Arturo Rodriguez, MD

July 24, 2009

Mary, Lap-Band Success

Mary, Lap-Band Success

MY JOURNEY OF LIFE

Mary, Lap-band Success

Mary, Lap-band Success

 

Ok—so that may sound a little dramatic, but I truly feel that this journey of weight loss has been more than just losing weight.  It has changed more than just the number on the scale—I have a new outlook on life, a healthier way to live and a new group of friends for life.

I had been overweight since 1988—tried every diet out there—including the ones that you order food delivered to you.  I spent enough on diets to have had the lap band done several times over!  I considered bariatric surgery off and on several different times.  Being a Registered Nurse, I saw both the successful and the unsuccessful surgeries done in the U.S.   In 2004 my brother had RNY bypass surgery done—and was successful—he lost 100 lbs in over a year.  I still wasn’t sold on that idea for myself—and started hearing about a new procedure called a “band”.  I started casually researching that –but all the while, I continued to gain weight.  Every time I tried to go on a diet, I would lose a little—then gain more than I lost.

But in October 2007, I was singing with my chorus at competition.  I literally hurt from the multiple rehearsals and performances and all the walking I had to do.  When I wasn’t in a rehearsal or on stage or somewhere I had to be, I was in my room taking a pain pill.  I was truly miserable.

One of the things they do during competitions is take candid pictures during performances and then put them out to see if anyone wants to buy copies for themselves.

That was my “wake-up”.  When I was looking at the pictures, I couldn’t find myself.  I literally didn’t recognize myself.  I knew it had to be me because of the people next to me—but I didn’t know that woman.  You see, I knew what the scales said—but I was in denial about how big I really was.  I thought I was carrying the weight better than that!  But there was the proof—I didn’t even know who I was.

Before I even got home, while I was in my hotel room, I started doing research about the gastric band.  One of the links that came up was for Dr. Arturo Rodriguez in Monterrey, Mexico.  I was amazed to find out that even though the gastric band procedure was still new in the US—he had been doing bands for over 12 years (at that time). I didn’t know they had been around that long!!  So I read everything I could about Dr. R—everything on his website—went to every lap band forum and web—and I learned a lot!! 

One thing to note—the procedure is called a gastric banding.  “Lapband”, “Realize Band”, “Allergan”, “VG”—those are all brand names from which ever company made that particular band.  Each band has individual things that make them a little bit different (that old business competition thing), but they all do the same thing.  It is strictly a matter of which band the Doctor feels is best for each patient.  Some Doctors only use one brand—some use more than one brand.  It’s like choosing which “tools” you want to use.   I personally left that to the Doctor—he is the one with the experience to know which one would work best in my situation.

 

So, back to me!  I spent about 3 weeks researching, reading,  looking before I even mentioned to my husband that I was considering it.  I wanted to be totally prepared for whatever question he had to ask me.  It did surprise me how open he was to the idea.  I had expected to really have to convince him—but once he knew that I had done the research and that this was not just a whim, he was supportive of me pursuing the procedure.   I asked my pt coordinator so many questions, it’s a wonder she didn’t just mark me down as a kook!  So with my husband’s support and encouragement, I scheduled my surgery.

On December 28th, 2007, I got on a plane at DFW and in less than 2 hours, I was landing in Monterrey.  Although we have made several vacation trips to Mexico—this was a new experience for me.  I knew what I had been told to expect—but I was still anxious about what would happen.

I came through immigration and customs, and just as promised, there was Dr. R’s driver standing there with my name on a sign.  He took my bags and we proceeded to the van.  It is about a 30 minute drive from the airport to the clinic (San Pedro) where I had chosen to have my surgery done.   All the way, I was watching the “sights” of Monterrey-Walmart-Sam’s –Maytag-Mary Kay—looked just like Texas to me!!

I chose to travel and have surgery on the same day, so when I got to the clinic, things started happening.  The nurses came in and after I had changed into the “very fashionable!” hospital gown, they started the IV and drew blood for the lab tests. Then the anesthesiologist came in—and then the internist—and the nutritionist—but then Dr. Rodriguez came into the room.  From the moment I met him, I was instantly at ease and knew that I had made the right decision.  He has a manner about him that makes you very comfortable and you know that you are in good hands.  I would like to send many Dr.’s to him to learn!

I was taken to the operating room and I have to say that Dr. Santos, the anesthesiologist is great!  I have had several surgeries before, but this was absolutely the easiest anesthesia I have ever experienced.  One minute I started feeling a little sleepy—and the next I was in the recovery room. The surgery itself takes less than an hour to finish.  After I was awake from anesthesia, I went back to my room and stayed in the clinic over night.  Every few hours the nurses would come in and give me antibiotics and pain medications through the IV.  Whenever I would wake up, I would walk around in the room—and then towards morning, I was walking in the hallways. Dr. Arturo Rodriguez came in to see me that evening and to make sure that I had gotten something to drink and that I had gotten some broth and jello.  The next morning, around 9, Dr. R and everyone else was back again—and as soon as I was dressed and ready to go, the driver was there again to take me to the hotel.  I was at the hotel by around 10:30 on Saturday morning—just 24 hours after I had left DFW.

When I got to the hotel, I took a shower and a nap—in that order!  After I had some soup, on Saturday afternoon, we went to the mall.  There are a couple reasons for that trip.  Primarily to walk—because that helps in many ways—and also to stop at the grocery store(supermercado) to get a few things to have in my room at the hotel to “eat” rather than calling room service every couple hours. I got some soup and yogurt, pudding and jello, Gatorade and water, that type of thing.  Then back to the hotel.  I rested, I walked, I drank.  On Sunday, I could have gone home—but I had messed up on my airline reservation, so I stayed till Monday.  So on Sunday I did basically the same things—and also went for a walk for a few blocks around the hotel.  At all times, I felt perfectly comfortable and safe in Monterrey.

On Monday morning, there was Dr. R’s driver, ready to take me back to the aiport and I was on my way home—ready for my new life to begin.  And that is exactly what it has been.

So—where am I today?  I have gone from wearing size 18W to size 8/10—I have lost about 65 lbs –so far- and am still losing. I would like to lose about another 30 lbs—but the difference is that now I don’t worry about it.  I know it will continue to come off. I eat regular foods—not diet foods—and as long as I don’t go “crazy”, I know that unlike every diet I have been on, this time I won’t gain all the weight back again.

And the crazy thing about this is—I would have never been approved to have had the surgery in the states!!  I was told I needed to GAIN about another 20 lbs to “qualify”!  Or have multiple co-morbidities caused by the weight.  That is NUTS!  Dr. Arturo Rodriguez looks at this as a preventative measure—let’s  get the weight off BEFORE the co-morbidities develop.  THAT is true care!

Almost 1 year from my surgery, I approached Dr. Rodriguez about becoming a patient coordinator and working with him to help other people.  I knew that with my nursing training and being a lap band patient myself, that I would be able to offer a unique perspective to potential clients.  I hope that I am.

So, while I have lost weight with the band—what I have gained is much more.  I have gained a new life—a new outlook and attitude—and I gained a group of friends that will be with me forever.

 

Mary Ellis, RN

http://www.thebariatric.com

http://www.bandstersforum.com

maryellis@thebariatric.com

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July 20, 2009

Lap Band Diet – After Surgery

Lap Band Diet – After Surgery

How should I Eat After Surgery?

You need to pay attention to what you eat and how you eat it during the first three weeks following your lap band surgery.  Your diet should be limited mostly to liquids and soft food. The reason for this is that the body needs time to heal and develop tissue around the gastric band or lap band, to maintain the band in its correct position.  If you eat solid food too soon after lap-band surgery , you may run the risk of dislocating the band, or developing an enlarged upper gastric pouch. Therefore, it is very important to chew your food well in order to decrease the risk of blockages or dislocation of the band.

