Archive for the ‘gastric bypass’ Category

Plastic Surgery after Bariatric Surgery (Lap band, Gastric sleeve or Gastric bypass)

Thursday, February 2nd, 2012

Plastic Surgery after Bariatric Surgery (Lap Band, Gastric sleeve or Gastric Bypass)

I know many individuals that are attracted by the idea of starting over.  It’s important for an individual to discover what they did wrong, and how we can change.  There is a need to lose weight or to keep the weight off successfully, to change your diet, to do some kind of exercise, to get fit and to stay fit by increasing your activity, to look younger, to have a totally new body so you can improve your body image. We are often dissatisfied or discontent with what we have, especially relating to our appearance – we want more or we want to look better!

Plastic Surgery has almost become a necessity for patients that have had a Bariatric procedure such as the lap band, gastric sleeve or gastric bypass.  Patients who have undergone bariatric surgery and are looking for Plastic Surgery should know that they will need more Reconstructive Surgery than just the normal Aesthetic Procedures such as Liposuction. This means that Liposuction (the most frequent plastic surgery among all the population) or a tummy tuck would not be enough, and in most cases they will need a Plastic Surgeon who has experience working with patients that have undergone a Bariatric procedure.

Patients that have lost a lot of weight after a Bariatric procedure have different personal image concerns and plastic surgery needs.  Before performing any procedure, the doctor must consider your age, your muscle tonicity, the amount of weight loss, the skin laxity or elasticity, the skin excess and the hygiene difficulty.

Frequent Questions among Lap Band Patients

Q: When is the best time to have a Plastic surgery after my Bariatric procedure?

A: The best time for Plastic Procedures for Lap Band patients is after reaching 60% of excess weight loss.

Q: Where can I start?

A: You should discuss your needs first, the surgical options and the cost of each procedure with your Plastic Surgeon and at that point, start planning a Plastic Procedure on what you can afford, what you want to improve or what bothers you most.

Q: Should I have all plastic surgery done at once?

A:  As a Surgeon I recommend to my patients to schedule plastic surgery in phases and not to have Plastic surgery done all in one procedure.  You have to consider that most of the Plastic surgery completed on a Bariatric patient takes a lot longer than in non-obese patients and this means that the surgery will be 6-8 hrs in the OR under general anesthesia.  There is also more blood loss and many times the patient may need to have a blood transfusion if there is a lot of work needed.

Q: How long does it take?

A: The Tummy Tuck takes 2.5 to 6 hrs depending on the patient needs.  The breast Lift takes 3.5 hrs.  A lower body lift takes 3 to 6 Hrs.

Q: What is the cost?

A: The cost varies from doctor to doctor but each procedure can cost from 6 up to 10 thousand USD

What to expect after Plastic Surgery in Lap band patient

Most of the procedures require a one or two night hospital stay. You will need to be out of work for about 10 days after surgery and you will also have drains for 5 to 7 days.  The patient must also wear a compression garment for several months.  While the scar is healing, the patient will also need oral antibiotics.

Arturo Rodríguez, MD

http://www.thebariatric.com

http://www.bandstersforum.com

Originally posted 2008-10-23 08:17:51. Republished by Blog Post Promoter

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Posted in Gastric band Procedure, Gastric Band surgery, Gastric Banding, gastric bypass, gastric sleeve, Gastric Sleeve Mexico, Lap Band procedure, Lap band surgery, Obesity, Obesity surgery, Plastic surgery after weight loss, Roux-n-Y, RYGB, Weight loss surgery | 6 Comments »

INTERNAL HERNIAS RELATED TO A GASTRIC BYPASS

Thursday, January 12th, 2012

INTERNAL HERNIAS RELATED TO A GASTRIC BYPASS

 

The internal hernias after a Laparoscopic Gastric Bypass may occur in 10 % of patients.  Early detection is important because they threaten the patient by causing intestinal obstruction, intestinal strangulation with perforation and peritonitis.

It is very important to know that the Internal hernias often pass unnoticed delaying the diagnosis and the treatment. 

The doctors either do not suspect the problem as a cause of the symptoms or the patients misunderstand the severity of their symptoms due to their initially vague clinical symptoms.

It is very common that the patients tend self medicate themselves delaying the prompt attention, not consulting with a doctor until symptoms are more serious with a higher risk of catastrophic complications.

Internal hernias in patients with Gastric Bypass occur most frequently 18 months after surgery, however there are reports from the first postoperative day up to 25 years after the operation.

It is important to know if your doctor completed a laparoscopic Gastric Bypass “retro colic” or gastric Bypass “ante colic”.

There are 3 sites in the first case (retro colic) where hernia occurs: At the Petersen’s space, at level the jejunum-jejunostomy and at the mesocolon underneath the transverse colon; and there are two sites in the ante colic laparoscopic Gastric Bypass with a potential internal hernia presentation.

When a surgeon uses sutures during the bypass surgery the potential of a hernia space decrease the risk of the presentation of internal hernia.

In some private hospitals operatory time is very expensive and some doctors prefer to ignore this very important surgical step, on the other hand, to close these spaces also requires the development of advanced laparoscopic skills to do it correctly and in expeditious manner with intracorporeal stitches to close such potential hernia spaces and that has to be done by hand (not staplers), as a result, that explains some of the incidence of hernia with intestinal obstruction.

