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Laparoscopic Gastric Banding

LAP-BAND System procedure for permanent weight loss.What is gastric banding?
A gastric band is placed on a portion of the stomach and reduces the amount of food that you are able to eat. It acts like a belt around the top portion of your stomach, creating a small pouch. This means that you feel full after eating only a small quantity of food.

There are a number of different gastric bands available. They are all very similar to one another and comprise of a silicone ring and a reservoir connected to the ring by a length of tubing. Inflating the ring makes the band tighter, therefore, restricting the opening between the new small pouch that the band creates and the main part of your stomach. By adjusting the amount of fluid in the balloon you can control the amount of food you eat.

The gastric banding technique has been used successfully for many years and offers several advantages:

  • It is adjustable - the adjustability of the band gives you and your doctor control to achieve weight loss without creating too many unpleasant symptoms due to the degree of restriction.
  • It is placed laparoscopically – this means that you can return to work soon after the operation with a minimal recovery time.
  • It is reversible – taking the band out would revert the stomach back to its normal size and you would therefore probably gain weight again. For this reason it is usually planned to leave the band around your stomach permanently.

    Lap -Band Surgical Procedure

    The Lap-Band® system is designed to help you lose excess body weight for resolution of obesity-related health conditions and enhancement of life. In partnership with leading bariatric surgeons around the world, a new surgical approach has been developed that eliminates many of the known associated operative risks and provides unique benefits compared to other obesity surgeries. This effort has resulted in the Lap-Band® system, the only adjustable and reversible obesity surgery that does not require cutting and stapling of the stomach or gastrointestinal re-routing to bypass normal digestion.

    Candidates for LAP-BAND
    Lap-Band System surgery is recommended for those persons who are 40 kg or more overweight and have or are likely to have medical complications that will be helped, and in many instances, cured by substantial weight loss. While weight loss surgery is not for everyone, there are a large number of patients for whom losing a lot of weight is imperative, including those suffering from diabetes, high blood pressure, heart trouble, shortness of breath, arthritis and orthopaedic (bone) problems with their legs, hips or back.

    The Surgery
    You will be admitted to hospital either the night before, or the morning of your surgery. Most patients stay in hospital 1-2 nights following their surgery. You will have a general anaesthetic, and the operation will take approximately 1 hour. The surgery is done laparoscopically, (keyhole). Through a serious of small incisions across your upper abdomen the surgeon will use laparoscopic instruments guided by a small camera attached to a telescope. The surgeon will be able to visualize the inside of your abdomen on a TV screen. The surgeon will then be able to secure the band round the upper part of your stomach. The port used to inflate and deflate the gastric band is placed under the skin of the abdomen so that the surgeon is then able to make adjustments easily in the clinic.

    What happens if the surgery cannot be performed Laparoscopically?
    In a small number of patients, the laparoscopic method cannot be performed. Factors that may increase the possibility of choosing or converting to the "open" procedure may include a history of prior abdominal surgery causing dense scar tissue, inability to visualize organs or bleeding problems during the operation.

    The decision to perform the open procedure is a judgement decision made by your surgeon either before or during the actual operation. When the surgeon feels that it is safest to convert the laparoscopic procedure to an open one, this is not a complication, but rather a sound surgical judgement. The decision to convert to an open procedure is strictly based on patient safety.

    What to expect after Gastric Banding
    You will usually be in the hospital 1 to 3 days after a laparoscopic procedure. You may have a tube through your nose into your stomach (inserted while asleep) and not be permitted to eat or drink anything until it is removed. You should be out of bed, sitting in a chair the night of surgery and walking by the following day. You will need to participate in breathing exercises. You will receive pain medication when you need it.

    On the first of second day after surgery you may have an X-ray of your stomach. The X-ray is a way for the surgeon to know if the stapling of the stomach is okay before beginning to allow you to eat. If no leakage or blockage is seen (the usual case) then you will be permitted to have one ounce of liquids every hour. The volume of liquid you drink will be gradually increased. Some surgeons allow you to eat baby food or a “puree” type of food. You will remain on a liquid or puree diet until your doctor evaluates you approximately 1-2 weeks after you return home.

    Patients are encouraged to walk and engage in light activity. It is important to continue the breathing exercises while at home after surgery. Pain after laparoscopic surgery is generally mild although some patients may require pain medication. At the first follow-up visit the surgeon will discuss with you any dietary changes.

    After the operation, it is important to follow your doctor’s instructions. Although many people feel better in just a few days, remember that your body needs time to heal. You will probably be able to get back to most of your normal activities in one to two weeks time. These activities include showering, driving, walking up stairs, and work and light exercise.

    When to call your Doctor

  • Persistent fever over 101F (39 C)
  • Bleeding
  • Increased abdominal swelling or pain
  • Persistent nausea or vomiting
  • Chills
  • Persistent cough and shortness of breath
  • Difficulty swallowing that does not go away within a few weeks
  • Drainage from any incision
  • Calf swelling or leg tenderness

    There are guidelines for changes in your diet and behaviour after LAP-BAND® surgery. But these guidelines are not all you need. Your weight management team will have specific instructions for you, so be sure you understand what they are. Also, keep regular appointments with your health care providers. That way, they can carefully keep track of your progress. You also need to promptly report any unusual symptoms you have to your surgeon.

    The benefits of Laparoscopic Gastric Banding
    75% of patients are expected to lose 75 to 80% of their excess body weight. Well over 70 to 80% of patients with hypertension will be off medications and well over 90% of patients with type II non-insulin dependent diabetes mellitus are expected to be off medication. Drastically improved, if not completely resolved includes sleep apnea, asthma, joint pain, arthritis, reflux, fatigue, shortness of breath and an overall increased sense of well-being. Click here for more information about the benefits of gastric banding surgery.

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