How Much Can I Eat?

Right after Lap-Band surgery the stomach can not hold more than 4 to 6 ounces per meal (3/4 cup). Therefore, one should be particular about the nutritional value of the food with every bite. I have written about the lapband diet since we started doing lap band surgeries thirteen years ago.  You can find detailed information on my website: http://www.thebariatric.com/lap-band/postoperative.html

What´s Happening?

People seem to think that nothing will happen if they “cheat” during the liquid phase and eat solid foods.   However, The truth is that solid food may cause increased pressure and may result in lapband dislocation, and the increased pressure over the “New Stomach” or Pouch at this time could be an early cause of lapband slippages.  Eating solid foods in the early stages after surgery has also been known to cause enlarged pouches which can occur after a period of time.

I try to tell people that their stomach is moving and churning (inside) while trying to digest solid food.  Solid foods are also pushed down to the restricted area and we want to keep the stomach as still as possible for that first week “liquid phase” after lapband surgery. So even though they don’t “feel” like it’s hurting anything, they could be.  Let’s reiterate that the purpose of the diet is not for starting weight loss but for healing after the Lapband surgery.  This way you will avoid stretching the pouch and it will also help you by letting the sutures become firmly attached and to hold the lapband in the right place.

Which Diet Should I Follow?

I recommend that my patients strictly follow the liquid phase for one week post-operatively.  During this time, they can eat clear liquids (water, Gatorade, broth, tea, apple, grape or cranberry juice, fruit popsicles) and full fluids (vegetables juices, cream soups,  low-fat milk and yogurt, and pudding).  There is no concern about malnutrition or low sugar intake during this time.  The diet slowly allows the patient to “graduate” to soft foods in the second and the third week post-op.

There are some foods that should be avoided or limited in order to decrease the risk of irritation or band dislocation.  Stomach irritants such as coffee, alcohol, carbonated beverages like coke, concentrated orange juice, vinegar, spicy food, etc, maybe cause discomfort or inflammation of the stomach lining, and vomiting might occur which may cause lapband dislocation.  Fruits such as oranges or grapefruits should have both the skin and seeds removed before eating them, in order to avoid blockages in the stomach or esophagus.  Vegetables such as cucumbers should also be peeled.

Other foods which need to be avoided are high fiber vegetables like celery, sweet potatoes, spicy foods, fried foods, spices (like cinnamon) pepper or soy sauce. If one is unable to tolerate milk, then calcium and protein rich foods such as cottage cheese and dry milk can be added to foods for proper protein intake.

Lap-Band patients should intake at least fifty to sixty grams of protein every day to avoid protein deficiency, but protein shakes or vitamins are not required. Include adequate sources of protein in your diet such as eggs, low-fat cheese, and fish such as salmon or tuna.  Lack of protein causes hair loss, edema, fatigue, muscle weakness, and a delay in wound healing. It also causes depression, anxiety, irritability, apathy, as well as gallstones, colds, headaches, low blood pressure, anemia, irregular heart rates. The amount of protein can be monitored by your doctor with a serum albumin blood test.

For more information, visit: http://www.thebariatric.com/lap-band/postoperative.html

 

Arturo Rodríguez, MD

http://www.thebariatric.com

http://www.bandstersforum.com

Originally posted 2009-01-10 22:59:33. Republished by Blog Post Promoter

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Losing Weight During The Holidays

Losing Weight During the Holidays

Holidays are a time to enjoy family and friends, and get-togethers almost always center around good food and conversation.  Everyone brings delicious foods and desserts to numerous parties and gatherings, and life can get very busy and hectic, leaving little time for your regular exercise routine. For someone who is trying to lose weight, the temptations can be overwhelming. 

Diet and exercise are the most important methods of losing weight. However, this may not always be possible or practical during holiday times. Either someone is staying at a hotel, where exercise options are limited, or they might be staying with friends or family where it is hard to get away. As well, it almost seems rude to refuse any food offered at these special occasions. However, the holidays is a time to focus on positive thinking.  Focus on ways to eat healthy and maintain your weight. For example, if you stay in a hotel, why not take the stairs to your room instead of the elevator, or check out the swimming pool? If you are staying with friends or relatives, start a game of soccer with the family or take a walk around town. When the food is on the table, choose your favorite vegetables and fruits first – and enjoy sharing a colorful, healthy meal. If the cake is calling your name, chose a smaller piece.

For people that have had a hard time losing weight, and have had little success with fad diets or “easy” solutions, you may have considered different options such as lap band surgery.  A lap band is a silicone device that is surgically placed around the stomach, and manually shrinks the size of the stomach so that the person is able to feel full with smaller amounts of food. Lap bands produce the best results when used in conjunction with a healthy diet and proper, moderate exercise. This is mostly because too much unhealthy foods can slow the results that the lapband is designed to give.  Combining the surgery with healthy diet and active living will soon results in a healthier person. If that isn’t a great holiday gift then nothing is!

For anyone who has been struggling with the idea of getting lap band surgery, or for anyone who really wants to lose weight, don’t think it is too late for you. Lapband surgery may be just the thing to put your life back on track.

The Bariatric Team

http://www.thebariatric.com

http://www.bandstersforum.com

Originally posted 2009-01-04 11:42:56. Republished by Blog Post Promoter

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Why My Weight Loss Procedure Can Fail?

Why My Weight Loss Procedure Can Fail?

The first and most important step to minimize the chances of failure from a Bariatric procedure and to increase your success rate is to be well informed about each one of the surgeries before you choose any of them.

What should you know about Weight Loss Surgery?

  • How does each procedure work? How will they assist in weight loss?
  • What should you expect from the Lap Band, Gastric Sleeve, or Gastric Bypass procedures, in terms of weight loss and/or Type 2 Diabetes
  • The difference in short and long-term benefits for each procedure
  • The operative risks and complication rates for each procedure
  • How much follow-up and support will you need for each procedure
  • How much of the Total Patient Care (TPC) program services will you need
  • What kind of adjustments will you need following surgery?
  • What kind of commitment is expected from you, for each procedure
  • What should you expect from the Doctor or Bariatric Group that you choose
  • The surgical options you have for each of the procedures in case of a failure
  • Finally, the cost of each procedure

What should you know about the Doctor or Bariatric Group?

You have to be well informed about the Doctors and medical team performing the Lap Band, the Gastric Sleeve or the Gastric Bypass.  Choose your surgeon and medical team wisely in order to ensure the best results for your weight loss success.

  • Ask about their education and training credentials if you are planning to go to a Latin Country. Look for Medical Degrees in Private Colleges like Monterrey Tech, University of Monterrey, or LaSalle School of Medicine, or other reputable medical universities.
  • Ask about where they received their Surgical Training. There can be a big difference in the treatment you will receive between doctors trained in well-known Private Hospitals, rather than in the Social Governmental Health Care System.
  • Ask about their Diplomas. Did they have to write a Medical Tests to join the Medical Society or Surgeon group, or did they just pay a subscription fee to become a member?
  • Check the number of Revision Surgeries they have been involved with. This may give you an indication of the quality of their work.
  • Check their Surgical Staff for credentials and experience. Consider the Anesthesiologist and any other assistant surgeons. It is important that they have experience in Bariatric surgery.
  • Double-check the Ethics and Professionalism of their Promoters or Coordinators.
  • Finally, check the Follow Up and Support they would provide you after your surgery.

Diet Rules to Follow (Regardless of the Weight Loss Procedure you Choose)

For any weight loss method to be successful and effective, you have to make some healthy lifestyle choices regarding the foods that you eat.  Bariatric surgery is an effective way to increase the rate of weight loss, but the best results can only happen when you make healthy choices.  After Bariatric surgery, you will feel full with a smaller amount of food – make sure to choose foods with the most nutritional value to help you on the journey to a new, healthier you!