Common symptoms of internal hernia after a Laparoscopic Gastric Bypass are mild peri umbilical pain progressing to an intermittently cramping pain but increases in frequency and if not treated it will progress to the classic intestinal obstruction.

Occasionally the intestinal obstruction is mild and resolves quickly but may become a true surgical emergency where the life of the patient is at risk and surgical laparoscopic treatment has to be done without delay.

If you experience any of the described symptoms you must act quickly to resolve the hernia and need to be explore the area by laparoscopic means.  Closure of the hernia ring is very feasible in most cases, even more, when a bypass patient arrives with obstruction and it is diagnosed quickly needs to undergoing laparoscopic exploration to avoid complications.  If not treated immediately the chances increase due to the high possibility of a second catastrophic event.

Don’t expect that the hernia will be resolved with general measures because sooner or later the patient’s life is in jeopardy.

Dr. Arturo Rodriguez

Gastric Surgery and Obesity

http://www.thebariatric.com

http://www.bandstersforum.com

Originally posted 2010-01-10 19:59:05. Republished by Blog Post Promoter

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Posted in gastric bypass, Obesity, Revision Surgery, Roux-n-Y, RYGB, Weight loss surgery | 2 Comments »

Making Healthy Choices after Bariatric Surgery

Thursday, December 29th, 2011

Food, Glorious Food!

Making Healthy Choices after Bariatric Surgery

Bariatric surgery can help you to lose weight, but you also have to make some long-term changes to your diet in order to see the best results.  Your stomach is much smaller after bariatric surgery, and can only hold a small amount of food.  It is important to choose HEALTHY and NUTRITIOUS food in order to help reach your weight loss goal and to keep your body nourished.  Here are some general guidelines to help you in creating your own unique and healthy lifestyle.

Plan Ahead. Your new lifestyle starts at the grocery store! If you buy cookies, sweets and chips, it will be hard to resist or limit these foods when they are accessible at home. Before you buy the groceries, make a list of the foods you plan to eat during the week and include healthy choices that are easy to prepare.

Include foods from all four food groups in your diet. Vegetables and Fruits, Grain Products, Dairy and Alternatives, Meats & Alternatives. There are many healthy foods to choose from. Make your plate colorful!

Start with protein-rich foods.  Beans, lentils, chicken, fish, eggs, and dairy products are all good sources of protein.  Your body needs protein to build muscle, skin, hair, and connective tissues, and support many essential chemical reactions.  Carbohydrate-rich foods like rice, pasta and cereals are an important source of energy and vitamins, but they can fill you up quickly. Save these towards the end of your meal… and don´t forget about your vegetables and fruits, rich in vitamins and minerals too!

Eat three small meals per day.  Make sure to include breakfast every day.  Skipping breakfast can lead to over-eating at lunchtime, and you also need that energy to help you start your day.  Spread the meals out evenly throughout the day, so that you are eating every 4-6 hours.  If there is a long stretch of more than 6 hours between meals, include a small healthy “snack” to keep you going.  Perk up with a small orange (35 calories) or whole wheat crackers (2 crackers = 80 calories) with low-fat cheddar cheese (1 oz = 49 calories), instead of a chocolate bar (280 calories!) 

Drink between meals instead of with meals to help your lap band work at its best.  The lap band is designed to restrict solids, not liquids. Drinking liquids during or immediately after meals tends to flush food through your stomach pouch and you will not get the prolonged feeling of satiety that you need.  Keep your foods and liquids separate to feel fuller longer, and stay hydrated too!

 

Making Healthier Choices

Here are some simple ways to make healthier choices at meal times.

  1. Breakfast?  In your coffee or tea, replace the sugar with artificial sweetener, or add 2% milk instead of cream.  Instead of a donut or package of cookies, choose a low-fat yogurt and spoonful of granola, or a soft-boiled egg and small apple.  
  3. Lunch?  On your sandwich, use margarine instead of mayonnaise, and just spread it on one side of the bread. Add fresh vegetables to your sandwich to increase the flavor – try tomatoes, cucumbers or green peppers sliced very thin.  Mix small pieces of cooked chicken and low-fat cheese into your salad to make a fresh meal, and choose low-fat salad dressings or make your own – olive oil, balsamic vinegar, lemon juice, and a dash of pepper!

Dinner?  Steam your vegetables instead of boiling or frying them.  Try baking your fish or chicken instead of frying it in oil. If you´re looking for a flavor kick, try adding some fresh herbs and spices to your dish.  For a simple, healthy meal, wash and cut potatoes, carrots, and broccoli, and wrap them in foil together with some fresh fish and herbs – pop the foil package in the oven for 30 minutes at 400°F and enjoy a delicious hot meal!

Do I need to Avoid or Limit any Foods?

High-calorie foods.

Avoid “Empty Calorie” foods like syrup, honey, pie, jam, chips, or cake, as they contain large amounts of sugar, and will fill you up quickly while providing very little nutritional value. Although you don´t have to give up your favorite high-fat treats forever, you will need to change the amount and frequency that you indulge in these foods in order to see the best results with your lap band.  For example, if you usually eat a large bowl of ice cream in the evenings, use a smaller bowl and choose one day per week when you will enjoy your favorite flavor.  If you love soda pop, choose the diet or light version instead, but watch out – the bubbles will fill you up fast.  Remember – your bariatric surgery is a tool that you can use to help you lose weight, but it will not work without your support!

