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What One Should Know About Lap-band And Laparoscopic Sleeve Gastrectomy

By Catherine Howard


There is an exponential rise in the demand for weight loss surgical operations in New York . The major contributing factor for this surge is the safety and the effectiveness of modern surgical techniques. The two most common types of bariatric surgery are lap-band and laparoscopic sleeve gastrectomy. Although these operations can be offered to anyone, the general advice is that one should first try losing weight using lifestyle changes.

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 typically performed laparoscopically. This involves entry into the abdomen through minimal access. Three small incisions (ports) are made in the anterior abdominal wall and used for the insertion of a camera and instruments. A silicon band is fixed to the upper stomach portion so as to cause compression. This converts the entire organ into a small pouch capable of holding just a small amount of food.

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 When water is injected the compression increases and when it is withdrawn, it reduces.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 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.

The ideal body mass index, BMI, of a potential candidate should be more than 40. For persons that are already suffering from conditions believed to be caused or aggravated by excessive weight, a lower BMI is usually considered. Examples of these conditions include sleep apnea, esophageal reflux disease, hypertension and diabetes among others. Research has shown that surgery helps reduce the severity of these conditions.

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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