  • Follow the Diet Steps recommended by your Doctor or the Nutritionist after surgery.
  • Chewing very well will help to maintain the pouch size, preventing stomach stretching and decreasing the risk of blockages and reflux in the esophagus or stomach.
  • Eat 6 small meals a day.
  • Eat slowly; take your time at the table.
  • Preferably, hydrate or drink beverages between meals.
  • Avoid Gastric Irritants like Alcohol, Coffee, Hot or Spicy, Vinegar, Soy Sauce or other Acid Beverages.
  • Limit high calorie foods like chocolate, cream and full-fat dairy products.

Failure Features Characteristically observed with Bariatric Procedures

These “failures” can be a result of a number of different circumstances or actions, or may develop slowly over time.  Therefore, it is important to have regular follow-ups to monitor your weight loss and the status of your lap band, sleeve or gastric pouch.  Remember: If you have any concerns, don’t be afraid to ask your doctor.

  • Big Gastric Pouches
  • Mega- esophagus
  • Wide Gastric Sleeve
  • Excessive tightness of the Gastric Band
  • Wide outlet of the Bypass Gastro-Yeyuno
  • Very Short common limb of the Gastric Bypass

 

Arturo Rodríguez, MD

http://www.thebariatric.com

Originally posted 2008-07-10 23:25:31. Republished by Blog Post Promoter

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Is the Lap Band Procedure for Anyone?

Is the Lap Band Procedure for Anyone?

Almost 95% of individuals with a BMI of 30 or more are unable to lose weight using only diet, exercise or drugs. Actually, all individuals with a BMI lower then 35 are not accepted into any Bariatric Program and those with BMI between 35 to 40 are only accepted if they have co-morbidities such as Type 2 Diabetes, Hypertension, Heart Disease, Sleep Apnea, Asthma, etc.

The question is if we want the patients to wait 5 to 10 years until they have gained such a weight and also to wait for high risk co-morbidities to show up in order to accept them for a Lap Band, which is a surgical procedure that takes 30 minutes and has proven to be the safest surgical technique to treat obesity and overweight.

I strongly believe that Lap Band Surgery is a good option for those individuals considering losing weight on a long-term basis, to improve their overall health and well-being.  Gastric Banding or a Lap band can be used to safely treat morbid obesity, and can also be a preventative measure for morbid obesity by individuals with a family history of Obesity, Diabetes, High Cholesterol, or other co-morbidities.

 

Arturo Rodriguez ,MD

Bariatric Surgeon

http://www.thebariatric.com

Originally posted 2008-04-23 18:43:22. Republished by Blog Post Promoter

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Lap Band Office Fills

Lap Band Office Fills

Your Lap Band fills are the most important part of the follow-up care that you need to succeed in your Weight Loss Journey. There is very little written about Lap Band Office Fills. Many people assume that the “office fill” is the best way to have the Lap Band adjusted.  Take some time to read through this information about office fills, and contact your Doctor if you have any questions.

Facts About Lap Band Office Fills

  • It is a fast profitable growing medical business as the Lap Band population increases in number
  • It is very rare that the Bariatric Surgeon is involved with the lap band fills
  • The Office Fills are cheap for most of the patients
  • No need for Doctor’s infrastructure (fluoroscopy)
  • It is easily done at the Doctor’s office
  • The Nurse is often in charge of doing the fills for patients
  • There is a learning curve to adjust the band properly
  • The fill might go into the fat instead of the port, and the need to return for another fill is frequently seen
  • You can get a leak from the hose due to needle puncture or penetration (due to multiple intents to reach the port’s target area) 
  • The Doctor will not know your lap band status with an office fill
  • The Doctor can’t detect early avoidable complications

 Office fills are an option for lap band adjustments. However, we do recommend having lap band fills done under fluoroscopy guide. If this is not possible, have your lap band checked under fluoroscopy at least once a year to determine the status of your lap band system and to check for any complications.

 

Arturo Rodríguez, MD

Bariatric Surgeon

http://www.thebariatric.com

http://www.bandstersforum.com

Originally posted 2008-07-19 22:32:22. Republished by Blog Post Promoter

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Lap Band Erosion: Clinical, Radiological and Endoscopic Correlation

Lap Band Erosion: Clinical, Radiological and Endoscopic Correlation

Erosion is a long-term complication of lap band surgery, and occurs when the Gastric Band fastened around the upper stomach gradually erodes into the stomach wall and extends into the gastric lumen.  Intragastric Lap Band Erosions have been reported at rates that vary from 0.6% to 10% depending of the operative technique, the doctor’s experience, the device used and the most important factor: the patient’s follow up.

The use of NSAIDS, alcohol and smoking have been proposed as three of the main factors contributing to hyperacidity and irritation of the mucosal layer of the stomach. This important layer prevents us from acquiring ulcers in normal conditions.  When the irritation is persistent, it can cause erosion of the wall layers of the stomach, which may allow the lap band to migrate into the stomach (“inside out” erosion theory).  Repeated vomiting has also been suggested as a possible accelerant, especially when a high degree of obstruction is present (For example, an over-filling of the lap band). Due to the erosion, saliva or food leaks through the hole or ulcer in the stomach and flows along the Lap Band tubing, causing the tissue under the skin of the Lap Band Port to become infected. 

 intragastric-lapband-migration
Figure 1.0 Intragrastric Lap Band Migration – Drawing of radiographic findings illustrates passage of liquid contrast material (Barium) around left section of band that has eroded into the stomach (small arrow).

In some cases, Lap-band erosion occurs gradually and may be silent or go unnoticed. However, several clinical symptoms may develop and should raise the suspicion of Lap Band Erosion: (1) cessation of weight loss, (2) weight regain with loss of restriction in the lap band, or (3) a port site infection. The Clinical Symptoms and Radiological or Endoscopic findings depend on the degree of Erosion.

The diagnosis of Lap Band Erosion can be made at the radiological evaluation performed under fluoroscopy during a gastric band adjustment in both symptomatic and asymptomatic patients.  If the radiological evaluation does not show signs of lap-band erosion and the patient has the symptoms, the doctor is obligated to perform an Endoscopy.

port-infection

Lapband Port Infection http://www.thebariatric.com

Figure 1.1  Lap Band Port Infection

Due to the fact that Lap Band Erosions usually open with a port infection (35%), the infection will continue after removal of the port, especially if erosion was not diagnosed.  In these cases of chronic infection, further radiological and endoscopic tests are needed to demonstrate the presence of Lap Band Erosion.

endoscopy-findings1

Lapband Erosion, http://www.thebariatric.com

Figure 1.2  Endoscopic View of Lap Band Erosion

endoscopy-findings-tips2

Lapband Erosion, http://www.thebariatric.com

Figure 1.3 Intragastric Lap Band Erosion – Note the “tips” of a Swedish band into the gastric lumen

erosion-xray

Lapband Erosion, http://www.thebariatric.com

Figure 2.0 – Intragastric Lap Band Erosion – Radiological evaluation shows 2 channels of contrast material, instead of one, clearly demonstrated in the later view of Fig. 2.1

erosion-xray2

Lapband Erosion, http://www.thebariatric.com

Fig. 2.1 – Intragastric Lap Band Erosion - In this lateral view you can see the “bridge” between the upper (the pouch) and the lower stomach, the barium contrast material bypasses the part of the lap band that has eroded through the stomach’s wall.

missing-port

Lapband Port infection http://www.thebariatric.com

Figure 3.0 - Missing PortAP plain film shows a lap band without the port. The Patient had a history of port removal secondary to port infection with a persistent infected fluid coming out from the port area.

fistulography

Lapband Fistulography http://www.thebariatric.com

Figure 3.1 Intragastric Lap Band Erosion demonstrated by fistulography.
Note the injected contrast material at the skin level is going through the fistula into the lower stomach.