Stomach Irritants

Some foods and medications can irritate your stomach, causing inflammation which can making eating uncomfortable and increase the risk of blockages.  Avoid or limit alcohol, spicy foods like chili, and tobacco.  Some medications like aspirin or iron supplements can also cause irritation. Talk with your doctor to find a safe alternative if you require these medications, and if possible, request a liquid format.

Hard & Bulky Foods

Some foods can get stuck in your lap band or stomach pouch, which can be an uncomfortable or painful experience.  Foods like popcorn, nuts and seeds are difficult to digest and may get stuck in your lap band, blocking other foods from passing through for digestion. It is best to avoid foods that are hard or difficult to digest.  Other foods such as pasta, rice, tortillas or dry bread can be bulky and may get stuck if you do not chew them properly.  Limit these foods in order to decrease the risk of blockages.  If you eat these foods, make sure you are chewing well and eating slowly.  If you feel that they are stuck, you may need a small sip of water to help them pass through.

 

R. Pallek

Nutritionist

The Bariatric Team

http://www.thebariatric.com

Originally posted 2009-04-03 11:36:22. Republished by Blog Post Promoter

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Posted in Bariatric diet, Gastric band Procedure, Gastric Band surgery, Gastric Banding, gastric bypass, gastric sleeve, Gastric Sleeve Mexico, Lap Band procedure, Lap band surgery, Lapband, Lapband mexico, Lapband procedure, Lapband surgery, Obesity, Obesity surgery, Roux-n-Y, RYGB, Weight loss surgery | No Comments »

Lap Band, Gastric Sleeve or Gastric Bypass? That is the Question!

Thursday, October 27th, 2011

Lap Band, Gastric Sleeve or Gastric Bypass? That is the Question!

The Bariatric surgical field has experienced extraordinary changes over the past 55 years.

With the initial empiric use of Intestinal Bypass surgery in 1954 by Kremen, Linner and Nelson at the University of Minnesota, severe obesity was identified as a disease that could be successfully treated.

Today, the acceptance of Bariatric Surgery is a proven surgical discipline.  It hasn’t always been that way, and has gone through a long bumpy road in a very hostile environment.  It has gone from acid critics and nonbelievers to a great demand of this kind of surgery all over the world.

The increase of obesity over the past 50 years has doubled or tripled in some countries.

One third of the population in the United States is obese (23 million) and patients seeking surgical treatment are becoming heavier each year.

The increase in weight has occurred in men, women and children of all ages.

The need of healthcare due to co-morbidities, is also rapidly escalating, which has greatly affected the public healthcare system and in the economy.

Some of the initial procedures have been abandoned because of serious complications. We have learned from these procedures what not to do, what to avoid and how to do it better.

Over the years, we have also learned about many different surgical techniques.  We have learned it’s short and long term complications, the procedures that gave poor results and the procedures that have produced good results.  We continue to be properly trained for new techniques and new procedures, how to be involved in the designs of instruments and devices and to make the surgery easier.   To help improve results of Bariatric Surgery, we learn how to apply new technology to our procedures like using the laparoscopic towers to decrease mortality, pulmonary insufficiency, operative time, hospital stay and pain.

Now we offer several procedures in which obesity would be prevented or cured by surgical means with similar long term results.

After all, we are facing 2 main problems now with so many patients that had a Bariatric Procedure and a lot of others seeking help: What would be the best Surgical Treatment to be offered to the patient?  And, how can we give the best Follow-Up care to make them succeed and avoid complications?

At where we stand now, we cannot say that one Bariatric Procedure over the others will always work for everyone. We have to recommend the best procedure for the patient.   Sitting down and talking with the patient is imperative to make the right choice for them.  We need to see what he understands and knows about different Weight Loss Procedures.  We need to get to know his habits and his environment.  We need to know what co-morbidities he has, know his fears, and most important, the commitment and the desire of making changes to his life.

Restrictive procedures like the Lap band and the Gastric Sleeve have lower operatory and long term complications.  These procedures are also less expensive than the Gastric Bypass and the Duodenal Switch but need a lot more commitment from the patient to follow diet restrictions and exercise to succeed.

It is well know that complex procedures such as Gastric Bypass and Duodenal Switch gives patients the desired weight loss during the first year, but causes unwanted Malabsorption.   Even if the procedure has failed and  the patient gains the weight back, he will have long term unwanted complications such as metabolic bone diseases which include Osteoporosis (from poor calcium absorption), Osteomalacia (from vitamin D deficiency),  Osteopenia and Osteitis Fibrosa Cystica (from Secondary Hyperparathyroidism due to low serum calcium). 

These diseases require long term, close follow-up care to prevent complications.  Our offices are sometimes not capable of providing follow-up care for different reasons. Many times the patient is unable to remember who performed his surgery or they have relocated.

Surgical goals should offer a lifetime decrease in Medical Healthcare.  Not only to offer the treatment for obesity and the actual problems that obesity creates, but to have a Follow-up System established for 15 to 20 years later.

