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Laparascopic Gastric Bypass

Less invasive than bariatric surgery, a laparascopic gastric bypass, also known as "lap band" surgery, places a prosthetic device around the upper stomach to restrict the amount of food patients consume. Morbidly obese men and women may choose to have lap band surgery after failing to lose weight with less dramatic diet and exercise programs. Aside from feelings of low self-esteem, overweight individuals may suffer from debilitating and chronic illness associated with obesity, such as high blood pressure, sleep apnea, diabetes, and osteoarthritis. Over time, excessive weight can place too much pressure on the skeletal structure, especially weight-bearing hips, knees and joints; and too much stress on the lungs, heart and kidneys. Obese individuals are also at increased risk of stroke, cardiovascular heart disease, or congestive heart failure.



As a drastic weight-loss measure, patients choose high-risk surgeries, such as bariatric gastric bypass, a procedure to decrease the size of the stomach or cause malabsorption of food. Gastric bypass procedures are highly effective in causing morbidly obese patients to lose weight, usually as much as 100 pounds. However, the side effects include death due to complications, infection at the incision, and the loss of nutrients due to malabsorption. Bypass patients must continue to take multivitamins for the rest of their lives to supplement lost nutrients. All types of gastric bypass surgery are invasive and involve cutting or removing part of the digestive system. Biliopancreatic diversion (BPD) and duodenal switch (DS) both involved creating a smaller pouch from the patient's normal sized stomach or restructuring intestines to re-route food to bypass the duodenum. Surgically stapling or cutting the stomach can cause complications and a distressful syndrome called "dumping," when patients try to consume more food the smaller stomach can hold. However, laparascopic gastric bypass does not result in dumping, has a lower degree of mortality, and does not result in malabsorption of vital nutrients.



Laparascopic gastric bypass is less invasive because surgeons perform procedures through the patients' navel cavity using a much smaller incision than other gastrointestinal operations. Surgeons place an inflatable band made from silicone around the top of the patient's upper stomach to restrict the amount of food consumed. After surgery, the band is filled with saline solution, making the opening to the stomach even smaller. Surgeons work with patients to properly fit the band, making adjustments through a port just under the skin, until there is an optimum space through which food can pass. Similar to bariatric gastric bypass procedures, laparascopic gastric bypass procedures create a smaller upper stomach which fills up with food quickly, creating a feeling of fullness before food can reach the lower stomach. Patients eat less and gradually lose pounds. Weight loss with lap band surgery tends to be more gradual and less dramatic than bariatric procedures; however studies indicate that ultimately, patients can lose nearly the same amount of excess pounds.



The benefits of laparascopic gastric bypass are fewer complications, lower degree of morbidity, less invasive incisions, the ability of patients to consume food and process nutrients without dumping, and the adjustabiliity of the lap band post-operatively according to a patient's individual need. Another positive feature of laparascopic gastric bypass is that the band can be removed in the case of women who desire to become pregnant or after patients achieve a desired weight. Unlike baratric gastric bypass procedures, which permanently alter the structure of the intestines and stomach, lap band surgery is completely reversible. Prior to deciding to become pregnant, women can have the band removed in order to get the nutritional benefits of food necessary to carry a fetus to full term. Pregnancy is not the time to be dieting, but to allow the body to prepare itself to conceive and provide vital nutrients through the umbilical cord and placenta, which can only be derived through an optimum diet. After delivering a healthy baby, overweight Moms who are not breastfeeding may elect to have lap bands replaced.



While laparascopic gastric bypass has fewer complications than other procedures, negative side effects exist. Patients may experience what is termed, "productive burping," or regurgitating undigested foods. Morbidly obese patients have to modify their eating habits to slowly chew food and take in less air and smaller amounts to avoid productive burping. Anyone who has struggled with being overweight knows that re-focusing the mind on something other than consuming food is also crucial to adhering to a diet and exercise program. "Man shall not live by bread alone, but by every word that proceedeth out of the mouth of God" (Matthew 4:4b). Blockages can also be formed in the upper stomach if portions are too large to pass through the smaller banded stomach opening. Possible side effects also include stomach ulcers; inflammation of the stomach lining, or gastritis; regurgitation after band placement, as patients adjust to smaller stomachs; frequent "fills," or band adjustments; lap band slippage; or an erosion of the lap band, as the device is gradually absorbed through the delicate walls of the stomach. Leaks in the gastric wall can also cause bleeding and require immediate surgery.



Overweight men and women considering laparascopic gastric bypass should consult with physicians and surgeons and explore all options. Surgeons require patients to have a Body Mass Index of over 40 and a history of being morbidly obese for at least five years. Doctors prefer patients to be 18 to 55 years of age. Insurance companies may cover weight loss surgery, especially for patients suffering from debilitating or chronic diseases associated with being overweight. Agencies require patients to undergo a six-month, physician-assisted diet and exercise program; submit documentation of chronic illness; and forward a physician's letter recommending weight-loss surgery to correct morbid obesity. Upon approval, physicians are given the red light to schedule surgeries; and patients begin the process of shedding unwanted pounds to experience a healthier life.

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