Arturo Rodriguez, MD

March 9, 2010

Safe exercises that can be done post Lap Band Surgery

Filed under: Bariatric diet, Gastric Band surgery, Gastric Banding, Gastric band Procedure, J & J Band, Lap Band, Lap Band procedure, Lap band surgery, Lapband, Lapband mexico, Lapband procedure, Lapband surgery, Obesity, Obesity surgery, Realize Band, Weight loss surgery — Dr. Arturo Rodriguez @ 8:41 am

Safe exercises that can be done post Lap Band Surgery

After taking the plunge and getting Lap Band Surgery you’ll want to make sure that you are getting the most out of the procedure. First, you’ll work with your doctor to get a good diet plan going. After that you need to think about what exercise plan will work best for you.

Some of the most highly recommended activities after the Lapband are walking and swimming. These are low impact exercises that can be done at your own pace. Additionally, they can easily be done seven days a week for maximum benefit.

The first thing you might want to try after lap band surgery is some walking. Start slow, and don’t worry if you can’t walk very far right away. If you walk for 15-20 minutes every day you will be making a difference in your health. Ideally you should work yourself up to 45-60 minutes at least 4 times a week.

Swimming is also a great exercise for those who have just had Lap Band Surgery. It doesn’t matter how good you are, or how fast you swim, but just that you get in the water and try. Swimming can be very beneficial because the water provides extra resistance and helps to make you work out harder in a shorter period of time. If you aren’t comfortable actually swimming in the water you may want to try walking in the water. This combination of exercises can be great for recovery from Lap Band Surgery.

For those who have not been on a regular exercise program before it can be difficult to get into a routine. Some suggestions for those of you would be to find a workout partner you enjoy spending time with. Ask a friend or loved one to join you for your walks or swims. You do them the favor of helping them get in shape, and you can strengthen the bond you share with them as well.

The Bariatric Team

http://www.thebariatric.com

http://www.bandstersforum.com

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January 23, 2010

Here is my Lapband Story…

Filed under: Gastric Band surgery, Gastric Banding, Gastric band Procedure, Lap Band procedure, Lap band surgery, Lapband, Lapband mexico, Lapband procedure, Lapband surgery, Obesity, Obesity surgery, RYGB, Roux-n-Y, Weight loss surgery, gastric bypass — Tags: , , , , , , , , , , , , — Dr. Arturo Rodriguez @ 11:58 pm

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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January 20, 2010

THE GASTRIC BANDS AND THE LAPBAND PROCEDURE

Filed under: Gastric Band surgery, Gastric Banding, Gastric band Procedure, J & J Band, Lap Band, Lap Band procedure, Lap band surgery, Lapband, Lapband mexico, Lapband procedure, Lapband surgery, Obesity, Obesity surgery, Realize Band, Weight loss surgery — Dr. Arturo Rodriguez @ 9:31 pm

The Gastric Bands and the Lap Band Procedure

When the Lap Band Surgeon discusses the lap-band Weight Loss Surgery, he will also discuss the lap band surgery cost with the patient. But more important than understanding the lap-band surgery cost, the patient must understand what the lap band is and what is involved in the surgery.

The Band or “belt” is constructed of a silicone material that is placed around the upper part of the stomach during the Lap Band Procedure. This is used to limit food intake. There is a hose or tube that connects the Lap band to a port or “valve”. This port is placed in the fat of the abdominal wall. It is used to inject saline solution into the band to increase or decrease its diameter. This changes the opening of the stomach where food passes through.

Different types of Adjustable Gastric Bands differ in design, shape, smoothness and edges. There are also differences in the way that the Band is placed in the abdominal cavity. They vary in length and after closing it differs from one to another in the way it ties to the stomach (concentric, in triangular manner, or as a clip).

Some of the Adjustable Gastric Bands can be seen by x-ray as opposed to other types of bands. The Port and the way it is connected with the hose differ with each band.  The ports are made of different material and come in different shapes and sizes.