Arturo Rodriguez, MD

Tricia Lackey

http://www.thebariatric.com

http://www.bandstersforum.com/

Originally posted 2009-10-23 16:31:10. Republished by Blog Post Promoter

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Posted in Bariatric diet, Gastric band Procedure, Gastric Band surgery, Gastric Banding, gastric bypass, gastric sleeve, Gastric Sleeve Mexico, J & J Band, Lap Band procedure, Lap band surgery, Lapband, Lapband mexico, Lapband procedure, Lapband surgery, Obesity, Obesity surgery, Realize Band, Roux-n-Y, RYGB, Weight loss surgery | 5 Comments »

Have Lap Band Surgery for Less in Mexico

Wednesday, October 5th, 2011

Have Lap Band Surgery for Less in Mexico

Mexico has become the best location to obtain surgical operations for less money, especially in the areas of weight loss and plastic surgery. You can have lap band surgery for less in Mexico, yet still enjoy the same level of professionalism, technology, after-surgery care, and state-of-the-art medical facilities.

The Mexicans have developed numerous reputable medical schools in recent years, such as the University of Monterrey, and some of the best Mexican hospitals are located nearby with exceptionally skilled physicians and surgeons. Many American medical students have also obtained their education from this University. In addition to gastric bypass or gastric sleeve surgeries, one of the most common and widely available surgeries in Mexico is the Lapband procedure.

Lapband surgery is also known as gastric band surgery. It is minimally invasive, especially when compared to other types of obesity control methods. The surgery is much safer as well. When comparing the price of this surgery between the United States and Mexico, patients can receive the exact same Lap band procedure in Mexico for up to 70% less than in the states. Despite the lower price, patients are advised to avoid the cheapest clinics.

Blindly placing trust in the least expensive location is not the best idea. Patients should expect to pay somewhere between $7,000 and $12,000 for the lap band or gastric bypass procedure. Avoid going to clinics that quote an extremely low Lapband price. Often, the reason for the deeply discounted price is due to a lack of business, poor reputations, a lack of proper facilities, or a lack of qualified personnel.

Choosing where you will obtain your lap band surgery is a very important decision. Certainly, you can have lapband surgery for less in Mexico, yet you must still make an informed, educated choice between hospitals, clinics and doctors. It is always the best choice to choose full-fledged hospitals for any surgical procedure in Mexico, primarily because they have all the necessary medical equipment and emergency surgical backup if any complications should arise. Good hospitals, such as Christus Health, will have major facilities such as blood banks, XRAY, MRI, and ICU centers. Some of these same hospitals will also have boarding facilities in which patients can stay along with a friend or relative. Finally, large hospitals will also have staff who speak English fluently, which is an important factor when considering a surgical procedure in another country. You need to be able to communicate your desires, your feelings, your pain, and your concerns to your physician or surgeon.

Christus Hopsital Http://www.thebariatric.com

The Bariatric Team

http://www.thebariatric.com

http://www.bandstersforum.com

Originally posted 2009-01-24 22:29:40. Republished by Blog Post Promoter

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Posted in Gastric band Procedure, Gastric Band surgery, Gastric Banding, gastric bypass, gastric sleeve, Gastric Sleeve Mexico, Lap Band procedure, Lap band surgery, Lapband, Lapband mexico, Lapband procedure, Lapband surgery, Obesity, Obesity surgery, Plastic surgery after weight loss, Roux-n-Y, RYGB, Weight loss surgery | 3 Comments »

Why My Weight Loss Procedure Can Fail?

Wednesday, September 14th, 2011

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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Posted in Gastric band Procedure, Gastric Band surgery, Gastric Banding, gastric bypass, gastric sleeve, Lap Band procedure, Lap band surgery, Obesity, Obesity surgery, Revision Surgery, Roux-n-Y, RYGB, Weight loss surgery | 2 Comments »

Lap Band Trials – Reviewing the Results

Wednesday, September 7th, 2011

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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Posted in Gastric band Procedure, Gastric Band surgery, Gastric Banding, gastric bypass, Lap Band procedure, Lap band surgery, Obesity, Obesity surgery, Stomach erosion, Weight loss surgery | No Comments »

What If my Bariatric Procedure Fails?

Tuesday, September 28th, 2010

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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Posted in Gastric band Procedure, Gastric Band surgery, Gastric Banding, gastric bypass, gastric sleeve, Lap Band procedure, Lap band surgery, Obesity, Obesity surgery, Revision Surgery, Roux-n-Y, RYGB, Stomach erosion, Weight loss surgery | 2 Comments »

DIET BEFORE LAPBAND

Monday, September 20th, 2010

DIET BEFORE LAPBAND

Why a low Carbs Pre Lap-band Diet is Helpful?

I am used to performing surgery on patients that have not done any pre-operatory diet mainly because many of them can’t follow any kind of diet and by asking for one just increases their stress before surgery.

Long term carbohydrates and fat diets will turn to storage and infiltration of fat into the hepatic cells. Under this condition, the liver total mass will be progressively enlarged to what’s called pre-cirrhotic stage. By this, fat infiltration of the liver and on patients, the liver will remain enlarged during the lapband Surgery, the Gastric sleeve or the Gastric bypass and the working surgical area turns into a tiny space, reduced for errors in placing the instruments in the right position.

Because there is less room to work with also makes it very difficult to see and recognize the structures, to have enough space to do the right sutures and perform a safely procedure unless the surgeon has enough experience to handle these kinds of situations and has the right bariatric instruments to work with.

We don’t know for sure how much the total liver mass will be reduced by one or two weeks with pre op-diet. My personal belief is that will not shrink too much to make a difference and that the surgeon should be able to adapt to all situations.