The upper GI x-ray does not reveal lap band erosion in its early stages. However, the radiological appearance of late-stage intragastric band erosion on the upper gastrointestinal series is pathognomonic when the “stair sign” is observed. Barium swallow during the upper GI shows a flow of contrast fluid around the portion of the band that has eroded into the stomach. As mentioned before, in cases where the radiological findings are missing, an endoscopic evaluation is mandatory.

stair-sign

Lapband Erosion, http://www.thebariatric.com

Figure 4.0 Intragastric Lap Band Erosion – Radiograph from upper gastrointestinal series shows characteristic appearance of intragastric lap band erosion. Note the liquid contrast material on both sides of penetrating portion of the lap-band, “the stair sign”.

 

band-migrated

Lapband Erosion, http://www.thebariatric.com

Figure 4.1 - Radiologic evaluation shows a complete eroded gastric band – Note the location of the migrated band; the lap band device is found in its totality intragastric at the level of stomach antrum (the lower stomach). The patient had not been loosing weight for 3 years.

band

Lapband Erosion, http://www.thebariatric.com

Figure 4.2 – Complete erosion of the gastric band (seen in Figure 4.1) the gastric band was removed by endoscopy

Treatment of lap band erosion requires removing the lapband by laparoscopy or by endoscopy.  Weight regain typically occurs following this procedure. However, it is necessary to remove the gastric band in order to avoid further complications.  It is recommended to treat Lap Band Erosions with another bariatric procedure 6 to 8 months after a de-banding procedure (Lap Band removal). This is due to the high incidence of complications and failures when the procedure is done immediately following removal, or sooner than 6 months after removal, since the portion of stomach that has been eroded is weak and prone to leaking.

It is true that Lap Band Migration means the failure of the operation and leads to a second bariatric procedure; however, erosion is considered a complication with a benign course if it is managed properly.

Susana González M.D.

Radiologist

http://www.thebariatric.com

 

Originally posted 2008-08-09 23:51:53. Republished by Blog Post Promoter

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Lap Band Surgery in Mexico

Lap Band Surgery in Mexico

When most people go away on vacation, it is to soak up the sun, see new things, meet new people, and to relax and “get away from it all.”  However, more and more people are going away to experience a different kind of tourism: medical tourism. This involves a person traveling away from their native country to have a health care procedure done in a different country.   People have all sorts of medical procedures done abroad: everything from joint replacement to cosmetic surgery is performed on such medical-based trips. Mexico is a country many people go to for such procedures In fact, having lap band surgery in Mexico is becoming more and more popular.

Lapband makes restriction to food intake

Lapband makes restriction to food intake

Many people are going to Mexico for lap band surgery. This surgery is something many believe will change their lives. Lap band surgery helps people who suffer from obesity to work towards returning to a more normal or healthy weight. Because of the price, many people are forced to have the surgery done in different countries, especially since some insurance companies will not cover the procedure.

As a person usually has to pay out of pocket for a surgery that they believe will save their life, they will head to countries where the procedure is less expensive.  For many people, lap band surgery is their last shot at being healthy.  Thus, for people who do not have insurance or a regular doctor, going to Mexico is a logical choice.

After all, once the surgery is done, they can then relax in a new or exotic location where no one has to know about their surgery. Privacy is a major reason for why people choose to have surgery and other medical procedures done abroad. They may not want their friends, family members, coworkers, or doctors to know that they had a little work done. This could be because they do not want to worry the people in their life, or it could be because they want to appear refreshed at all times.

There are a number of things to take into account when considering LapBand surgery - make sure you are well informed before making the decision to have the procedure.  Many Mexico based doctors have set up support forums and telephone consultations so that you can get the information you need to make a decision.  Here’s a testimonial from a patient of Dr. Arturo Rodríguez, who practices in Monterrey, Mexico:

Lapband success

“My name is Linda Pearce I’m 58 years old. I found Dr. Rodriguez’s web site and after much research I knew he was the Doctor for me.  I had my lap band surgery  Oct. 2005. I have loss 85 lbs.  My  whole life has changed because of Dr. R and his team. The hospital and care in Monterrey Mexico was awesome, better than some of the hospitals in the States. Everything went just as they told me it would from being pickup at the airport to going to the hospital and back. Thank you Dr. Rodriguez and your team. You guys are the best. My life has changed forever.”

For more information on the lapband and Realize band procedure, visit The Bariatric Group

http://www.thebariatric.com

http://www.bandstersforum.com

Originally posted 2008-12-12 21:44:47. Republished by Blog Post Promoter

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What If my Bariatric Procedure Fails?

What If my Bariatric Procedure Fails?

Patients can have minor or large complications after a Lap Band, Gastric sleeve or Gastric Bypass procedure.  Many patients may need another surgery to correct the complications, which can cost them more money. However,  medical complications are not always a result of a bariatric procedure failure.  A Weight Loss Procedure is classified as a failure if the procedure is no longer working.

When a Bariatric Procedure Fails for a patient, there are several different consequences to be considered.  They include the emotional, economical, and physical impacts of the failure.  

What are the emotional consequences of Procedure Failure?

Depending on the type of procedure (Lap Band, Gastric Sleeve or Gastric Bypass), the patient may regain all the weight back again. This can be emotionally devastating because it gives the patient the feeling that he or she has thrown away money for nothing.  They feel anger towards the doctor and themselves, and during this whole process, their health and life could be at risk due to the complications. It is important for patients to know they are not alone. It is also important that they take positive action to address the situation, since this increases the probability of succeeding in the future. 

 What happens after a Procedure Failure?

We can say a Bariatric Procedure is no longer working when the patient has regained all the weight originally lost. This means that the patient needs a new procedure called Revision Surgery. The need for a revision surgery after a procedure has failed may jeopardize the health or life of the patient, as the complication rate increases from 2% to 25%. In addition, it will cost additional money for the revision surgery.

The chances for success for a second, different, Bariatric Surgery are lower then the first time, and the morbidity increases up to 25% depending on the revision procedure to be done. This is in part because the doctor has to be able to finish a new Weight Loss Procedure over the scar tissue and be able to repair what went wrong in the first place. The decision as to which will be the chosen bariatric surgery for the second time will depend on the type of surgery first performed.

How can a patient succeed after Revision surgery?

The patient must be careful to avoid any mistakes made before that may have influenced the development of complications.  It is very important that you ask your doctor and yourself questions like:

  • Why didn’t the first procedure work for me?
  • Which procedure works for me best after failing the first time?
  • Am I going to be able to follow the rules for success with the procedure I am choosing?
  • How much help will I get from the doctor and his staff after revision surgery?
  • Am I looking only for the best price I can get, or for the procedure that can work best for me?

You have to analyze both the pros and cons for any procedure that you are considering, especially when considering a second procedure or revision surgery. You have more chances to succeed if you keep in mind what went wrong the first time, in order to develop a plan for success in the future.

 

Arturo Rodríguez, MD

http://www.thebariatric.com/

http://www.bandstersforum.com/

Originally posted 2008-07-27 21:53:21. Republished by Blog Post Promoter

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10 Ways to Succeed with the Lap Band

10 Ways to Succeed with the Lap Band

Here are some helpful tips to help you succeed with the Lap-Band on a long-term basis.

Before you have the Gastric Lap Band:

1. Search for the Right Doctor for You
Many companies or groups claim to be the Best Experts in Lap Band surgery.  However, it is important to check the qualifications and experience of your surgeon before making your decision.  Find out whether the doctor is a member of any medical organizations and whether they have any experience in bariatric surgery.  Make sure to research the company and the Doctor´s credentials, and look into the facilities and medical team.  You can also check with the companies that manufacture the lap band products, like Allergan or Johnson & Johnson, to find more recommendations.  It is very important to be in the right hands when you have surgery.  The experience of your surgeon can make a big difference in your weight loss outcome.  Surgery can be life-changing – Don´t play with your health.  Look for the right doctor, and not just the cheapest deal.

