Bariatric Care Center

Sleeve gastrectomy is one of the surgical methods of weight loss. In this procedure, stomach will be reduced to 25% of its normal size; by using this surgery, a large part of the stomach will be removed. And then open edges are attached together to form the tube or sleeve with the banana shape. This method permanently decreases the stomach size. This surgery is performed laparoscopically and it is not reversible.

Laparoscopic sleeve gastrectomy is the restrictive method without using any malabsorptive components that are present in other weight loss procedures. This is a fashionable procedure, in this approximately 70% of the stomach will be removed, which releases hunger hormone called ghrelin that results in a smaller, new stomach that is roughly the shape and size of a tube or sleeve. This will provide decreased appetite and increased satiety.

With this decreased stomach size, patient feels full after eating less food, takes in lesser calories, and then loses weight. Hungry hormone drive will be taken away after this surgery, so patents do not feel hungry.

Procedure:

Laparoscopic sleeve gastrectomy is a very simple procedure than the gastric bypass surgery, because it doesn’t require reconnecting or rerouting the intestine. The Laparoscopic Sleeve Gastrectomy is performed with small incisions, and it takes about an hour to perform. Same as the adjustable gastric band, and roux-en-Y gastric bass, this procedure is conducted in minimally invasive manner through small incisions. As in this laparoscopic gastric bypass, camera, harmless gas and instruments would be utilized.

Eligibility:

Particularly this procedure is indicated for people who are at high risk for the bypass procedure, have complex surgical history or high BMI. To avoid potential risks of the foreign body, patients can also consider the laparoscopic sleeve gastrectomy procedure instead of gastric banding procedure.

Advantages:

·         Stomach size will be reduced without any loss of function or anatomy change. This will result in few chances of developing lack of minerals and vitamins and eliminate the dumping syndrome in the gastric bypass surgery.

·         Almost 75% weight loss of overweight.

·         Too much decrease in the ghrelin.

·         In this no implantable band devices are used, so erosion or slippage is not a risk.

·         Surgical risks lesser than with gastric bypass surgery, but weight loss is same.

·         This is performed by using minimally invasive method, which helps in reducing the recovery time.

·         No device is used, it only requires adjustment. The band is inserted, so follow up hygiene is not as acute as it would be with band.

·         Reduces the chances of developing ulcers.

·         Fewer visits than the lap Band, because here no need for the adjustment of band size.

Recovery Period:

·         You may need to stay 2 days in the hospital.

·         You can return to your daily routine within 3-4 days.

·         Usually complete surgical recovery occurs in 7-10 days.

Lap band surgery has low surgical complications as compared to the other weight loss methods. The death rate is about 1 in about 2000 people. There is a possibility of the eroding or band slipping into the stomach and of the mechanical malfunction. The other complications include: bleeding, infection, and abdominal pain.

Lap band surgery complications are very common after having the surgery. However many of these are very minor complications and they can be alleviated by following few post operative instructions.

Lap band complications range from annoyances to the complete failure and also removal of the lap band.

Following are the complications of potential lap band treatment:

Band erosion: This is also called as band migration. This condition occurs actually when the band moves into stomach. Only treatment for this is permanent removal of band.

Band intolerance: Some people’s bodies cannot handle the band. So after completion of the surgery the band becomes an alien object in their body. The intolerance of band includes: vomiting or uncomfortable feeling all the time. For this condition permanent band removal is the only solution.

Band slippage: This condition occurs if the lower portion of the stomach slips from the band, and creates a large pouch above the band. Surgical repositioning or removing the fluid is required to set the band slippage. The symptoms include reflux and vomiting, and this can be diagnosed by having a dye and using the X-Ray to see it.

Band leak: Usually patients can tell if their gastrointestinal system has the leak, if feelings of the patients of restriction decrease with the time without the surgeon unfilling the port. To conclude that whether you have the leak, your surgeon may inject the colored fluid and then take an X-Ray to observe if any of that colored fluid is presented outside of that gastric banding system. To repair this, surgery may require.

Blood Clots: These are also called as thrombus. Obsess people have high risk of developing the blood clots after and during any type of surgery. Some blood thinners are used to prevent the blood clots. Walking periodically after having the surgery may also very effective. The symptoms of blood clot include pain or swelling in the legs and this can be diagnosed by the doctor by using an ultrasound. Blood clots would be treated by taking the prescribed blood thinners. If you left this untreated, clots may lead to the pulmonary embolism. So it is better to inform your doctor as soon as possible. Smoking may increase the risk of this condition, so if you are a smoker try to stop smoking before having the surgery. That should be not later than 2 months out.

The lap band surgery is used to drop excessive amount of weight. It is possible by manipulating the intake food of stomach. Inflatable band is used in this process to divide the stomach in to two parts, lower and upper. It is fitted around the stomach as like belt which will reduce the intake of liquids and food of stomach. A small opening is made by the surgeon in between lower and upper sections which is useful to pass some amount of food but it is very small amount.