 

Arturo Rodriguez, MD
http://www.thebariatric.com
http://arturorodriguezmd.com
phone: 011 52 818 3783177

Originally posted 2009-07-20 10:09:31. Republished by Blog Post Promoter

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Posted in Bariatric diet, Gastric band Procedure, Gastric Band surgery, Gastric Banding, gastric bypass, gastric sleeve, Gastric Sleeve Mexico, J & J Band, Lap Band procedure, Lap band surgery, Lapband, Lapband mexico, Lapband procedure, Lapband surgery, Realize Band, Roux-n-Y, RYGB, Weight loss surgery | No Comments »

What is the Best Surgical Weight Loss Procedure for Me?

Monday, September 6th, 2010

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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Posted in Gastric band Procedure, Gastric Band surgery, Gastric Banding, gastric bypass, gastric sleeve, Lap Band procedure, Lap band surgery, Obesity, Obesity surgery, Revision Surgery, Roux-n-Y, RYGB, Stomach erosion | No Comments »

Simplified Gastric Bypass

Monday, July 26th, 2010

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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Posted in gastric bypass, Obesity, Obesity surgery, Roux-n-Y, RYGB, Weight loss surgery | 3 Comments »

Obesity: Surgery as a Weight Loss Option

Monday, July 12th, 2010

Obesity: Surgery as a Weight Loss Option

Obesity: Health Risks

Morbid obesity is a disease of excess energy stores in the form of fat (BMI >40 kg/m2).  Being overweight is associated with many physical problems which are now well recognized in both the medical community and general population.  Serious consequences of severe obesity are well documented and include cardiac dysfunction, pulmonary problems, digestive diseases, and endocrine disorders as well as obstetric, orthopedic, and dermatologic complications.  Obesity is also linked to an increased prevalence of cardiovascular risk factors known as Metabolic Syndrome. These include Hypertension, Type 2 Diabetes Mellitus, Hypertriglyceridemia, Hyperinsulinemia and low levels of high density lipoprotein (HDL) cholesterol.

The risk for diabetes has been reported to be about twofold in the mildly obese, fivefold in moderately obese and tenfold in severely obese persons. The duration of obesity is also an important determinant of the risk for developing diabetes. The association between average weight of population groups and the prevalence of non-insulin-dependent diabetes has been repeatedly observed.

Cancer mortality rates are increased in severely obese females; e.g. endometrium (5.4 times), gallbladder (3.6 times), uterine cervix (2.4 times), ovary (1.6 times), breast (1.5 times). Cancer mortality rates are increased in severely obese males; e.g. colorectum (1.7 times), and prostate (1.3 times). The morbidly obese patient is also at risk for affective, anxiety and substance abuse disorders. People who are obese often consider their condition as a greater handicap than deafness, dyslexia or blindness.

Managing Obesity: What are the Options?

For people that are overweight or obese, weight loss can results in significant improvements to their health and decrease the risks for developing many long-term chronic diseases.   Statistically significant improvements have been observed in both diabetes and hypertension, with >10 percent weight loss, and in cardiovascular conditions, with only a 5 percent weight loss of overall body fat for overweight patients.

Generally, the first option for weight loss is a change in diet and exercise.  Many people have had success when sticking to a realistic plan and making permanent lifestyle changes.  However, for those that have struggled with morbid obesity, diet and exercise may not be sufficient to see the degree of change that they require in order to improve their overall health and achieve a healthy weight.

The use of anorectic medications has recently been advocated as a long term therapeutic modality in management of what is clearly a chronic disease. In a nearly four year study, utilizing a two drug regimen of Phentermine and Fenfluramine, behavior modification, diet and exercise, the initial optimistic results have not been sustained, with a one third drop-out rate and a final average weight loss of only three pounds in those who were followed for the four years of the study. This drug combination appears to have an unacceptably high association with cardiac valvular disease and has been withdrawn from therapeutic use because of these potentially life threatening sequelae.

Bariatric Surgery

Published scientific reports document that non-operative methods alone have not been effective in achieving a medically significant long term weight loss in severely obese adults. It has been shown that the majority of patients regain all the weight lost over the next five years.

For people who have exhausted other options such as diet and exercise, Bariatric Surgery may be medically necessary to achieve long term weight control for the morbidly obese. Bariatric surgery involves reducing the size of the gastric reservoir, with or without a degree of associated malabsorption. This can assist patient to improve their eating behaviors dramatically, which reduces caloric intake and ensures that the patient practices behavior modification by eating small amounts slowly, and chewing each mouthful well.

Success of bariatric surgical treatment must begin with realistic goals and progress through the best possible use of well designed and tested operations. These have been worked out over the last thirty years, and are now standardized, clearly defined procedures, with well recognized and documented outcome results including the Lap Band, Gastric Sleeve, Gastric Bypass and Duodenal Switch.

Prevention of secondary complications of morbid obesity is an important goal of management. The biological basis for morbid obesity is unknown, though recent work has demonstrated a genetic component of between 25 and 50%. Several studies confirm the influence of genetically determined proteins produced by the fat cell to be among the many mechanisms which have a place in the control of satiety. These studies confirm that morbid obesity is a disease, not a disorder of willpower, as sometimes implied. The physiological, biochemical and genetic evidence is overwhelming that morbid obesity is a complex disorder. Contributing causes include family history, environmental, cultural, socioeconomic and psychological factors.