Arturo Rodríguez, MD

http://www.thebariatric.com

http://www.bandstersforum.com/

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January 16, 2010

Talking About Several Lap Bands? The Hidden Story Behind the Lap Band…PART I

Filed under: Gastric Band surgery, Gastric Banding, Gastric band Procedure, Lap Band procedure, Lap band surgery, Obesity, Obesity surgery, Weight loss surgery — Tags: , , , , , , , , , — Dr. Arturo Rodriguez @ 8:49 pm

Talking about SEVERAL Lap Bands? The hidden story behind the Lap Band…PART I

You find yourself searching through Doctors or Promoters websites and you don’t find information about the existence of different Lap Bands.  How come?  Why is this information so hard to find?  How long have there been different Lap band Models?

When you visit message boards and forums and find little information about different models of the Lap Band, the information you do find usually comes from someone with misinformation (even when they think they are informed and write with some kind of authority because they have had the Lap Band surgery done) and their contribution to this subject is manipulated by comments by others.

Why is this not discussed PROPERLY on the message boards and forums?  It is difficult to believe that nobody cares about this.  Why is there little interest in this? Is it important to know that there are several different kinds of Lap Bands? Or does it matter at all?

Why is the market distracted by the Lap Band price and not the quality of the Lapband, the patient’s satisfaction with the Lap Band procedure or the doctor’s service?  Why hasn’t anyone questioned Allergan’s practices of flooding the border town’s market with Lap bands that have been stolen from the factory?   Why is Allergan letting this happen?  What does Allergan gain from this practice?

Other important questions to ponder:

  • Can weight loss be affected by the design or size of the Lap Band?
  • Does the design of the lapband have anything to do with complications?
  • Why is this information about the lapband not on the Doctor’s websites?
  • Why is this information about the Lap band not on the Promoter’s websites?

 Is anyone going to be responsible for hiding this important information about the lapband to the patients?  Are there any legal aspects, corners or sides involved with these behavioral practices or with these different lapband models?   Why do Lap Band doctors in the U.S. say nothing about the existence of many different Inamed-Allergan models and say nothing about their results with each of them?

Why do Lap Band doctors outside the States say nothing about this on their websites and the other kind of bands they commonly use to make the Lap Band procedure cheaper?  How can you be alerted about a poor quality lapband before having Lap Band Surgery?  What should you ask about the Lap band before having surgery?

To find the Answers to these questions, read on in Part II – “Talking About Several Lap Bands…”

TO BE CONTINUED…

 

Arturo Rodríguez, MD

http://www.thebariatric.com

http://www.thebariatric.com

Originally posted 2008-09-20 20:38:20. Republished by Blog Post Promoter

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January 9, 2010

Vertical Gastrectomy Procedures

Filed under: Gastric Band surgery, Gastric Banding, Gastric band Procedure, Lap Band procedure, Lap band surgery, Obesity, Obesity surgery, RYGB, Revision Surgery, Roux-n-Y, Weight loss surgery, gastric bypass, gastric sleeve — Tags: , , , , , , , — Dr. Arturo Rodriguez @ 8:19 pm

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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January 2, 2010

Lap Bands: Truth or Myth?

Filed under: Gastric Band surgery, Gastric Banding, Gastric band Procedure, Lap Band procedure, Lap band surgery, Obesity, Obesity surgery, Weight loss surgery — Tags: , , , , , — Dr. Arturo Rodriguez @ 5:39 pm

Lap Bands: Truth or Myth?

I can’t have a Lap Band Surgery if I am not Super-Obese: Every day we do more Lap Band Surgeries in overweight and mildly obese patients, especially if they have a family history of co-morbidities such as Type 2 Diabetes, High Blood Pressure or High Cholesterol.  The tendency world wide is that patients qualify for the Lap Band Procedures with BMI of 30 and above. The Lap band works also very well in patients who don’t want to gain weight but maintain in the weight they are and this is possible due to the Lap Band versatility to be adjustable to the patient’s needs.

You have to lose more than 10 pounds the first month after a Lap band Surgery: Yes, you do… The liquid diet should help you to lose much more than 10 pounds in the first month after surgery. When patients don’t reach this minimum it is because they are drinking many liquid calories and/or are not moving at all to burn the excess fat. Your goal after the first month of your surgery would be to lose at least 2 pounds per week and exercise will help you to reach this goal.