Cost of the surgery: Nowadays cost of the lap band surgery is big problem. It is in between $12,500 to $30,000. Several factors are included in determining the costs of lap band surgery. They are:

1. Diagnostic tests and laboratory fees: Depending on the person’s priority to surgery approved diagnostic tests are performed, while declaring the person’s eligibility for the surgery is concluded by using preoperative laboratory tests.

2. Hospital Fees: The facilities which are available with the Hospital may decide the cost of the surgery. Before signing up for the surgery, candidates are advised to observe the clinic and hospital environment.

3. Doctor’s fee: The big portion of lap band surgery fee is paid to bariatric surgeon as professional fees. The surgeon who has more experience could pay ample amount to their services. Since this procedure requires experts in handling tools and laparoscopic elements. Then only the surgery will be successfully completed.

4. Visits: Patient should visit the surgeon before and after the surgery for a complete guidance. These are called fallow up visits. The cost of these visits can be included in the surgery amount.

Factors that Affects externally:

1. Geographical location: The cost of the lap band surgery will be high in urban areas. It is more expensive in metropolitan cities when compared to the rural areas.

2. Surgery procedure: If patient wants to stay in hospital to ensure recovery, then it will cost more when compared to self maintenance.

3. Insurance Policy: Most of the insurance providers don’t provide complete amount. So, care should be taken while providing the documents and papers needed for the insurance.

4. Additional Charges: Additional procedures after the lap band surgery include body contouring, Extra Skin Removal, liposuction, face lift and breast lift operations may charge high amount to pay. Normally these are not included in the health insurance policy of patient so it should be paid by the patient separately.

A lap band surgery is also referred as laparoscopic adjustable gastric band. Obese patients can be treated with this surgery with body mass index ranging from 35 and above with assured co-morbidities. Obesity can cause various health problems like, diabetes, hypertension, sleep apnea which are identified to recover through weight loss surgery. Lap band surgery is done using a lap band, which is a silicone device positioned on upper portion of the stomach. The intake of the food is restricted with this surgery.

Lap band surgery failure is of two types:

1. Ineffective weight loss: If the weight loss is between 25 to 30 percent and less of your excess weight then the lap band surgery is deliberated to be a failure. The surgery is said to be successful if weight loss percentage is 50 percent.

2. Risks and complications pertaining to band removal : For some patients band is totally removed because of the complications such as:

a. Band infection: Antibiotics can heal band infections, but sometimes band removal is required. The patients who have band infections may range from 1.5 percent to 5.3 percent.

b. Band leak:  Band leak is usually recognized by injecting colored fluid and x-ray is taken to find any colored fluid leak on outer side of the gastric band.

c. Band erosion: band erosion can happen when band grows up into the tummy. The treatment is enduring in elimination of the band.

d. Band slippage: This can transpire, when the lower portion of the stomach slides all the way through the band, forming a big pouch on top of the band. Band slippage can be repaired by surgical relocation of the lap band or removal of fluid from the band. Two types of band placement techniques are used. They are Pars flaccid technique (PFT) and per gastric technique (PGT).

e. Band intolerance: some patients cannot tolerate the band because the band is a foreign object placed in the stomach. Symptoms of band intolerance include feeling discomfort or uneasiness all the time and have terrible vomiting. Band removal is the only option for band intolerant patients.

f. Bowel functioning: The bowel functioning is distorted after lap band surgery, which may include Dyspagia and Constipation. Swallowing difficulty is called as Dyspagia. The reason for this is not chewing the food properly and taking the food quickly. Constipation is seen in patients. This can be treated with fiber diet (fiber supplements) and drinking lots of water.

g. Esophageal dilation: The expansion of esophagus is seen because of band, which is too tight or incorrectly placed.

h. Food trapping: Food is being trapped in a small opening of digestive system. This can be treated by puncturing the band completely until the food passes by.

If you are obese or overweight, dieting might seem impossible to lose weight. Most people have experienced the problem with those diets, where attempt for weight loss is followed by a period of weight gain. Those who have tried several non-surgical methods to lose, lap band surgery has given a new hope for weight loss.

With lap band weight loss surgery, you do not have to be opened up and only minor incisions will be made. During the surgery, a small stomach pouch is created in the upper portion of the stomach. Usually, this stomach pouch will hold only about ½ to 1 ounce of food. This pouch connects to the rest of your stomach pouch from an outlet known as stoma. Usually, you feel full when the upper stomach is full and you can control your weight gain and finally lose weight.

The entire procedure is very easy in which the band is positioned around the stomach to create a smaller pouch. In future, if you want to alter the size of the procedure, then the band can be easily adjustable with only a short office visit. In this way, you can inflate or deflate the lap band whenever needed and you are able to control the amount of food that you eat.

As soon as the surgery, you have to follow liquid diet for few days. Then you will be back to your normal diet, but you need to listen to your doctor’s suggestions to ensure that you eat properly. You can also stretch the smaller pouch if you want to eat more than what is necessary to fill the stomach. Once you feel full, you need to stop eating more otherwise there is no meaning for lap band surgery.