Is Bariatric Surgery for Anyone?

The option of surgical treatment should be offered to patients who are morbidly obese, well informed, motivated, and acceptable operative risks. The patient should be able to participate in treatment and long term follow-up. A decision to elect surgical treatment requires an assessment of the risk and benefit in each case. Increased abdominal fat or “central obesity” (apple shaped as opposed to pear shaped or “external obesity”) is an important risk factor associated with the major complications of obesity.

Functional impairments associated with obesity are also important deciding factors for surgical treatment. Patients whose BMI exceeds 40 are potential candidates for surgery if they strongly desire substantial weight loss, because obesity severely impairs the quality of their lives. They must clearly and realistically understand how their lives may change after any of the operations.

In the USA and under certain circumstances, less severely obese patients (with BMI’s between 35 and 40) also may be considered for surgery, and in Mexico, patients with BMI 30 or more are considered for surgery. Included in this category are patients with high risk co-morbidities such as life-threatening cardiopulmonary problems (e.g. severe sleep apnea, Pickwickian syndrome, obesity-related cardiomyopathy, or severe diabetes mellitus). Other possible indications for patients with BMI’s between 35 and 40 include obesity-induced physical problems that are interfering with lifestyle (e.g. musculoskeletal, neurological, or body size problems precluding or severely interfering with employment, family function and ambulation).

Available published series report that the immediate operative mortality rate for Vertical Banded Gastroplasty, Roux-en-y Gastric Bypass and Lap band is relatively low.  Morbidity in the early postoperative period (i.e. wound infections, dehiscence, leaks from staple breakdown, stomal stenosis, marginal ulcers, various pulmonary problems, and deep thrombophlebitis) may be as high as ten percent or more. Splenectomy is necessary in 0.3% of patients to control operative bleeding. However, the aggregate risk of the most serious complications of gastrointestinal leak and deep venous thrombosis is less than one per cent. In the late postoperative period, other problems may arise and may require reoperation. The mortality and morbidity rates of reoperation are higher (30%) than those of primary operations.

Complications and Risks of Bariatric Surgery

The most frequent “major” complications for bypass patients were GI leak (0.73%), GI hemorrhage or bleeding (0.44%), and small bowel obstruction (0.40%). Simple restrictive procedures (vertical banded gastroplasty, Gastric sleeve) with no bypass were reported to have GI leak (0.47%) and stoma obstruction or stenosis (0.35%) as the most frequent defined major complication. Lap band does not show leaking.

Risk and efficacy of operations for obesity must be understood in the context that severe obesity is a chronic, frequently progressive, life threatening disease. The therapeutic program applied should be designed to be beneficial throughout the patient’s lifetime. Long term follow-up is essential when reporting treatment effectiveness. Weight loss usually reaches a maximum between 18 and 24 months postoperatively. Mean percent excess weight loss at five years ranges from 48 to 74 % after gastric bypass and from 50 to 60% after vertical banded gastroplasty.

Pure gastric restrictive procedures such as vertical banded gastroplasty (VBG), silastic ring gastroplasty (SRG) and adjustable silastic gastric banding (AGB or LAPBAND) all achieve weight loss by restricting volume of intake. Intake becomes a function of the patient’s motivation to chew well and eat slowly. Failure to do so may result in repeated vomiting and isolated cases of protein and vitamin deficiency have been reported in these circumstances. Careful patient follow up is therefore mandatory, with particular emphasis on the first three postoperative months. Adjustable silastic gastric banding (LAPBAND) approved in 2001 for use in the USA following FDA trials can be considered functionally similar to vertical banded gastroplasty.

Gastric bypass with Roux-en-y (RGB) results in ingested food bypassing the gastric fundus, body, antrum, duodenum and a variable length of proximal jejunum. In consequence, these patients are at risk to develop iron deficiency secondary to lack of contact of food iron with gastric acid and consequent reduced conversion of iron from the relatively insoluble ferrous to the more absorbable ferric form. In addition, vitamin B12 deficiency may result in consequence of food no longer coming in contact with gastric intrinsic factor. Vitamin D and calcium absorption may also be reduced since the duodenum and proximal jejunum, which are the preferential sites of absorption, are bypassed by this procedure. Life long supplements of multivitamins, vitamin B12 iron and calcium are mandatory following this procedure. Long-term follow-up is essential for physical, nutritional and metabolic evaluation.

Weight Loss: Benefits

Weight loss surgery has been reported to improve several comorbid conditions such as glucose intolerance and frank diabetes mellitus, sleep apnea and obesity associated hypoventilation, hypertension, and serum lipid abnormalities.  A recent study showed that Type II diabetics treated medically had a mortality rate three times that of a comparable group who underwent gastric bypass surgery. Benefits also include increased ambulation, and decreased incidence of clinical depression, among a wide variety of improvements on a long-term basis.

 

Arturo Rodriguez, MD

http://www.thebariatric.com

http://www.bandstersforum.com

Originally posted 2008-11-23 21:08:52. Republished by Blog Post Promoter

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Posted in Gastric band Procedure, Gastric Band surgery, Gastric Banding, gastric bypass, gastric sleeve, Gastric Sleeve Mexico, Lap Band procedure, Lap band surgery, Obesity, Obesity surgery, Revision Surgery, Roux-n-Y, RYGB, Weight loss surgery | 5 Comments »

Bariatric Procedures: Being More than Fans

Monday, June 28th, 2010

Bariatric Procedures: Being More than Fans

The last 10 years I have been very busy participating in a lot of meetings around the world.  I have found, unfortunately, that we have spent such a long time discussing what procedures are the best for treating obesity that we have forgotten the main point, the core of any of the procedures’ success: the patient.

