The Roux en Y gastric bypass is a combination
of a malabsorptive and restrictive procedure, which can
result in significant weight loss. At
Upper Chesapeake Bariatric Surgery, the Roux en Y gastric bypass is performed
using a laparoscope rather than through an open incision. This laparoscopic
method allows the surgeon to make a series of much smaller incisions.
Laparoscopic gastric bypass usually reduces the length of the hospital stay, the amount of scarring, and results in a quicker recovery than an open procedure.
The Roux en Y procedure involves stapling the stomach to create a small pouch that holds less food and then shaping a portion of the small intestine into a "Y." The "Y" portion of intestine is then connected to the stomach pouch so that when food is being digested it travels directly into the lower part of the small intestine (called the jejunum) and the first part of the second section of the small intestine (call the duodenum). The effect of bypassing these organs is to restrict the amount of calories and nutrients that are absorbed into the body.
The laparoscopic approach uses several small incisions and three or more laparoscopes - small thin tubes with video cameras attached - to visualize the inside of the abdomen during the operation. The surgeon performs the surgery while looking at a TV monitor. The advantage of the laparoscopic approach is that it allows direct viewing of the abdominal structures without the need for a large incision.
The benefits of the minimally invasive laparoscopic procedure include:
Laparoscopic adjustable gastric banding (LAGB) is a type of minimally
invasive weight loss surgery that is categorized as a restrictive
procedure. It has been widely used in Europe and Australia
for patients who suffer from morbid obesity, unable to lose excess weight
with conventional medical therapy such as diet and exercise. In 2001 the
United States FDA gave approval for an adjustable band, the LAP-BAND®, to be used in assisting morbidly obese patients to loose excess weight.
The LAP-Band
System consists of a band with an inflatable cuff, catheter
and access port. The band is placed around the upper portion
of the stomach creating a smaller stomach by restriction. The catheter
with access port is brought to the posterior (underneath) abdominal wall
allowing access with a specialized needle to insert fluid (usually normal
saline) to the cuff of the band in order to increase or decrease the restriction
around the stomach. It is the restriction that allows a person to eat less
thus decreasing their calorie intake and allowing them to lose weight.
Eligibility
criteria for the gastric band are the same for other weight
loss procedures such as the gastric bypass. A person must be
at least 100 lbs over their ideal body weight (body mass index
40 or above) or a body mass index of 35 with existing associated illnesses
such as diabetes, hypertension, sleep apnea. Additionally patients are
required to meet their insurance company's
criteria to include documentation of morbid obesity for at
least 5 years.
As with any weight loss surgery, adjustable gastric banding
has risks and complications thus there is the need for appropriate
patient selection, pre operative consultations, insurance authorization,
hospitalization and a multidisciplinary approach to care.
All surgical procedures have known risks related to the type of procedure
being performed, anesthesia, and a person's current health status.
Below is a list of risks and complications for each procedure.
Talk to your surgeon in detail about all the risks and complications
that might arise. Then you will have the information you need
to make a decision.
Known "Risks and Complications" for Roux
en Y Gastric Bypass include but not limited to:
Death
Spleen or Liver damage
Damage to major blood vessels
Blood clots
Anastomatic leak
Small bowel obstruction
Internal hernia
Gastric ulcer
Gastric fistula
Wound infection
Vitamin deficiency ( including Vitamin B12 and Calcium )
Nausea
Vomiting
Failure to loose weight
Weight regain
"Risks and Complications" for Adjustable
Gastric Banding include but not limited to: