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More on WLS choices

Wednesday, January 06, 2016

Yesterday I wrote briefly about the 3 main choices in weight loss surgery: Bypass, Sleeve and Band



Of course any surgery is serious. Especially when they knock you out with anesthetics. Complications are always possible.

The Adjustable Gastric Band, aka Lap Band is touted to have the least risk, since there is no cutting of the stomach or intestines. On the down side, the band is a collar that can rub and wear into the stomach, causing damage. Also, the band is adjustable, and requires a port under the skin where saline is injected every 2 weeks or so to keep it tight. The patient can't make the adjustments, but can ask for it to be tighter or looser, and so change the amount of food that can be eaten. It can be very lax, or too tight to eat anything. Some hospitals no longer offer this option because of the number of them that they'd had to remove.

The Lap Band was originally my first option when I started investigating, but I quickly ruled it out. Even without the potential complications, the idea of the port and the continual attention required to its maintenance kind of freaked me out.

The Roux en-Y Gastric Bypass, is sometimes called the gold standard of WLS. Perhaps due to the fact that the best weight loss results are expected from this procedure. Its downsides to the very tiny egg sized stomach and the bypassed intestines, are the dumping syndrome and malabsorption issues. Dumping is when the patient eats something too fatty or too sugary, or maybe even just too much volume. The result could be vomiting, diarrhea, chills, and/or dizziness. Maybe more. Malabsorption is the body not getting enough nutrients from the food being eaten. Vitamin and mineral supplements must be taken for life.

The Vertical Sleeve Gastrectomy seems to be a middle of the road procedure. There is no rerouting of the food path, but a large portion of the stomach is removed, so it is one continuous tube from the esophagus to the intestines. The part of the stomach that is removed is where a hunger hormone is produced, so patients usually experience less physical hunger. On the downside, that resulting stomach sleeve could possibly be made too tight, causing a stricture which must be stretched by endoscopy. (inflating a balloon kind of thing to stretch it) Sleeve patients also are at some risk for malabsorption, and should take vitamin and mineral supplements for life. With the sleeve, there is a long incision running the length of the stomach, closed with staples. There is the potential for some leakage, but this is usually tested for and caught during the procedure or its hospitalization.

As I wrote yesterday, all of these procedures are usually done laparoscopically, unless there is some complication. This greatly reduces the recovery time, and many patients can return to work in a week or so.

(More info coming soon)
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Member Comments About This Blog Post
  • SEAGLASS1215
    My doctor said I was a good candidate for surgery yesterday (shocked me, I hadn't brought it up, he did)...he recommended the sleeve...I am still in shock that he even mentioned it but your research and thorough explanations are very timely and helpful, thank you!
    892 days ago
  • MISSUSRIVERRAT
    "The part of the stomach that is removed is where a hunger hormone is produced, so patients usually experience less physical hunger."

    Is the above also true in the gastric bypass? I realize the stomach is not removed in a bypass, but it really is not engaged in the actual eating process.

    It just seems to me that the removal of the hunger hormone producer is the most significant feature of the operation.

    894 days ago
  • KJDINSC
    Tough decisions ahead. You will have to decide what is best for you.
    894 days ago
  • DSJB9999
    You really have researched this. emoticon
    894 days ago
  • WHITE-GREEN
    Must have been a very though choice to make.
    894 days ago
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