2. Double-check the Doctor´s Coordinators
Some coordinators will say anything to convince you that their team and services are the best. The personality of the coordinators or the medical team can tell you a lot about the kind of work they do.  When talking on the phone, check for signs of aggressiveness, or whether they speak poorly of other bariatric teams or surgeons.  If they tell you that they know “everything” about Lap Bands or bariatric surgery, this is probably not true.  Take your time to analyze their ethics and professionalism, and keep your ears and eyes open.  Be cautious of coordinators that seem too pushy or don´t respect your requests.  These coordinators are not looking out for your best interests – they are just looking for your money.  Instead, look for coordinators that demonstrate clear communication and professionalism, honesty, friendliness and a helpful and caring attitude.

3. Avoid companies that are just “moving patients through the border”
Some “coordinators” may contact you to promote weight loss surgery without an actual connection to a qualified bariatric surgeon.  They may not even work for the Doctor that they are promoting, and are just looking to make money.  They do not have your best interests in mind – you are a merchandize for them.  They might make promises that they can´t follow through with, and may get any Doctor for your surgery as long as they get paid for arranging things for you.  When researching into the company, find out as much as you can about all the details, including any hidden costs or fees.  Be sure that you feel confidant and comfortable with the people that you are working with before you make your final decision.

4. Communicate with other Banded Patients
Often, the best source of information is someone that has already gone through the experience before.  You can find out answers by asking other people that have had the lap band procedure.  Search for online forums, chat rooms, or message boards.  Some questions you might ask could be:

  • What kind of surgical weight loss procedure did they receive?
  • Was the surgery what they expected?
  • How did the Doctor and his medical team treat them?
  • Did they have any complications after surgery?
  • How long did the surgery process take?
  • How have they adjusted to life with the lap band?
  • Did they see the results that they were expecting or hoping for?
  • How soon did they see results?
  • Would they recommend their doctor to someone else looking for the same surgery?

After you have the Gastric Lap Band Procedure:

5. Begin the Journey: Develop Good Habits
After Lap Band surgery, you will need to make some changes to your diet and activity.  Small actions can results in big changes and lead to successful weight loss with your new lap band.  Make sure that you learn about what foods to eat and what foods to avoid after your surgery, and determine if you can make these changes.  You will also see better results if you include physical activity in your daily routine.  If you are always used to driving in the car or riding the bus, try going for a short walk or getting off the bus earlier. If you do walk, try walking faster.  Park your car farther away from where you are going so you can get some extra steps into your day. Use any excuse to move your body, like taking the dogs out or doing some gardening. Do anything that will help you to develop new, healthy habits.

6. Your Lap Band Expectations
Imagine yourself at the end of the “Lap Band Road” and keep Focused on that image. The vast majority of banded patients expect the band to work alone by itself, without changing any of their old habits. But the truth is that you do need to put a lot of energy into yourself and encourage yourself to improve your eating habits and activities in order to each your weight loss goals. The Lap Band is a tool to help you, but it won’t do the job alone. For the best results, you need to be committed to positive change.

7.  Find the optimum Lap Band Fill
My advice is to reach a “fill point” where you can keep enjoying the foods you like, while still being able to lose or maintain your weight. Too much tightness or restriction will have you at the border line for being de-banded, and stomach erosion can happen frequently in patients with large fills. Do not compete with the Lap Band by trying to force food to pass through the band. If you feel excessive restriction, visit your doctor to have your band adjusted. 

8. Maintain Good Communication with your Doctor
This is the most important of the 10 “keys for success.”  Make sure you can reach your Doctor whenever you need him or her.  The Bariatric Surgeons and Doctors are different than General Surgeons in the follow-up care.
Don’t hesitate to call your Doctor if you have any of the following symptoms: Heartburn, pain at the port area or in the abdomen, frequent vomiting, difficulty swallowing or reflux.  

9. Have a Barium Swallow or an Endoscopy atleast once a year
This can help to indicate the condition of your stomach, esophagus, and the lap band system, including the positioning of the band and port.  This may also help to detect any problems earlier, which can allow for more time to solve the problem. 

10. Have your Fills done under Fluoroscopy as often as possible
Office fills do not detect early, easily-correctable problems until it may be too late.  Slippage and erosion are more frequently seen in patients that have never had follow-ups under fluoroscopy.  Check with your Doctor to find out their process for lap band fills – if they only do office fills, ask your Doctor to recommend someone that can provide fills under fluoroscopy for you.

 

Arturo Rodriguez, MD
http://www.thebariatric.com
http://www.bandstersforum.com

Originally posted 2008-05-31 20:39:08. Republished by Blog Post Promoter

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Old Treatments For Weight Loss Are New For Diabetes

Old Treatments for Weight Loss are New for Diabetes

Approximately 22% of adults in the United States and 35% of the adults in Mexico have been diagnosed with Type 2 Diabetes, which is the type that also accounts for 95% of all Diabetes cases.  About 60% of obese patients have Metabolic Syndrome (Type 2 Diabetes, High Blood Pressure and High Cholesterol) and 20% of people over 65 years are Diabetic in the US.  With an estimated over 300 million affected individuals by 2025, the lifetime risk of developing type 2 Diabetes will approximate 20%.

There is an increased interest world-wide for surgical procedures that improve Type 2 Diabetes and Metabolic Syndrome.  Many Bariatric or Weight Loss Surgeons are asked about their experience in this matter for the better understanding and treatment of this disease.  We now know after years of Gastrointestinal Weight Loss procedures, that there are two main effects achieved through bariatric surgery: one is the Bariatric Effect (successful weight loss), and the second is the Metabolic Effect (a positive change in features of Metabolic Syndrome).

People that are overweight or obese will see improvement in blood sugar levels when they lose weight. Except with the Gastric Band, other gastrointestinal weight loss procedures (Gastric Bypass, Duodenal Bypass, Gastric Sleeve, Duodenal Switch or Bilio-Pancreatic Diversion) can promote an improvement in blood sugar levels long before there is significant weight loss.  Often the improvement can be seen just days after the surgery.

Improvement of blood sugar levels for people with type 2 Diabetes can be very successful for those that receive the Gastric Band (50% of the cases), the Gastric Bypass (70%), the Gastric Sleeve (85%) or the Duodenal Exclusion Procedures with or without Sleeve (92%). Patients that need insulin, and those that have been Diabetic for a longer period of time, are more resistant to blood sugar improvements.  However, the gastric procedures have still been shown to help these patients.

There are different explanations about the Metabolic Effect.  In the gastric bypass, this effect is related to the nature of the malabsortive procedures. The Duodenal exclusion is related to the secretion changes of the Ghrelin Factor (Hunger Factor) and other Neuro-hormonal factors called Incretins as the GIP (gastric inhibitory peptide), GLP-1 (glucagon like peptide) and the YY peptide. In operated patients where the stomach and the duodenum are excluded, the increase in Incretin secretion has a direct effect on lowering the Sugar Insulin Resistance, promoting the Growth of the BETA Pancreatic Cells that produces insulin and also for the improvement of the sugar-insulin action.  For individuals with a BMI 35 or less, we observed lower weight loss with the malabsortive procedures, but the metabolic effect remained the same as seen in heavier patients.  This indicates that the procedures are very effective for improving blood sugar levels.  In the Gastric Sleeve, the effect is related to the removal of 80% of the stomach. 

Both obese patients and those with Type 2 Diabetes should discuss with the surgeon each procedure’s surgical risk, the rate of bariatric and metabolic effect, and the long-term co-morbidities that each surgical option has before deciding on any of them.

