By Martha Foster


Lifestyle changes are highly recommend as ways of losing weight and remaining healthy. Unfortunately, these two are not effective in everyone and there is often a need for other options. Surgical weight loss procedures such as gastric banding and sleeve gastrectomy have increased in popularity in New York in recent years due to their effectiveness and safety profile. The two are types of bariatric surgery.

The two types of procedures are restrictive surgeries. This means that they reduce the size of the stomach which effectively reduces the amount of food that it can hold. Persons who have had the procedures begin to have early satiety which reduces their food intake. Over time, they begin to lose weight since most of the food that is eaten is used to provide energy and very little, if any, is stored as fat.

Gastric banding is achieved by use of a silicon band using laparascopic approach. When the band is slipped onto the upper part of the stomach (the fundus), it squeezes it to leave just a small outlet. The estimated capacity of this pouch is one ounce of food. Laparascopic procedures, use small entry points (ports) that result in smaller scars later on. This is in contrast to open surgeries in which large incisions have to be made.

The band is usually connected to the skin using a small plastic tube. This helps the surgeon (and the patient) to exert some control over the band. By injecting or removing saline (or water) into this tube, the pressure that is exerted on the stomach can be increased or reduced as desired. An increase in the squeeze may be needed if the rate of weight loss is too slow. A reduction may be needed, on the other hand, if there are adverse side effects of the operation.

The results of gastric banding greatly vary from one person to another. Studies show that most people achieve weight loss of between 40 and 50% in a few months. While it is a generally safe procedure, there are a number of side effects that one should anticipate. Those that are most commonly encountered include vomiting, nausea, minor bleeding and infections. Adjusting the squeeze helps reduce the nausea and vomiting.

Sleeve gastrectomy (or gastric sleeve) refers to the surgical removal of a part of the stomach. This may be as much as 80%. The remaining stomach is a tubular pouch which closely resembles a banana. This method helps reduce weight in two ways: reduced capacity of the stomach and faster movement of food (hence less absorption). The shape is also believed to influence gastric hormone production such that one feels less hungry.

Sleeve gastrectomy is safe for use in children and adolescents. There are no adverse effects on growth for children aged less than fourteen years according to studies. The main side effects of this operation include leakage, aversion to food, vomiting, esophageal spasms and infections among others. With time, the stomach may dilate. This occurs over years and is rarely a cause for worry.

The two bariatric operations are usually done as day cases. You can home on the same day that you are operated. One can resume their daily routine within 24 to 48 hours. The general advice is that one remains on light diet consisting of mashed up foods and liquids for at least two weeks. Soft foods and the regular diet follow thereafter.




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