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.

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.

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.

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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