We all look like fans of a football team, cheering for their favorite team.  Some doctors cheer for the Gastric bypass as the best and only option to cure obesity. Then we have the doctors that prefer the lapband as the first option. In another corner, there are the doctors that promote the Gastric sleeve as the new treatment for obesity and Type 2 Diabetes.

There are several good medical reasons involved in the doctor’s preferences for one procedure over the other but also their preferences points toward which procedure the doctor feels more comfortable performing or is more skilful.  In Mexico, we have to add to this discussion, the place were the doctor was trained, for instance, if he was trained in the Mexican Health Care System they will know very little about the Lap band and would prefer to perform the Gastric Sleeve or the Gastric Bypass.  This is because the Lap band is not yet available for the government hospitals.  This means that these doctors started with Bariatric procedures such as the Gastric Bypass 3-4 years ago, and the Gastric Sleeve 1-2 years ago.

I personally recommend the Lap band as the first option. There is less risk for operatory complications involved, it is less expensive and it’s adjustable.   You don’t have to be overly obese to have the Lap Band.  You can have Lap band revision in case the lapband fails the first time or jump to any of the other procedures available including the Duodenal Switch. The Lap-band also helps in the control of co-morbidities related to obesity such as high blood pressure or Diabetes in almost 6 out of 10 patients.

The arguments against having the Lap band as the first option are valid with patients that have difficult behavioral control such as alcohol abuse. Arguments are also valid for patients that don’t like the idea of having lapband fills done periodically or when there isn’t a doctor or center to do the fills close to where they live.  The arguments against the Lapband that are not valid, are erosion rates (less than 2 %), slippage (less than 4 %), or obtaining insufficient weight loss as a strong argument for deciding on other surgical options such as the Gastric sleeve or Gastric Bypass.

There are no “complication free” bariatric procedures.  With any bariatric procedure there are advantages and disadvantages.  We also found that with all bariatric procedures, there is a chance for insufficient weight loss and a chance that patients may need revision surgery. Mean percent excess weight loss at five years ranged from 48 to 74 % after Gastric Bypass and from 50 to 60% after Vertical Banded Gastroplasty, the same results are for the Gastric Sleeve.

However, with all this in mind, we must remember that the best and most effective procedure will ultimately depend on the individual patient that is looking for a weight loss procedure.  The patient and doctor must work together to discover all the facts and make the best informed decision in order to be successful. Don´t rush your decision – get informed!

 

Arturo Rodríguez, MD

http://www.thebariatric.com

http://www.bandstersforum.com

Originally posted 2008-11-13 22:11:41. Republished by Blog Post Promoter

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Posted in Gastric band Procedure, Gastric Band surgery, Gastric Banding, gastric bypass, gastric sleeve, Gastric Sleeve Mexico, Lap Band procedure, Lap band surgery, Obesity, Obesity surgery, Revision Surgery, Roux-n-Y, RYGB, Stomach erosion, Weight loss surgery | No Comments »

Here is my Lapband Story…

Saturday, January 23rd, 2010

Here is my Lap Band Story…

I was overweight most of my life.  I had tried every diet out there only to gain all the weight back. I was depressed and frustrated.  I had heard so many Weight Loss Surgery success stories and realized that Lapband surgery was my only option for permanent Weight Loss. While researching my options I ran across Dr. Arturo Rodriguez’s website and decided to call.  I was skeptical about traveling outside the U.S. but after a lot of research I was certain that Dr. Arturo Rodriguez was the right doctor for me. 

An important thing I learned in my research was that the experience of your Lap-band Surgeon plays a huge role in your success with Lap-band.  Dr. Arturo Rodriguez has performed thousands more Lap-band Surgeries than any doctor I could find in the U.S.  I decided that if I was going to have this surgery I wanted the best Surgeon to do it!

My experience in Monterrey was amazing!  I was greeted at the airport and taken directly to the hospital.  When we arrived, Dr. Rodriguez and his assistant met my husband and I.  They discussed everything that would take place.  After surgery I was taken to my hospital room.  There was always a nurse to help if I needed.  I have never received such good care in any hospital in the U.S. as I did in Monterrey.

The next day I was picked up and taken to my hotel room and later that evening, one of  Dr. Arturo Rodriguez’s staff came to check on me and take my husband and I around Monterrey.  The next day someone picked us up and drove us to the airport.  We never had to worry about a single thing the entire time we were there.

My life since Lap-band Surgery has changed dramatically. I can play with my boys and not get tired, I’m more outgoing, I wake up and my back doesn’t hurt, and I have endless amounts of energy.  It’s also taught me what true portion control is and given me the skills to lifelong Weight Loss!  I’ve learned what it takes to keep the weight off forever!  Most importantly I have eliminated my chances of acquiring obesity related illnesses. 

