Adjustable Gastric Banding:
Laparoscopic Adjustable Gastric Banding is a restrictive procedure. Because it is adjustable, it can accommodate changing needs. In this procedure, a medical device is implanted and placed around the top portion of the stomach in order to create a small upper stomach pouch. The band is then attached to an injection port that allows the band to be inflated or deflated.
The concept of the gastric band is to create two stomach chambers, a small upper pouch and a larger lower chamber. Food fills up the small upper pouch quickly creating a sensation of fullness after a small amount of food. The food drains slowly into the larger lower chamber where it is digested normally.
Advantages
- Minimally invasive outpatient procedure with rapid recovery
- Adjustable, no weight loss "window"
- Less dependent on vitamin and mineral supplementation
Two different band brands are available and your surgeon will discuss your options to help you choose which may be right for you.
Click below to see how a gastric banding works:
EXPERIENCING COMPLICATIONS?
HAVING COMPLICATIONS WITH THE BAND PROCEDURE?
What is a band slip?
A slippage is where the lower part of the stomach comes above the band and may even dislodge the band. It can occur after
episodes of productive belching, vomiting or being too tight after fills. The signs may be sudden onset of gastric reflux
or not being able to eat or drink. In other cases, the signs may be that you can eat more and not feel any restriction and
in some cases there are no signs at all. When a slip occurs most of the time you can let all the fluid out of your band
for a few weeks and allow the stomach to go back into place. There are rare occasions that the band does have to be surgically
adjusted or removed.
What is an esophageal dilatation?
Esophageal Dilatation is when the esophagus becomes stretched, usually caused by overeating. Symptoms may be gastric reflux
or chest pain after eating or being able to eat more and not feeling restriction. Letting the fluid out of your band for
several weeks and allowing the esophagus to go back to its former shape usually treats dilatation.
What problems can I have with my port?
The port can get a tear in the diaphragm or become unstitched from the muscle and actually flip. This can require a minor
outpatient procedure to either replace the port or re-suture the port back into place.
What is erosion?
Erosions are when the band actually perforates the stomach. This can be caused from aggressively tightening the band, a
too tightly filled band, or by consuming aspirin or NSAIDS. Signs of erosion can be either none or stomach pain or not being
able to eat. Erosions require that the band be surgically removed.
If you have any additional questions
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Gastric Bypass Surgery:
The Roux-En-Y Gastric Bypass is the most widely used procedure in the United States for the treatment of morbid obesity.
This procedure combines restriction and malabsorption to attain significant weight loss. In this procedure, stapling
creates a small pouch. The remainder of the stomach is not removed, but is stapled and divided from the new pouch.
Next, the small intestine is divided and one end (called the Roux limb) is brought up and connected with the new
stomach pouch. The other end of the divided intestine is then connected into the side of the Roux limb of the
intestine, creating the “Y” shape that gives the technique its name. By bypassing part of the stomach, a majority of
hunger-stimulating hormones (ghrelin) are bypassed, therefore reducing hunger.
After surgery, there is a reduction in the amount of food that is able to be consumed and the food from the small pouch now empties directly into the Roux limb, bypassing some calorie, fat, and nutrient absorption.
Advantages
- Good resolution of hunger in most cases
- Rapid weight loss and improvement or resolution of many other health conditions such as type II diabetes, hypertension, sleep apnea, and high cholesterol
- No adjustments required
- Is reversible
Click below to see how a gastric bypass works:
EXPERIENCING COMPLICATIONS?
BYPASS COMPLICATIONS
Leak:
Leaks can occur after the surgery along the internal suture line(s) allowing the gastric juices to “leak” into the abdominal
cavity. A leak usually occurs within the first few days to first several weeks. You are checked for a leak while in the
operating room and often again before you leave the hospital to be sure there is no leak. Eating solid foods before you
are medically cleared can contribute to a leak. Fever and rapid heartbeat can be signs of a leak and should be reported
to your doctor. Leaks have to be repaired surgically.
Bowel Obstruction:
This is a narrowing or obstruction within the colon or stomach that can occur early or later after the surgery. Many times
you may have nausea, vomiting, abdominal bloating and no bowel movements. You need to let your doctor know immediately if
this occurs. X-rays will need to be taken and sometimes a dilation or surgery is required.
Blood Clot:
Pulmonary emboli are blood clots that travel to the lungs. They can happen to anyone but there is an increased risk after
bariatric surgery. A sign of a blood clot to the lung is chest pain that does not move and is accompanied by shortness of
breath. Swelling in one or both of the legs can precede these symptoms with some calf tenderness. If this occurs contact
your surgeon immediately or go to the emergency room. To help prevent blood clots from forming, it is important to keep
moving after the surgery. In addition, if you are traveling long distances by car or plane within 4 weeks of your surgery,
be sure to change positions every hour and get up and move around.
