12 Aralık 2009 Cumartesi

Laparoscopic Gastric Banding Surgery

Gastric Banding Surgery has been brought forward with it’s first time application by Dr. Kuzmak, an American surgeon. The essential of the application is to insert a silicon band to upper part of the stomach just below the esophagus as to form a volume of approximately 15-20 cc. In simpler words is to bring the stomach into sandglass shape.

This is a restrictive (that limits the stomach volume) operation. The essential of weight loss is based on the limited food intake by decreasing the stomach volume. It is not possible to intake excess food when the small stomach which has been formed as a result of staple insertion got full.

The most important feature of the staple is inflatable effect by giving fluid to its internal reservoir. Thus, the openness that has provided the connection between the upper small stomach and lower stomach parts can easily be adjusted. The advantage is that if the person’s eating is much the food intake can be decreased by this adjustment and weight loss can be increased in this way.

This adjustment is made through a connection tube with reservoir at the end. This reservoir is inserted on the muscle layer under the skin. By this way the transition from upper stomach to lower stomach can be limited by inflation of internal volume of the band through fluid has given by an injector.

The most important thing which should be paid attention at the patients those have considered the gastric banding is to examine their eating habits. Particularly the persons called ‘sweet eaters’ who have nutrition habit with the high calorie foods (ice cream, chocolate, dessert etc) must be careful. Because these types of foods are small in the volume and high in the calorie. Hence, no matter how much the staple is adjusted at the patients with stomach stapling, weight loss rates will decrease as intake and passage of these foods will be easy. Many specialist suggest gastric bypass for long term weight loss at morbid obese persons (BMI>40 kg/m2) and the sweet eaters.

Most important advantage of this operation is to be executed laparoscopically and the short length of stay at hospital (1 – 2 days). Returning to work is faster and quicker. But the patients need some time to shift to the solid foods after operation. It is no longer imposible to maintain an eating habit as before. Compliance with the rules is very important for this operation, otherwise some problems can be encountered with the staple and this can lower the weight loss rate.

Most important problems those can be experienced after the stapling can be specified as; reaction of the body against the staple (rarely), sliping of the staple from the place where it has been inserted in the stomach or changing of it’s position, going forward into the stomach (rarely) and infection at the reservoir. Sometimes a secondary operation is required at such cases as well as the removal of staple. Incidence of the complications have been mentioned differs at a range of 1 – 10%.

Weight loss at the long term differs at a range of 50 – 60% of the excess weight at the monitoring after stomach stapling. (at 7 – 10 years monitoring)

In conclusion the stomach stapling application is an operation which has satisfactory level of weight loss rate at long term and can be easily implemented to the morbidly obese patients those have been called as ‘non-sweet eaters’ and haven’t got a habit of nutrition with high calorie foods.

Assoc. Prof. Halil Coskun M.D.

halilcoskun@hotmail.com

1 yorum:

  1. I just had a Laparoscopic surgery for my fibroid and my tubes unclog where the put dye throughout them?

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