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Adjustable Gastric Banding
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Lap Band, the most recent device that has won the FDA approval, has been in use in Europe and Australia for many years. The Lap band, is a restrictive procedure, that limits the amount of food intake. The amount of restriction can be controlled by the means of a implantable port under the skin which can be used to inflate or deflate (increase and decrease) the restriction.
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It is purely a restrictive procedure, so, it causes an important reduction in the food amount that can be consumed. The surgery consists on placing a circular complement of a material called silastic, surrounding the highest part of the stomach, like a belt, that creates a small gastric deposit above the band and the rest of the normal stomach below the band. |
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This band can be adjusted, to close or to open it, according to the necessities of the patient, through an accessory called “port” or “reservoir” that it is placed below the skin and goes connected to the band. This devise helps people to avoid eating great volumes of food since their eating capacity is limited to the size of the small deposit. Progressively food will advance towards the rest of the stomach and to the normal digestive system.
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This procedure is made by laparoscopic surgery, which allows the patients to experience less pain, small wounds and in most of the cases, patients are able to leave the hospital by the next day.
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Advantages:
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| a) |
It is a surgery that, through laparoscopic procedure, is normally done rapidly, in an average time of an hour.
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| b) |
It usually allows a 24 hours departure from the hospital and a recovering from seven to ten days.
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| c) |
Patients can travel 2 days after the surgery.
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| d) |
Cuts or resections of the stomach or intestine are not made, so the risk of leak is inexistent. |
| e) |
It is completely reversible in case of retiring the band or in case of a failing results.
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| f) |
It accomplishes a maximum loss of 60% of the weight excess, an average of 45 to 55% within five years. |
| g) |
Patients do not require taking vitamins or minerals supplements, although it can be recommendable.
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| Risks: |
| a) |
It requires discipline to obtain the desired results of weight loss, mainly in the feeding habits, since it is indispensable to eat slowly, in small mouthfuls and with very good mastication.
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| b) |
There are some foods, like meat and flours, which would be difficult to swallow sometimes and, could cause important disturbances like pain in the chest, breathlessness sensation and vomit.
Sometimes, not usually, it could require of an endoscope procedure to extract or to advance some portion of food that has remained stopped in the band.
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| c) |
It requires to adjust the band once or twice yearly, and to be in permanent contact with the medical group that takes care of it (surgeon, nutriologist, intern, etc.) in order to be able to obtain the wished loss of weight, and in spite of it, the benefit are only reached by 70% of the patients.
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| d) |
It cannot have good results if the patient ingests drinks of high caloric content that the band cannot avoid when they are consumed.
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| e) |
The band can migrate towards the interior of the stomach, which will restrain a good lost of weight and in most of the cases, a retirement surgery will be necessary.
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| f) |
Sometimes reservoir problems are possible, with leaks or infection of the area, although the probability is low (around 4%), and it is solved by smaller procedures.
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