Bleed:
On rare occasions, there can be some bleeding from surgery that may require a blood transfusion and/or an extra day in the
hospital. On more rare occasions, you may have to return to the operating room for the bleeding to be surgically corrected.
If you have any additional questions
please
click here to contact us.
Vertical Sleeve Gastrectomy:
The Vertical Sleeve Gastrectomy, like gastric banding, is a restrictive procedure. In this procedure, a measuring tube (bougie) is inserted into the stomach. The stomach is then stapled and cut along this measuring tube to create a long "sleeve" shape. Once the sleeve is created, the measuring tube is removed and the remaining stomach is also removed. Therefore, this is a permanent procedure.
Although approximately 85% of the stomach is removed, the stomach continues to function normally, but with smaller quantities of food. Also, by removing the majority of the stomach, the amount of hunger-stimulating hormones
(ghrelin) is dramatically reduced.
Advantages
- Best resolution of hunger
- Rapid weight loss and improvement or resolution of many other health conditions such as type II diabetes, hypertension, sleep apnea, and high cholesterol
- No adjustments required
Click below to see how a gastric bypass works:
EXPERIENCING COMPLICATIONS?
Sleeve Gastrectomy Complications
Leak:
Leaks can occur after the surgery along the internal suture line(s) allowing the gastric juices to “leak” into the abdominal
cavity. A leak usually occurs within the first few days to first several weeks. You are checked for a leak while in the
operating room and often again before you leave the hospital to be sure there is no leak. Eating solid foods before you
are medically cleared can contribute to a leak. Fever and rapid heartbeat can be signs of a leak and should be reported
to your doctor. Leaks have to be repaired surgically.
Bowel Obstruction:
This is a narrowing or obstruction within the colon or stomach that can occur early or later after the surgery. Many times
you may have nausea, vomiting, abdominal bloating and no bowel movements. You need to let your doctor know immediately if
this occurs. X-rays will need to be taken and sometimes a dilation or surgery is required.
Blood Clot:
Pulmonary emboli are blood clots that travel to the lungs. They can happen to anyone but there is an increased risk after
bariatric surgery. A sign of a blood clot to the lung is chest pain that does not move and is accompanied by shortness of
breath. Swelling in one or both of the legs can precede these symptoms with some calf tenderness. If this occurs contact
your surgeon immediately or go to the emergency room. To help prevent blood clots from forming, it is important to keep
moving after the surgery. In addition, if you are traveling long distances by car or plane within 4 weeks of your surgery,
be sure to change positions every hour and get up and move around.
Bleed:
On rare occasions, there can be some bleeding from surgery that may require a blood transfusion and/or an extra day in the
hospital. On more rare occasions, you may have to return to the operating room for the bleeding to be surgically corrected.
If you have any additional questions
please
click here to contact us.
StomaphyX™:
The StomaphyX™ device is a sterile, single-use device for use in transoral tissue approximation and ligation in the GI tract. Without incisions and with minimal patient downtime, the StomaphyX™ can be used to create durable large tissue folds in the gastrointestinal tract. Performed under endoscopic visualization, StomaphyX™ is introduced into the body transorally (through the mouth). Once inside the stomach, the stomach wall is suctioned into the tissue port on the StomaphyX™ creating a large plication. Non-resorbable fasteners are then deployed across the fold to hold the tissue in place. Typically 10 to 20 folds are required depending on patient anatomy.
The procedure is safe and atraumatic, as it is completely incisionless so using it reduces or eliminates the risk of infections and herniations. Most patients can return to work in as little as one day.
Duodenal Switch
The Biliopancreatic diversion with duodenal switch (BPD-DS) procedure reduces the amount of calories absorbed by the body by permanently altering the normal digestive process. It also limits the amount of food that can be eaten by reducing the size of the stomach; however, BPD-DS is considered a malabsorptive procedure. Stomach removal is restricted to the outer margin, leaving a sleeve of stomach with the pylorus and the beginning of the duodenum intact. The small intestine is then divided with one end attached to the stomach pouch to create what is called an alimentary limb. All the food moves through this segment; however, not much is absorbed. The bile and pancreatic juices move through the biliopancreatic limb. This separates digestive juices until they join at the common channel.
Advantages
- Does not restrict types of food that can be eaten and allows for larger meals compared with other bariatric procedures.
- Average excess weight loss is generally greater than with gastric banding or sleeve gastrectomy because it provides the highest level of malabsorption.
- No postoperative adjustments are required.
- Shown to help resolve type 2 diabetes, high blood pressure, obstructive sleep apnea, and to improve high cholesterol.
