Lap-Band revision is a surgical weight loss procedure that may be performed to replace the existing Lap-Band or to remove the Lap-Band and perform another weight loss surgery, such as the gastric sleeve or gastric bypass.
There are a number of reasons why Lap-Band patients may need revision. The Lap-Band could slip, leading to an acute or chronic condition that may require emergency surgery.
Lap-Band erosion may also occur, causing a hole to be worn into the stomach. As a result, saliva leaks through the hole in the stomach and flows along the tubing of the Lap-Band. This can cause an infection to the tissue under the skin where the Lap-Band port is located. The Lap-Band ultimately becomes ineffective as well.
Other times, Lap-Band patients are simply unsuccessful achieving desired weight loss or minimal to no improvement in obesity-related health conditions is seen despite making necessary changes to their diet and exercise regimen.
The need for Lap-Band revision does not necessarily mean that the initial procedure was a poor choice, but that something with the patient or the surgery itself is not as effective as hoped.
The Lap-Band is a restrictive type of weight loss surgery. The second type is malabsorptive.
Patients who had excellent weight loss but experienced Lap-Band failure due to technical reasons such as port infection or erosion are likely to do well with another restrictive procedure. For many of these patients, the gastric sleeve surgery has been very effective.
For patients who had minimal results following an initial Lap-Band, choosing another restrictive procedure may not be most effective. Typically, a malabsorptive procedure such as the gastric bypass (Roux-en-Y) is recommended.
According to research, patients experience similar results when the Lap-Band surgery is performed as both the initial and revision surgery. This involves simply removing the previous band and replacing it with a new one.
This restrictive procedure is typically performed laparoscopically, removing approximately three-quarters of the stomach and creating a new tube-shaped stomach. As the size of your stomach is reduced, the amount of food you can eat is restricted and you feel full more quickly. The surgery takes about an hour to perform. Typical hospital stays are two to three days with a recovery time of two to four weeks, but this can vary.
The Roux-en-Y is a malabsorptive procedure that reduces the number of calories that are absorbed and restricts the amount of food you can eat.
The surgical procedure can be performed via open surgery or laparoscopically. Open surgery involves the making of one 10 to 12-inch incision to your abdomen. If performed laparoscopically, five to six small abdominal incisions are made, approximately ¼ to ½-inch in size.
During this procedure, a small pouch at the top of your stomach will be created using surgical staples. This is your new, smaller stomach which is capable of holding about one cup of food. The small intestine is cut and attached to your new small pouch. This changes digestion, making food bypass the lower stomach and upper portion of the small intestine. To allow the flow of digestive fluids, the upper portion of the small intestine is attached to the middle portion of the small intestine.
Surgery time for this procedure is approximately two hours, with a typical hospital stay of two to three days. The recovery period for most is two weeks.
Many health professionals believe the duodenal switch to be the most effective weight loss surgery for improving sleep apnea, diabetes, and high cholesterol.
The duodenal switch is a combination of many other techniques. During this almost four-hour surgery, a large portion of the stomach is removed. The small intestine is cut at the top, leaving the duodenum attached to the stomach. The duodenum is where most digestion occurs.
A cut is then made to the small intestine several feet from where it meets the large intestine. The remaining portion still attached to the large intestine is then connected to the duodenum.
The mixture of digestive juices and food coming from the stomach is allowed in the last 15 to 20 percent of the small intestine as the loose portion of the small intestine not attached to the stomach is attached to the small intestine.
This combination procedure is both restrictive and malabsorptive as the stomach size is reduced and digestion is only allowed to occur in a small portion of the small intestine.
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