By Catherine Howard


The demand for weight loss surgery has been increasing in New York thanks to the numerous advances in surgical techniques that have not only made this option safe but quite effective as well. Lap-band and laparoscopic sleeve gastrectomy are also known as bariatric surgeries. While the may be used in virtually anyone, it is important to stress that they are most suitable for persons that have tried the lifestyle options of losing weight but have been unsuccessful.

These two surgeries are slightly different in the way in which they are done but their effect is the same; they all reduce the size of the stomach. As a result the amount of food that can be eaten during a single meal is markedly reduced. Most of what is consumed is used for energy provision and very little ends up as stored fat. Over time, there is net weight loss. The main difference that exists is that lap band is temporary (reversible) while gastrectomy is permanent.

The lap band procedure is usually done using an instrument called a laparoscope. The exact procedure involves minimal access of the abdomen using three small incisions. A silicon band is usually placed on the upper region of the stomach where it causes compression. With the organ now converted into a small pouch, only a small amount of food can be held at any one time.

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 is a surgical operation that involves the reduction of the stomach size by as much as 80%. The resultant tubular structure resembles a sleeve (hence the name). Apart from faster filling, the stomach also causes faster movement of food which effectively reduces the amount of nutrients absorbed. Side effects include leakage of food into the abdominal cavity, bleeding and infections.

Experts recommend that the ideal candidate should have a body mass index (BMI) of at least 40. However, if they have some conditions that may have been contributed or worsened by excess weight, then a lower value of BMI may be considered. The reason for this is that bariatric surgeries may help slow the progression of such conditions. Examples include sleep apnea, gastro esophageal reflux disease, diabetes and hypertension among others.

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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