I am eating too much therefore I should go for a fill: Getting a lap band fill should not be based on the amount of food you are eating.  As long as you are losing weight or sizes, you won’t need a fill. If you are eating more, this could mean that you are moving or exercising more than you did before, or that you are making better choices about the foods that you are eating.  If you are in a plateau or gaining weight, then you should go for a fill. The purpose of the fill is to increase the restriction to food when you quit losing weight.

Should I expect to lose weight without exercising? You can lose weight without exercise if you are eating a very low calorie diet, but normally you will need some kind of exercise in addition to the diet to lose or maintain a healthy weight. Remember that the Lap band is a tool and you have to learn how to use it – this includes the change in the bad old habits.

I was expecting not to be dieting with the Lap Band Surgery.  The Lap Band procedure is a restrictive aid for treating excess weight and needs full cooperation from the patients in order to work as desired. Even in patients with a big fill, there are calories that will pass through easily, like ice cream or chocolates, and you can gain weight if you choose too many high-calorie foods. The key is: Follow a healthy, well-balanced, low-calorie food intake and also get active – do some kind of exercise to boost your health.

The Lap Band shows me when I am over eating and that is why I vomit all the time: History of vomiting is frequently found in patients that have to be de-banded because of Lap Band Erosion or Slippage. You have to learn to be satisfied before vomiting. If you are someone that vomits frequently, you may have developed a bad habit of over eating, not chewing well or eating too fast - and at some point you will end up hurting your stomach.

I don’t need fluoroscopy for a Lap Band fill: I recommend a fluoroscopic check-up done at least once a year.  Fluoroscopy helps us to detect early complications such as anatomical changes in your stomach and esophagus, and also the functional status of the Lap Band.

My friend has a very good fill with 3 cc and I do not: Stomachs differ in size from person to person, and everyone reacts differently to the Lap Band. You can’t compare yourself with anyone. That was Inamed’s big mistake: the Lap Band was made too short to fit all the patients’ stomachs, assuming that they were equal in size. This caused some patients to have complications such as disphagia (difficulty swallowing) after having the Lap Band for several months.

Support Groups and Message Boards are a waste of time: It is critical for the patients to have a supportive group if they truly want to succeed. I encourage all my Lap Band patients to join our Lap Band Message Boards where they can feel comfortable exchanging and sharing experiences in a friendly environment.

Arturo Rodríguez, MD

http://www.thebariatric.com

 http://www.bandstersforum.com

Originally posted 2008-09-15 21:12:18. Republished by Blog Post Promoter

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December 26, 2009

Making Healthy Choices after Bariatric Surgery

Filed under: Bariatric diet, Gastric Band surgery, Gastric Banding, Gastric Sleeve Mexico, Gastric band Procedure, Lap Band procedure, Lap band surgery, Lapband, Lapband mexico, Lapband procedure, Lapband surgery, Obesity, Obesity surgery, RYGB, Roux-n-Y, Weight loss surgery, gastric bypass, gastric sleeve — Tags: , , , — Dr. Arturo Rodriguez @ 3:48 pm

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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December 19, 2009

The Answers to Gastric Sleeve Failures

Filed under: Gastric Band surgery, Gastric Banding, Gastric band Procedure, Lap Band procedure, Lap band surgery, Obesity, Obesity surgery, Revision Surgery, Weight loss surgery, gastric sleeve — Tags: , , , , , , , , — Dr. Arturo Rodriguez @ 12:59 pm

The Answers to Gastric Sleeve Failures

The Gastric Sleeve is an open procedure, and is known as part of the Duodenal Switch since 1988.  The Laparoscopic Gastric Sleeve on high risk patients started in 2004 as the first stage of the Duodenal Switch (DS) and soon after that date, several teams started Laparoscopic Gastric Sleeve programs as primary or solitary surgical procedures for morbidly obese patients. In 2007 the Gastric Sleeve was proposed as a treatment for Metabolic Disease regardless of the excess weight of the patient. 

