) while gastrectomy is permanent.

Lap band surgery is usually conducted using a laparoscope. This is an instrument that makes it possible to enter the abdomen through minimal access. A silicon based band is placed on the upper section of the stomach such that it compresses the area and reduces the organ to a small pouch. Approximately one ounce of food can be held by the pouch after a single meal.

The surgery is generally safe but one needs to be aware of the potential complications. Nausea, vomiting, bleeding and aversion to food are among those that are most likely to be seen. To reduce nausea and vomiting, the compression by the band is reduced so that the stomach size increases slightly. This is done by drawing saline from a plastic tube joined to the band.

In sleeve gastrectomy, surgical resection of the stomach helps to reduce it by as much as 80%. The resultant stomach takes the shape of a sleeve (hence the name). Due to the reduction in capacity there will be early satiety and generally a reduction in consumption of food. The other benefit of this transformation is the fact that transit time is greatly reduced and so is the absorption of nutrients.

Generally, surgical weight loss surgery is most beneficial in persons with a body mass index (BMI) of more than 40. In case they have weight related complications such as diabetes, hypertension, sleep apnea and gastro esophageal reflux disease, a lower BMI may be considered. Bariatric surgeries have been shown to reduce the symptoms associated with these conditions.

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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