Dr. Arturo Rodriguez
http://www.thebariatric.com

Originally posted 2008-05-19 19:15:45. Republished by Blog Post Promoter

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Lap Band Erosion

Lap Band Erosion

There are many terms that have become familiar to the lap band population because they are commonly used among doctors and patients.  One popular term is “Lap Band” which stands for Laparoscopic Gastric Banding.  The term “Lap Band Erosion” also became very popular among the banded patients as lap band message boards increased in popularity. The patients that already had the Lap Band were concerned as“erosion” was often connected to topics such as de-banding or surgical removal of the band.  However, the term actually means that the stomach has developed a penetrating ulcer and has eroded (worn away) towards the balloon of the band.

How does Stomach Erosion happen in Lap Band Patients?

Intragastric band erosions have been reported at rates that vary from 3 to 10% depending on the operatory technique or surgeon´s experience, the device used and the patient’s eating behavior.  There are several different and controversial theories for the cause of erosion:

  1. The Lap Band around the stomach gradually erodes into the stomach wall over time, and goes into the gastric lumen, as we have seen with other intrabdominal devices.
  2. The stomach damage done during the Lap Band procedure debilitates the layers of the stomach wall, resulting in erosion at a later time.
  3. The sutures were placed too deep and trespassed all the wall layers of the stomach, causing micro perforations that generate leaking, infection and later erosion.
  4. Events that happens inside the stomach, such as frequent vomiting, medications, ingestion of irritants as spicy or hot food, alcohol, etc. as well as a large adjustment to the band system, will produce an ulcer that penetrates toward the balloon of the band. 

I believe the last theory is the most consistent and also the most frequently seen in the vast majority of patients with erosion.  Other theories,  such as a crease or a fold in the balloon, which may harm and erode the stomach lining, were not scientifically proven. We have seen erosion with all kinds of Lap Bands and with all kinds of balloons and find no correlation with the fold theory.

Once the erosion-ulcer is established it is not possible to cure the ulcer, not even by removing all the fluid in the band. Therefore the need to remove the band itself becomes imperative. I recommend the band be removed AS SOON AS POSSIBLE, not because this is an emergency in any way, but because there is a risk of increasing the ulcer’s size.  Removing the Lap band can help to decrease the risk of complications such as infection traveling along the hose to the port and to the skin, or stomach bleeding.

How Can Lap Band Erosion be Prevented?

There are several ways to prevent erosion.  The first way that I personally recommend is to avoid “large fills” to the Lap Band, in order to prevent vomiting or gastric reflux.  The second way that I recommend is to protect the stomach with anti-acids frequently, especially at bed time.  The third recommendation is to avoid alcohol, hot or spicy food, vinegar, soy sauce, and coffee.  Talk with your Doctor about the medications you are actually taking and ask about exchanging the ones that can hurt your stomach for others with the same effect but less stomach irriation.

 

Arturo Rodriguez,MD
Bariatric Surgeon

http://www.thebariatric.com

http://www.bandstersforum.com

Originally posted 2008-06-12 21:18:18. Republished by Blog Post Promoter

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Lap Band Surgery and Exercise

Lap Band Surgery and Exercise

Exercise plays an important role in weight management after Lapband surgery, as well as overall fitness. It is important to put the emphasis on physical activity for both weight control and health.

“Weight Maintenance” rather than weight loss should be your primary focus.  We encourage people personally and at our FORUM to increase their exercise activity and reduce their sedentary activity, to lose or maintain a certain weight after Lapband surgeryIt is recommended that a minimum of 30 minutes of daily moderate to intense exercise is needed to maintain a healthy lifestyle.

The day after Lapband Surgery, you should start walking as usual.  Two weeks after Lapband surgery you can do any kind of exercise.  You can start full exercise 2 weeks after Lapband surgery.

It has been determined that there are direct links between weight gain, health risks, and obesity. With the Lapband Procedure there is a direct link between exercise and successful weight loss. One of the only factors that reduces the risks associated with obesity is exercise. After Lapband surgery, exercise is the most important factor in losing weight or at least in maintaining weight loss.

Planning an exercise program after the Lapband should be based on personal goals as well as on individual capabilities. The most important element to be considered is to think long-term and make exercise a permanent part of your life. There are several types of alternative exercise programs that are available today. It doesn’t mean that you have to join a gym or a fitness center after Lap-band surgery.  But if you join a gym or fitness center, the key is to be consistent.  You can make sensible fitness choices that are more desirable or fit your lifestyle.

Here are some examples:

Moderately Intense Activities:

  • Brisk walking (3-4 mph)
  • Cycling (10 mph)
  • Swimming or calisthenics
  • Racket sports or table tennis
  • Golf (without a cart)
  • Housecleaning, general*
  • Raking leaves*
  • Dancing*
  • Playing actively with children*

*Considered moderate only if they are performed at intensity comparable to brisk walking. (Source: Journal of the American Medical Association 273:402:1995.

Arturo Rodriguez, MD

http://www.thebariatric.com

http://www.bandstersforum.com

Originally posted 2008-12-16 20:16:40. Republished by Blog Post Promoter

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Simplified Gastric Bypass

Simplified Gastric Bypass

What is Gastric Bypass Surgery?

The Gastric Bypass is considered as the “gold standard” of Weight Loss Surgery by the American Society of Metabolic and Bariatric Surgeons (ASMBS).  Roux-n-Y Gastric Bypass Surgery (RYGB) is the most commonly practiced weight loss surgery world wide.

The Gastric Bypass is also considered by the SAGES and ASMBS as the most complex and technically challenging procedure to be done by laparoscopy and requires a large number of operations to achieve competency.

Open RYGB as treatment for obesity was introduced by Dr. Mason and Dr. Ito in 1967. The first Laparoscopic RYGB was performed in 1994 by Dr. Wittgrove following the surgical steps of the open surgery.

The Simplified Gastric Bypass was developed by Dr. Almino Ramos in Sao Paulo, Brazil and was called Simplified Laparoscopic Gastric Bypass consisting in simplifying and standardizing the surgical steps of the traditional Gastric Bypass in a way that it can be done in the superior half of the abdomen easily, by trained Bariatric Surgeons with less operative time (average of 75 minutes) and with more efficiency.  Today, thousands of patients are operated by this technique all over the world.

The Simplified Gastric Bypass technique involves a gastric stapling, and its division (forming the gastroplasty, new gastric chamber or pouch), lowering the gastric capacity by 90% (20-30cc). The Gastric Bypass is done ante-colic (the open way was retro-colic, meaning that was done behind the transverse colon) and as far as 1.5 to 2 m (the small bowel has 4 to 7 m in length).  At the end of the procedure, the gastroplasty is connected with the deviated intestinal limb (gastrojejunostomy) by stapling and suturing them, to allow the food to pass again.

What are the Risks of Gastric Bypass Surgery?

International literature describes an average of 10% of cases with complications (morbidity), and a 2% mortality rate.  Anastomotic leak is the most serious complication of gastric bypass procedure and is associated with increased morbidity and mortality.  The ideal treatment is prevention by meticulous operatory technique and pre and postoperative care.  The leaks that are likely to result in mortality (about 15%) are those for which the patient manifests a high systemic inflammatory response, and is closely related with a high BMI, with fever, increased leukocyte count and heart rate and also signs of organ failure.

How does the Gastric Bypass Work?

This operation involves two effects: predominant gastric restriction, and intestinal malabsorption.  The food arrives at the new stomach (gastroplasty) and promotes distention on the walls of the pouch, inducing satiety and fullness with small amounts of food.  Then the food passes slowly through the calibrated gastrojejunostomy of 11 mm and proceeds for digestion (1.5 to 2m after the new formed gastric pouch).  When the fullness sensation of the small chamber is exceeded, pain or vomiting can occur.

After a Gastric  Bypass, the liquids with high concentration of carbs will not be totally absorbed, especially during the first year.  This may result in “dumping syndrome” where the food moves too quickly into the small intestine.  Symptoms include bowel irritation, abdominal pain, diarrhea, and increased heart rate with palpitation and sweating.

