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Basics Relating To Gastric Banding And Sleeve Gastrectomy

By Martha Foster


Lifestyle changes are one of the most effective approaches in achieving weight loss. While their effect can be clearly appreciated in a majority of New York residents over time, there is a smaller group of people in whom these lifestyle changes alone cannot achieve the desired results. These people form the bulk of potential candidates for surgical weight loss procedures which include gastric banding and sleeve gastrectomy. The two operations are examples of bariatric surgery.

Bariatric surgeries are also known as restrictive surgeries. This is because they are designed to reduce the capacity of the stomach which effectively reduces the amount of food that is held at any given point in time. Since, the stomach fills a lot faster than before, there is early satiety and by extension, reduced food intake. The weight loss that is seen in subsequent weeks and months is mainly due to reduced food intake.

As the name suggests, gastric banding involves the use of an elastic band made of silicone. This band is slipped onto the upper portion of the stomach using a laparoscopic approach. In laparascopic surgeries, procedures are conducted through small incisions made in the abdomen as opposed to open procedures where one large incision is needed. The squeeze that is provided by the band on converts the stomach into a small pouch.

The band is connected through a plastic tubing to an area just below the skin. The surgeon (or patient) can exert control on the pressure created by the band. When saline is injected through the tube, the pressure is increased which decreases the volume of the stomach further. This may be needed if the desired effects are not being seen. Drawing the saline achieves the reverse effect which is a reduction in the squeeze and an increase in the stomach volume.

Gastric banding has been shown to cause up to 50% in weight loss in a couple of months. The procedure is largely safe but a few side effects may be experienced. Such may include nausea and vomiting, wound infections or minor bleeding. Adjusting the tube often resolves the nausea and vomiting but removal of the tube may be needed if these effects are severe.

In sleeve gastrectomy, a large part of the stomach is removed with the remainder being between 20 and 25% of the original. The longitudinal resection (cutting) leaves a tubular structure which looks like a banana. The benefits of this operation are mainly twofold: reduced stomach capacity and increased transit time of consumed food. This means that food has less time to be absorbed.

Sleeve gastrectomy has been approved for use in children and adolescents. Studies show that it has no negative effects on the growth of children. Possible complications of this procedure include leakage of food, nausea, aversion to food, infections and esophageal spasms. Over time, the stomach may dilate but not significantly. It is important to remember that unlike the banding procedure, the sleeve procedure is irreversible.

The two procedures are considered day cases in most centers. What this means is that you can go home on the same day of the operation. One can resume their normal daily routine within a day or two. Usually, one has to be on a light diet comprising of liquids and mashed up foods of about two weeks. This is followed by soft foods for another two weeks then the regular diet.




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