Lap-Band® is an adjustable gastric banding system used to facilitate gradual weight loss in morbidly obese patients. This laparoscopic obesity surgery involves the placement of a hollow doughnut-shaped tube around the upper part of the stomach, which is then filled with saline (salt water) to restrict the amount of food the stomach can hold. The name of the procedure signifies the laparoscopic techniques and gastric band used in this minimally invasive surgery.
The Lap-Band works in two ways: it reduces the size of the stomach to hold less food, and it limits the amount of food that can enter the stomach. This means you feel full faster, so you eat less and lose weight. This system is the only laparoscopic obesity surgery approved by the FDA and the only adjustable and reversible procedure for long-term weight loss available in the U.S. Lap-Banding is generally considered to be the safest, least invasive, and least traumatic of all weight loss surgeries.
Patients who undergo Lap-Band surgery typically lose about one to two pounds a week, and lose up to 50 percent of their excess weight within the first year of surgery. It is important to maintain a healthy life after surgery in order to maximize and fully enjoy the results of the procedure. This includes a diet that is low in fat and calories, as well as regular daily exercise.
Gastric Sleeve Surgery
Sleeve gastrectomy (gastric sleeve surgery) is a restrictive form of bariatric surgery that shrinks the stomach to approximately 15% of its original size. It is commonly performedon severely obese patients who are not healthy enough to undergo a successful gastric bypass, biliopancreatic diversion or similar weight loss surgery. The procedure enables rapid weight loss with fewer complications than the more conventional weight loss surgeries, but its effectiveness loses stride because there is no intestinal bypass.
Sleeve gastrectomy is currently under evaluation for lower weight patients as an alternative to the Lap Band® weight loss procedure. This is because the procedure does not require insertion of any foreign object into the body for permanent restriction, nor is it vulnerable to the unique issues the band presents. For example, the band can slip or be wrongly positioned by an inexperienced surgeon while the sleeve is at once cut and sealed, unable to inadvertently "fix" itself.
The actual sleeve gastrectomy procedure is quite simple. The surgeon's tools enter through a small incision and staple the stomach down into a long tube which is of a greatly reduced volume. Once the "sleeve" is examined to ensure quality and no leakage or bleeding, the excess stomach tissue is then excised. This direct removal has a secondary bariatric effect of reducing the secretion of the hormone Ghrelin, responsible for inducing hunger. One of the few parts of the body to produce and secrete Ghrelin is the stomach lining, most of which is removed in surgery.
A distinct advantage of sleeve gastrectomy is that it is a solely restrictive procedure; it does not include any rerouting or manipulation of the intestines whatsoever. This completely eliminates absorptive complications such as vitamin and nutrient deficiencies related to the "skipping" of the duodenum. Most bariatric patients must take a multivitamin the rest of their lives due to this issue, but sleeve gastrectomy is free of this hindrance. Marginal ulcers that typically plague bypasses at the jejunal junction are also avoided. The reattachment of the pylorus to the jejunum of the small intestine is fraught with complications even if surgery and healing go well.
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