What happens post-op (after surgery)?

Most of the patients are discharged from the hospital within 48 to 72 hours after the operation. The complete return to normal activities occurs in about one week.  During 4 weeks following the operation, the patient should consume a liquid diet, and advance in a stepwise way to a puree/baby food type diet for one or two additional weeks, eventually evolving to an almost normal diet by the fourth week.  In this operation there is a need to supplement vitamins and minerals. Iron must be followed by regular I.V. tests and reposition is usually needed.

Who  would benefit from a Gastric Bypass?

  • Patients with a metabolic disease (Type 2 diabetes, high blood pressure, hyper-lypidemia)
  • Persons with any degree of binge eating disorder
  • Moderate risk patients (few co-morbidities)
  • High expectations (those who need to lose weight, up to 80% EWL [excess weight loss])
  • Low to moderate patient commitment

 

Arturo Rodriguez, MD

http://www.thebariatric.com

Originally posted 2008-07-03 07:48:58. Republished by Blog Post Promoter

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Lap Band Trials – Reviewing the Results

Lap Band Trials – Reviewing the Results

I would like to review an issue that was recently presented to me the other day regarding lap band trials.   As a number of companies produce the Lap Bands used for the surgical procedure, comparisons have been made in the past between different brands.   Testing trials were held by Inamed (in the late 90’s) and by Johnson & Johnson (three years ago) and reports have attempted to compare these two bands.  However, the information obtained is being manipulated with results that favor the use of one band over the other.

Under the marketing competition, the comparison focuses specifically on the Lap Band explantation (or de-banding) during these trials.  The huge difference shown between the two brands of lap bands is now being used to manipulate doctors and patients into using a particular brand.  The problem is that the trials were not done under the same circumstances and cannot fairly be compared.

To correctly interpret the results of the trials, we need to look at the difference in circumstances.  The Lap Band trials were all done by surgeons, and placed in obese patients in both trials.  However, the comparison between trials does not include details about the surgeons’ experience in placing the band. The main difference between the trials is the surgeon’s ability and knowledge of the Lap Band.  At the time of the Inamed trial, the doctors were Gastric Bypass surgeons and had little to no experience with lap bands, while the Johnson & Johnson Realize Band trial was done by surgeons with more experience in Gastric Banding.  Therefore, it is likely that the famous “learning curve” adversely affected the Inamed trial.

It is also true that the first three Inamed models had many factory disadvantages.  Proof of this is that they have been pulled out slowly from all world markets, and Inamed has changed those first models for two different improved devices with fewer design problems.

Regardless of this last statement, we can conclude that the trials can not be compared, as the factors involved differ.  I believe there is more to do to improve the lap bands and that we will see changes on this matter in the near future.  I am placing the result of both trials for you to review and make your own conclusions.

Johnson & Johnson’s Realize Band trial

Realize Band – U.S. Clinical Trial  N=276
Key Serious Adverse Events
Band slippage

9 (3.3%)17

Band erosion

1 (0.4%)17

Port displacement

7 (2.5%)17

Band explantations

417

Port revisions/replacements

2717

 Inamed’s Lap-Band trial

Lap-Band® - U.S. Clinical Trial  N=299
Key Serious Adverse Events
Band slippage

11 (3.7%)18

Band erosion

1 (0.3%)18

Port displacement

18(6.0%)18

Band explantations

75

Port revisions/replacements

26

 

Arturo Rodriguez, M.D

http://www.thebariatric.com

Originally posted 2008-08-13 07:55:28. Republished by Blog Post Promoter

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De-Banding the LapBand Can be Complicated

De-Banding the Lap Band Can be Complicated

Today I want to share some concepts that frequently are misunderstood by Doctors starting a bariatric program, and by Banded Patients.  There are several reasons for De-Banding a Lap-Band patient. Today I would like to focus on EROSION.  The incidence of Stomach Erosion ranges from 2 to 15% of the patients who underwent a Lap Band Procedure .  The occurence of erosion depends on the Surgeons learning curve, and various patient actions such as the consumption of alcohol, spicy or hot food, frequent vomiting or the use of some medications like Aspirin.

The concept I want to strongly point out is that De-banding due to stomach erosion could be much more challenging and difficult than the initial LAP BAND procedure itself, and requires a lot more experience and skills to do it safely and properly without having complications like leaking, intra-abdominal abscesses or infection at different levels.

Doing the De-Banding properly also means that the Surgeon has to keep in mind that the patient may require a Revision Surgery after six months, for a Re-banding, a Gastric sleeve or a Gastric Bypass Procedure.

In cases of infection or leaking during the De-Banding, the revision surgery will be very difficult, and prone to more frequent complication rates (5 to 30%), or may almost be impossible to be done because of heavy adhesions at the operatory site.  As a matter of fact, the so called “learning curve” among Doctors when doing a De-Banding procedure requires a larger number of “supervised surgeries” than with the initial lap band, and the supervisions are usually done by an experienced Surgeon teaching the new bariatric surgeons or the General Surgeons under these conditions, to provide an opportunity for those patients to receive a new bariatric procedure.

If you require De-banding, be sure to inform yourself and look into finding the most experienced and qualified surgeon.  Your health is important.

Dr. Arturo Rodriguez
Bariatric Surgeon

http://www.thebariatric.com

Originally posted 2008-04-28 13:27:42. Republished by Blog Post Promoter

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The Laparoscopic Journey: Past and Future

The Laparoscopic Journey: Past and Future

Our History

The knowledge that we have today about laparoscopy has developed through the patience, hard-work and determination of dedicated doctors and individuals. When we started doing laparoscopic surgery, many doctors without laparoscopic training argued that open surgery had a better view through the large incision, than from the tiny camera’s panoramic view. They also thought that the sense of touch was lost by using instruments instead of fingers tips. They stated we were introducing unnecessary risks to any procedure by doing so. However, over time we have discovered that laparoscopic surgery is a very safe method.  The view is much better with the cameras moving in all possible directions, and the tip of the instruments act as well as finger tips do after you have been trained to use the instruments.

We also were discouraged from performing laparoscopic surgery in the elderly, in the young and in the morbidly obese patients. The patients under this category were unable to have laparoscopic procedures of any kind in all major hospitals.  However, time and experience have also demonstrated the safety of this technique for higher-risk patients.  Now, everyone recognizes the laparoscopic method as the best option for many surgical procedures, and many people are now are surprised when procedures are not done using laparoscopy.

Advancement in the quality of lap band products has continued over the past 30 years.  The first lap band model in the United States was the Inamed Lap Band, approved by the FDA in 2001.  Doctors in the States began using this band as it was the only approved model in the US.  We initially promoted another type of Lap Band that was developed in Europe, with a softer ring, and a bigger, low-pressure balloon to adjust to any stomach size.  This type of Lap Band was approved by the FDA in 2006, and has now become the most widely used type of lap band in the world.  A few years ago, this band was purchased by Johnson and Johnson and is now known in the US market as the Realize Band.  Inamed (Now Allergan) has five different models of the Lap Band, which have been designed to emulate many of the characteristics of the Realize band.

What´s Next?

Initially, there was much resistance against treating patients with a BMI less than 35, with bariatric procedures such as the Lap Band.  The medical community now supports preventative medicine, by encouraging patients to be pro-active rather than waiting five or tens year and developing co-morbidities before they treat the medical problem.  Today, there are various procedures acceptable for patients with a BMI of less than 35, including the Gastric Band, as well as more drastic procedures such as the Gastric Bypass, Duodenal Bypass, Gastric Sleeve and Duodenal Exclusion.  These procedures are also helpful if you are looking for your patient to obtain the Metabolic Effect from these procedures, and to improve blood sugar control for patients with Type2 Diabetes, High blood pressure and High Cholesterol (Metabolic Syndrome).