I have Dr. Arturo Rodriguez and the Lap-band Surgery to thank for all of this.  It changed my life so much that my Mom even decided to have Gastric Bypass Surgery (by Dr. Arturo Rodriguez of course) and she too has had amazing success losing over 100 lbs and going off many of the medications she was on prior to surgery. In fact, I was so impressed by Dr. Rodriguez and his staff that when the opportunity came to work with them and to help others see the many benefits of this surgery, I jumped at the chance.

I would love to talk to you about how much this amazing Surgery can change your life and why Dr. Arturo Rodriguez is the right Surgeon for you.

shelby

Shelby, Lapband patient, http://www.thebariatric.com

 

Shelby Hashagen

Patient Coordinator / Dr. Arturo Rodriguez

(360) 304-0610

shelby@thebariatric.com

http://www.thebariatric.com

Originally posted 2009-03-25 19:53:23. Republished by Blog Post Promoter

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Posted in Gastric band Procedure, Gastric Band surgery, Gastric Banding, gastric bypass, Lap Band procedure, Lap band surgery, Lapband, Lapband mexico, Lapband procedure, Lapband surgery, Obesity, Obesity surgery, Roux-n-Y, RYGB, Weight loss surgery | 2 Comments »

Vertical Gastrectomy Procedures

Saturday, January 9th, 2010

Vertical Gastrectomy Procedures

The original procedure, conceived by Dr. D. Johnston in England, was called The Magenstrasse and Mill Operation. The stomach is stapled vertically and divided from the incisura angularis to reach the angle of His at the gastric fundus. Dr. Johnston’s procedure of leaving a long gastric tube that resembles the German highway Magenstrasse was rapidly called that way.  The Magenstrasse, or “street of the stomach“, is a long tube fashioned from the lesser curvature of the stomach, which conveys food from the esophagus to the antral Mill without the total partition of the stomach.  The normal antral grinding of solid food and neuro-hormonal, antro-pyloric-duodenal regulation of gastric emptying and secretion are preserved.

It is now called the Vertical Sleeve Gastrectomy (VSG) but is also known as Vertical Gastroplasty. If a silastic ring or mesh is added to the technique, it is called the Vertical Banded Gastroplasty (VBG) and was suggested to help increase the restriction needed for a better weight loss.  If a silastic ring is added to the pouch of a Gastric Bypass, it is called the Fobi-Capella Procedure.

These techniques (VSG and VBG) generate weight loss by restricting the amount of food that can be eaten (Purely Restrictive Procedure) without having any bypass of the intestines or malabsorption. Both procedures have largely been abandoned due to poor long term results.

The more popular procedure known today as the Gastric Sleeve (much longer “street” than the Magenstrasse procedure) is done laparoscopically and is considered a variation of the Vertical Gastrectomy, but includes the removal of the remaining 80% of the stomach after its partition.

I met Dr. Gagner several years ago, a very friendly Canadian doctor that was living in NY and then moved later to Miami.  He is considered among bariatric surgeons as one of the fathers of the Gastric Sleeve (GS) as a primary procedure and told me that the success of the procedure was largely discovered by accident because no one expected the remarkable weight loss produced by the Gastric Sleeve.  Later medical scientific publications revealed that the driving force for the weight loss was the decreased level of Ghrelin Factor when removing the 80% of the stomach.

 GASTRIC SLEEVE Advantages:

  • Stomach volume is considerably reduced to more than 100 cc but not as much as compared to the pouch of the Lap band (15 cc) or the Gastric Bypass (30 cc).
  • The Sleeve motility gradually returns to normal functioning after 3 months following the operation, so most regular foods can then be consumed but in smaller amounts. 
  • The procedure eliminates the portion of the stomach that produces the Ghrelin Factor (the hormone that stimulates hunger).  By avoiding the intestinal bypass, the chance of intestinal obstruction (blockage), anemia, osteoporosis, protein deficiency and vitamin deficiency are eliminated.
  • Very safe and effective as a Primary procedure, First Stage procedure for very high BMI patients or as a Revisional procedure.
  • Can be checked with a scope when needed.
  • Appealing option for people with existing anemia, Crohn’s disease, arthritis and numerous other conditions that make them too high risk for intestinal bypass procedures.
  • Success rate is 60-80% of excess weight loss.
  • Proven to work better on Type 2 Diabetes and on Metabolic Disease than other procedures because increases in the Incretins secretion which lower the sugar Insulin resistance.
  • It can be converted to almost any other weight loss procedure.

GASTRIC SLEEVE Disadvantages:

  • Poor patient cooperation will result in inadequate weight loss or weight regain like binging eaters.
  • Patients with a high BMI often need to have a second stage procedure later to lose all the remaining extra weight.
  • Two stages is safer and more effective than one operation for high BMI patients.
  • Soft and liquid calories from ice cream, milk shakes, chocolates, etc., can be absorbed and slows down the weight loss.
  • This procedure does involve stomach cutting and stapling and therefore leaks and other complications related to cutting and stapling may occur.
  • It is not a reversible procedure.
  • Considered investigational by some surgeons and insurance companies.

Arturo Rodríguez, MD.

http://www.thebariatric.com

Originally posted 2008-09-05 01:09:58. Republished by Blog Post Promoter

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Posted in Gastric band Procedure, Gastric Band surgery, Gastric Banding, gastric bypass, gastric sleeve, Lap Band procedure, Lap band surgery, Obesity, Obesity surgery, Revision Surgery, Roux-n-Y, RYGB, Weight loss surgery | No Comments »