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Weight Loss Surgical Procedures Adjustable Gastric Banding System
Adjustable Gastric Banding Systems - Lap-Band ™ Adjustable Band - REALIZE ™Adustable Band
The adjustable gastric banding has becoming quite a popular weight loss surgical options in the United States, although it has been widely used in European countries for more than ten years. Many are now considering the adjustable gastric banding procedure over the Roux-en-Y or gastric banding procedures as it is less invasive and it is reversable.
Click picture for larger view Adjustable Gastric Banding Video
With the adjustable gastric bandingprocedure, the surgeon places a silicone band around the upper part of the stomach. This placement is critical as it must restrict the portion of the stomach that sends the message to the brain that the stomach is full. The band also slows the passage of food from the restricted stomach to the lower stomach, allowing for the patient to experience fullness for a longer period of time. A small port is positioned into the upper abdoman, directly below the skin. Six to eight weeks following surgery, the patient will return to the office for saline injections into the port. With the injection, the band "balloons," thus causing further restriction on the stomach. On average, the patient will receive between 4-6 fills of saline before their own, individual, optimum restriction is received. Weight loss with the adjustable gastric banding surgery is not as dramatic initially as it's Roux-en-Y or Gastric Sleeve counterparts. The gastric adjustable banding patients, on average, loose 1.5 to 2 pounds per week. The adjustable gastric banding surgery is performed laparoscopically. This procedure, although just finding popularity here in the United States, has been performed in Europe and Australia for the past 15 years. It is a viable alternative to weight loss to those patients who are not at such great BMI risk as well as for patients that are comfortable with loosing their weight at a more gradual pace.
The Roux-en-Y Gastric Bypass surgery has been the most popular weight loss surgery in the United States. In this procedure, the surgeon creates a small stomach pouch and then constructs a “bypass” for food. The bypass allows food to skip parts of the small intestine. With this bypass, fewer calories and nutrient are absorbed by the body. This procedure can be performed either laparoscopically or open. The laparoscopic operation is performed with the surgeon making six, one inch incisions, around the outside of the abdomen. Directed by camera, the surgeon performs the surgery by working around the abdomen with instruments. The open procedure is performed by the surgeon making a 4 inch incision in abdomen. This procedure is often preferred for the higher risk patient as it allows the surgeon easier access to the abdomen. The trend now, however, is with the laparoscopic Roux-en-Y operation as this allows for faster recovery for the patient. There are many advantages for the Roux-en-Y patient following surgery. Although the "why" has not yet been determined, studies show that 83.7% of Type II diabetes is resolves, often days following the surgery. The resolution rate of this procedure does exceed the rate of Type II Diabetes resolved by banding. Additionally, nearly 97% of hyperlipidemia cases, as well as over 75% of hypertension is resolved. Also of note is that of the hypertension cases that are unresolved, 87% of those cases are improved. Studies show that the Roux-en-Y patient looses 61.6% of their excess weight, thus greatly improving their overall health, well being and quality of life. Because the Roux-en-Y procedure bypasses a portion of the smaller intestine, the patient's absorption rate is less. It is important for the patient, following surgery, to supplement with iron and B-12 vitamins to ensure optimal health and to eleviate the possibility of iron deficiency and issues associated with such. The patient must also pay close attention to the portion and content of their diet. Too much sugar, or ingesting too much food at one time, can lead to dumping syndrome. Although dumping syndrome is not serious, it can cause discomfort with vomiting and feeling faint. Diarrhea can also occur. Gastric Sleeve Surgery
The Gastric Sleeve, or vertical sleeve gastrectomy, is the newest kid on the block in weight loss surgery. The gastric sleeve is similar to the Roux en Y gastric bypass although the advantage with this surgery is that it does not involve any bypass of the intesinal tract With the gastric sleeve surgery, approximately 85% of the stomach is divided off and removed, leaving a cylindrical or sleeve shaped stomach. This new stomach can hold only between 60 and 150 cc's. Weight loss is not quite as rapid as with the Roux en Y gastric bypass because the intestinal tract is not bypassed and therefore there is no malabsorption. Originally, the gastric sleeve was used as a two part procedure for the super morbidly obese patient. The gastric sleeve was performed allowing the patients to drop a significant amount of weight in effort to prepare them for the second part of the operation. The second part of the operation was the performed with bypasing of the intestinal tract. Over time it was determined that many of the patients who had undergone the initial gastric sleeve operation did not require the second part of this operation as they continued to loose weight. The gastric sleeve was then considered a viable weight loss surgery with growing popularity on its own for many interested in weight loss surgeyr. Because the intestinal tract is not bypassed, the risks such as intestinal obstruction and malabsoption do not exist with the sleeve. As well, the new stomach continue to function normally so there are far fewer restrictions on foods which patients can consume following surgery. The downside with the gastric sleeve is that, because it is a relatively new operation, many insurance carriers consider this to be an investigational surgery and will not allow coverage for the procedure. |