 

Arturo Rodríguez, MD
http://www.thebariatric.com
http://www.bandstersforum.com

Originally posted 2008-06-02 00:35:50. Republished by Blog Post Promoter

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What is the Best Surgical Weight Loss Procedure for Me?

What is the Best Surgical Weight Loss Procedure for Me?

I hear this question all the time and there is no single answer for every person. You have to find your own answer by asking some questions like:

Is the cost of the procedure an issue that will influence my decision on which procedure to have?
Am I looking for a simple or complex bariatric procedure?
Am I looking for the safest procedure?
Am I going to be able to follow the rules for success with the procedure I am choosing?
How much help will I get from the doctor and his staff after any of the Weight Loss Procedures?
Which of the Weight Loss Procedure fits my life style better? 

You have to be well informed about all the surgical Weight Loss Options in order to have the answers, but it is also very important for you to know about the doctors that perform the surgies (the Lap Band, Gastric Sleeve or Gastric Bypass), their bariatric experience, their surgical staff, the experience they have in revision surgeries, the ethics and professionalism of the promoters and the Weight Loss follow up and support  that they will provide for you after your surgery.

Helpful Facts About Weight Loss Surgery

  • There is no ideal Weight Loss Procedure that works for every person.  Everyday we do more revision surgeries because of Lap Band, Gastric Sleeve and Gastric Bypass failures.
  • Gastric Sleeve is the Weight Loss Procedure that results in the best response for patients with Type 2 Diabetes, Hypertension and Hyper-Cholesterol (the Metabolic Effect).
  • The Lap band is the simpler and cheapest among the Weight Loss Procedures.
  • It is not true that if you are very heavy you will need to have the most drastic procedure.
  • Young or elderly patients can have the Lap Band, the Gastric Sleeve or the Gastric Bypass.
  • The doctor’s experience influences the outcome of the Weight Loss Procedures.
  • The patient´s eating behavior can modify the outcome of any of the Weight Loss Procedures.
  • The open message boards have very many doctors’ coordinators trying to send patients their way and might confused patient’s right decisions.}
  •  The procedure with lowest surgical risk is the Lap Band.
  • The procedure with the most surgical risk is the Duodenal Switch, followed by the Gastric Bypass.
  • The average hospital stay following the Lap Band procedure is one night.
  • The average hospital stay following the Gastric Sleeve procedure is two nights.
  • The average hospital stay following the Gastric Bypass procedure is three nights.
  • The Lap band needs to be “filled” periodically in order to provide optimum weight loss results.
  • A person with a Gastric Bypass will need nutritional supplements for life to avoid deficiencies.
  • You should avoid alcohol with any bariatric procedure, due to high risk of getting an ulcer.

 

Dr. Arturo Rodriguez
Bariatric Surgeon
http://www.thebariatric.com
http://www.bandstersforum.com

Originally posted 2008-06-26 00:34:53. Republished by Blog Post Promoter

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Obesity: Is Fast Food Responsible?

Obesity: Is Fast Food Responsible?

The reasons for obesity are multiple and complex.  Despite conventional wisdom, it is not simply a result of overeating.  Research has shown that in many cases, the significant underlying cause of morbid obesity is genetic. Studies have demonstrated that once the problem is established, efforts such as dieting and exercise programs have a limited ability to provide effective long-term relief.  

Science continues to search for answers but, until the disease is better understood, the control of excess weight is something patients must work at for their entire lives.  That is why it is very important to understand that all current medical interventions, including the Lap Band, Gastric Sleeve and Gastric Bypass procedures should not be considered medical cures. Rather, they are attempts to reduce the effects of excessive weight and alleviate the serious physical, emotional and social consequences of the disease.  

Contributing Factors  

The underlying causes of severe obesity are not known.  There are many factors that contribute to the development of obesity including genetic, hereditary, metabolic, environmental, and eating disorders.  There are also certain medical conditions that may result in some special type of obesity, such as the long term intake of steroids and some diseases such as hypothyroidism and hyper-adrenalism

Genetic Factors  

Numerous scientific studies have established that your genes play an important role in your tendency towards excess weight gain.  The body weights of adopted children show no correlation with the body weights of their adoptive parents, who feed them and teach them how to eat.  However, their weight does have an 80 percent correlation with their genetic parents, whom they have never met.  As well, identical twins with identical genes, show a much higher similarity of body weights than do fraternal twins.

Certain groups of people, such as the Pima Indian tribe in Arizona and the growing Mexican-American population have shown a very high incidence of severe obesity. They also have significantly higher rates of diabetes and heart disease than other ethnic groups.  

We probably have a number of genes directly related to weight.  Just as some genes determine eye color or height, others can affect the appetite by increasing the amount of secretion of the Ghrelin Factor by the stomach, or the ability to feel full, satisfied, or have an early age-related change in metabolism. Our fat-storing ability, and our natural activity levels may even be affected by some predetermined gene. 

Environmental Factors

Environmental and genetic factors are obviously closely intertwined.  If you have a genetic predisposition toward obesity, then the modern American lifestyle and environment may make controlling weight more difficult.  Fast food, long days sitting at a desk or in front of a TV screen or monitor, and suburban neighborhoods that require cars all magnify hereditary factors such as metabolism and efficient fat storage.   For those suffering from morbid obesity, anything less than a total change in environment usually results in failure to reach and maintain a healthy body weight.  

Metabolism

We used to think of weight gain or loss as only a function of calories ingested and then burned. Take in more calories than you burn, gain weight; burn more calories than you ingest, lose weight. But now we know the equation isn’t that simple.  Obesity researchers now talk about a theory called the “set point,” a sort of Thermostat in the brain that makes people resistant to either weight gain or loss. If you try to override the set point by drastically cutting your calorie intake, your brain responds by lowering metabolism and slowing activity. You then gain back any weight you’ve lost.

Eating Disorders & Medical Conditions

Weight loss surgery is not a cure for eating disorders. And there are medical conditions, such as hypothyroidism, that can also cause weight gain. That’s why it’s important that you work along with your doctor to find out whether you have any conditions that should be treated with medication and counseling.

 

Arturo Rodriguez, MD

http://www.thebariatric.com

Originally posted 2008-04-23 14:06:19. Republished by Blog Post Promoter

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Getting to Know You…


Getting to Know You…

Learn More About your Bariatric Surgeon

Dr. Arturo Rodríguez is a highly skilled, compassionate surgeon with more than 13 years of surgical experience. He is a member of the American Society for Metabolic and Bariatric Surgery and Johnson & Johnson Proctor. He has performed more than 6,500 weight loss surgeries for patients from Mexico and the United States.

Dr. Arturo Rodríguez understands the life-changing effect that Bariatric Surgery can have on an individual, and he is committed to providing long-term support for his patients as they embark on their journey to healthier and happier lives.  Dr. Rodríguez specializes in minimally invasive laparoscopic Gastric Banding Surgery-Lap Band, Gastric Sleeve and Gastric Bypass which greatly reduces scarring and postoperative recovery time.  He is highly skilled in placing and monitoring both the Lap Band and the Realize band, and he personally consults with each one of his patients to determine which procedure best suits their needs. His extensive experience and education also allows him to help patients who suffer from complications of morbid obesity.

Dr. Rodríguez and his professional medical team are dedicated to providing expert care and compassionate support from the first consultation through years of follow-up.  Patients also receive long-term support through follow-up consultations, interaction with Dr. Rodríguez in the online forum and patient reunions held in Monterrey.

To schedule an in-person or online consultation with Dr. Rodríguez and learn more about your weight loss options, you can contact him at: 

ArturoRodriguez, MD

md@thebariatric.com

http://www.thebariatric.com

http://www.bandstersforum.com

Phone: 011-52-81-8378-3177.

Originally posted 2008-11-23 15:04:20. Republished by Blog Post Promoter

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