samedi 11 juin 2016

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.

There are a number of side effects associated with this surgery. They include bleeding (usually minimal), vomiting, nausea and aversion to food. The compression force from the band can be increased or reduced to minimize the symptoms. This is can be achieved by injecting or withdrawing water from a plastic tubing attached to the band. When water is injected the compression increases and when it is withdrawn, it reduces.

Sleeve gastrectomy is a surgical operation that involves the reduction of the stomach size by as much as 80%. The resultant tubular structure resembles a sleeve (hence the name). Apart from faster filling, the stomach also causes faster movement of food which effectively reduces the amount of nutrients absorbed. Side effects include leakage of food into the abdominal cavity, bleeding and infections.

Experts recommend that the ideal candidate should have a body mass index (BMI) of at least 40. However, if they have some conditions that may have been contributed or worsened by excess weight, then a lower value of BMI may be considered. The reason for this is that bariatric surgeries may help slow the progression of such conditions. Examples include sleep apnea, gastro esophageal reflux disease, diabetes and hypertension among others.

There are some situations in which these operations are deemed unsafe. In case one has hormonal imbalance (as is the case of hypothyroidism), the surgery is usually postponed until the condition has been treated. Other high risk situations include the presence of gastrointestinal diseases such as peptic ulcers, esophagitis and inflammatory bowel disease among others.

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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