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Lap Band and Gastric Bypass Surgery

Aside from cosmetic procedures such as liposuction, there are two main options for those wishing to lose significant amounts of weight using medical means: gastric bypass surgery and Lap Band surgery.

In todays world where size has become a hefty issue, people crave information on all the possible ways to lose weight. Fad diets do not work in the long run, and a lifestyle change involving adjusting eating habits and exercise can only take someone so far depending on genetics.

Aside from cosmetic procedures such as liposuction, there are two main options for those wishing to lose significant amounts of weight using medical means: gastric bypass surgery and Lap Band surgery. We will take a very basic look at both of these procedures in the following paragraphs, providing facts and insight on each.

Lap Band Surgery

Lap Band Surgery is a minimally invasive restrictive procedure requiring no stomach stapling or re-routing of internal organs. The Lap Band consists of a silicone ring that is placed around the top of the stomach. Inside the Lap Band is an inner balloon which connects to the access port through a small tube. The access port is placed deep under the skin on the left-hand side of the stomach and is adjusted with a shot of saline solution that tightens or loosens the band according to personal weight loss goals. This fluid regulates the amount of satiety (feeling of fullness) and satiation (feeling satisfied after meals) felt by the patient.

BioEnterics Corporation in Carpinteria, Calif., created the Lap-Band device. It's been around for about 10 years, but did not get approval from the Food and Drug Administration until 2001. While gastric bypass is still the more prevalent option for weight loss surgery, there has been increasing interest in the Lap-Band. According to studies completed by BioEnterics for the FDA, the band can have side effects like nausea and vomiting, heartburn and abdominal pain. Sometimes patients need another operation to correct a problem with the device. However, the Lap band surgery procedure is the least traumatic and the only adjustable and reversible obesity surgery available in the United States.

The surgery lasts under an hour and requires an overnight stay in the hospital. The stomach is not stapled and the small intestine is not cut and rerouted as it is in gastric bypass surgery. The banding procedure also eliminates 'dumping syndrome', the sick feeling associated with eating sweets or drinking alcohol after gastric bypass surgery. Lap Band surgery typically costs thousands less than gastric bypass surgeries do. Both operations improve or eliminate diabetes, hypertension and other illnesses associated with obesity.

Similar to a gastric bypass, the banded stomach can hold about two ounces of food. That's equivalent to a piece of cheese the size of your index finger or a cut of meat smaller than a deck of cards.

Gastric Bypass Surgery

Gastric Bypass is both a restrictive and malabsorptive procedure that has been performed worldwide for over 35 years. Gastric bypass involves cutting and stapling a small piece of the stomach so that it becomes separate from the other portion. This area acts as a new, smaller stomach with the rest being restricted permanently. The top of the small intestine is then severed completely with the stapling device with the ends of the intestine routed to the smaller stomach pouch. The other end is attached to the small intestine so that the digestive liquids from the liver, gallbladder, duodenum and pancreas can process food.

Some surgeons perform this operation by using a laparoscope- a small, tubular instrument with a camera attached- through short incisions in the abdomen (laparoscopic gastric bypass). The tiny camera on the tip of the scope allows the surgeon to see inside your abdomen. Compared with traditional "open" gastric bypass, the laparoscopic technique usually shortens your hospital stay and leads to a quicker recovery. Fewer wound-related problems also occur. Not everyone is a candidate for laparoscopic gastric bypass, however.

Gastric bypass surgery takes about four hours. After surgery, you wake up in a recovery room, where medical staff monitors any complications. Your hospital stay may last from three to five days. You won't be allowed to eat for one to three days after the surgery so that your stomach can heal. Then, you must follow a specific progression of your diet for about 12 weeks. The progression begins with liquids only, proceeds to pureed and soft foods, and finally to regular foods. With your stomach pouch reduced to such a small size, you'll need to eat very small meals during the day. In the first six months after surgery, eating too much or too fast may cause vomiting or an intense pain under your breastbone. The amount you can eat gradually increases, but you won't be able to return to your old eating habits. Gastric bypass isn't for everyone with obesity, however. It's a major procedure that poses significant risks and side effects and requires permanent changes in your lifestyle. Before deciding to go forward with the surgery, it's important to understand what's involved and what lifestyle changes you must make. In large part, the success of the surgery is up to the individual.

Weigh Your Options Carefully

Both gastric bypass and lap band surgery provide significant health benefits through proven long-term weight loss. Not only are health conditions and diseases such as diabetes (type-II), hypertension and sleep apnea improved or eliminated, the effect of weight loss on your quality of life and mental well-being is priceless.

Having weight loss surgery is a life-changing decision and seeking advice from a medical professional such as your primary care physician is recommended. Your doctor or healthcare specialist will be able to provide advice on each weight loss surgery to determine whether gastric bypass or lap band surgery is right for you. Some patients find it difficult to decide which procedure is right for them. This can be a tough decision and I encourage you to take your time and do your research.

Dr. Gerald Kirshenbaum performs gastric surgery in Denver, Colorado. Lap Band surgery offers the advantages of reduced postoperative pain, shortened hospital stay and quicker recovery.

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