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Facts On Lap-band And Laparoscopic Sleeve Gastrectomy

By Catherine Howard


The number of weight loss surgical procedures being done in New York has continued to increase tremendously. Part of the reason for this is the fact that the techniques that are employed have been greatly improved and the procedure is now not only safe but also very effective. Lap-band and laparoscopic sleeve gastrectomy are two of the most commonly performed bariatric operations. It is important that one first tries out lifestyle changes before turning to surgery for weight loss.

The two operations work by reducing the functional capacity of the stomach. The stomach tends to fill faster than before hence there is a reduction in the amount of food eaten. Most of the food that is consumed undergoes metabolism to produce energy and very little is converted to fat. With time, there is net weight loss. The fundamental difference between the two is the fact that while lap-band surgery is can be reversed while sleeve 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.

The surgery is generally safe but one needs to be aware of the potential complications. Nausea, vomiting, bleeding and aversion to food are among those that are most likely to be seen. To reduce nausea and vomiting, the compression by the band is reduced so that the stomach size increases slightly. This is done by drawing saline from a plastic tube joined to the band.

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.

Generally, surgical weight loss surgery is most beneficial in persons with a body mass index (BMI) of more than 40. In case they have weight related complications such as diabetes, hypertension, sleep apnea and gastro esophageal reflux disease, a lower BMI may be considered. Bariatric surgeries have been shown to reduce the symptoms associated with these conditions.

There are a number of situations in which bariatric surgery is deemed inappropriate. One such situation is when there is a high risk of complications. Underlying hormonal problems such as hypothyroidism are among the reasons why the procedure may be cancelled or postponed until the problem has been managed. Other examples include gastrointestinal tract diseases such as inflammatory bowel disease, peptic ulcers and esophagitis.

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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