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April 21, 2008

What Is Gastric Bypass Surgery?

What Is Gastric Bypass Surgery?

The introduction of the fluoroscope into the surgery room has paved the way for refinements in gastric bypass surgery. Adjustable gastric banding stands out as being a refinement with great benefits for the patient, and with maximum potential for continued use by overweight individuals.

Patients like the fact that gastric banding does not call for restrictive surgery. Gastric banding does not limit the amount of time that food has access to the absorptive lining of the GI tract. Therefore, gastric banding does not interfere with absorption of the nutrients in the foodstuffs consumed by the patient.

The surgeon performing a gastric banding places a lap band around the upper stomach of the patient. The lap band does not prevent the movement of food into the lower part of the stomach. The lap band simply allows the patient to feel “full” after eating only a small amount of food. Eventually that food moves into the lower stomach, and then on to the small and large intestines.

The lap band is adjustable. The size of the entrance into the lower stomach can be increased as the patient begins to eat less and thus loses weight. Adjustments to the band are done by adding saline from a saline port, a port that has been placed under the patient’s skin. Adding saline inflates the band and widens the diameter of the entrance into the lower stomach.

The adjustable band represents but one of the benefits of gastric banding. When the surgeon performs a gastric banding, the patient does not receive a long cut across the abdomen. Because the surgeon uses the fluoroscope, he or she can place the band on the stomach while operating through a small incision.

Moreover, the gastric banding does not carry the irreversible stamp of stapling, the procedure formerly used for gastric bypass surgery. Once the patient reaches a suitable weight, the lap band is adjusted, and the upper stomach becomes closer to the average stomach size.

Because gastric banding calls for the placement of a foreign object into the body, the patient could suffer complications. Until the patient adjusts to the band, the small stomach could reject food ingested in large quantities, or food eaten very rapidly. Then the gastric banding could cause vomiting. And because less food is descending into the intestine, the patient could become constipated.

Besides the short-term complications associated with gastric banding, the patient could have to deal with an infection over a longer period of time. Bacteria find that an implanted device, such as a lap band, is a great place to grow. The body’s immune defenses cannot easily fight such bacteria. So threat of infection is one long-term problem with gastric banding.

A second long term, potential problem is band migration. If the surgeon uses a Swiss band, then the patient faces a 3% risk that the band could migrate. French bands have so far been shown to stay in place. None of the complications that can arise cancel out the great benefits derived from use of gastric banding.

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