There are no long term follow-up results currently available for Gastric Sleeve Patients as a primary procedure. However, due to the increasing popularity of the Laparoscopic Sleeve, we are starting to see an increased number of failures. What we have observed in most of the Gastric Sleeve failures is the presence of large stomachs or large sleeves instead of a small volume sleeve. We have also observed a very poor nutritional and dietary change of habits in patients exhibiting gastric sleeve failure .

gastric-sleeve-proper-size   = CLICK VIDEO

When we started performing Lap Band Procedures we were creating 50 cc pouches; soon after started creating 15 cc pouches in order to give patients restriction and to avoid failures.  We are experiencing similar conditions with the Gastric Sleeve.  The remaining stomach is too large (large sleeve) so patients don’t have adequate restriction to lose weight as we expected. The use of a smaller bougie during surgery to calibrate the size of the sleeve is imperative to avoid such technical failures. The running suture reinforcement will also help to prevent a large stretching of the sleeve.

When we started performing Gastric Sleeves we didn’t have enough appropriate follow-up care for patients because we were assuming the sleeve will work and do its job (by creating enough restriction and decreasing the Ghrelin levels to lower  hunger). The truth is that patients need to be monitored closely and assisted on a regular basis with support groups and counseling in order to succeed.

We believe that the stretching of the Sleeve over time will also play a huge role in all of the cases of failure just as we learned from the lap band. Dilated pouches (large pouches) played a huge role in Lap Band failure in the past, and now in the case of the Gastric Sleeve, failure is due primarily to a large stomach pouch or sleeve.

Arturo Rodríguez, MD

http://www.thebariatric.com

http://www.bandstersforum.com

Originally posted 2008-09-11 19:41:17. Republished by Blog Post Promoter

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December 12, 2009

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

Filed under: Gastric Band surgery, Gastric Banding, Gastric Sleeve Mexico, Gastric band Procedure, Lap Band procedure, Lap band surgery, Obesity, Obesity surgery, Plastic surgery after weight loss, RYGB, Roux-n-Y, Weight loss surgery, gastric bypass, gastric sleeve — Tags: , , , , , , , , , , , , , — Dr. Arturo Rodriguez @ 9:45 am

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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November 28, 2009

CHEAP Lap Band or Gastric Sleeve Costs – What Does it All Mean?

Filed under: Gastric Band surgery, Gastric Banding, Gastric Sleeve Mexico, Gastric band Procedure, Lap Band procedure, Lap band surgery, Obesity, Obesity surgery, Weight loss surgery, gastric sleeve — Tags: , , , , , , , , — Dr. Arturo Rodriguez @ 8:04 am

CHEAP Lap Band or Gastric Sleeve Costs – What Does it All Mean?

July 6 (Health Day News) — Soaring U.S. medical costs are causing many Americans to take to the skies on “medical tourism” junkets, looking for high-quality yet low-priced health care at foreign clinics but experts also warn that the booming industry does have some risks.

“My own advice would be to look carefully at the accreditation of the hospital and consider the nature of the procedure. Are you sure it is the procedure you need? And is it done well at the place you are going?” said Dr. Ann Marie Kimball, a Professor of Epidemiology and Health Services at the University of Washington School of Public Health, in Seattle.

Medical tourism isn’t without some concerns, of course. Experts in the United States worry that consumers might end up getting substandard care if they don’t choose their hospital and physician carefully.

“It may be difficult to assess the training and credentials of surgeons outside of the United States.”

The risk for complications with people seeking this kind of surgeries rise three folds in the past six months says “El Norte”, a big News Paper alerting the Mexican Health Regulatory System of a very dark business going on which involved American Citizens crossing the border for a Lap band Surgery or a Gastric Sleeve procedure under not very clear circumstances.

Getting deeper in their investigation, the news paper says that the only ones that get some benefit from this medical tourism are the very dishonest intermediaries and the promoters where they want to capture the vast majority of patients regardless the outcome, questioning the doctor’s medical capacity that are hired to perform these kind of surgeries in obese patients.

What kind of doctors would you get in Mexico to do the Lap band or the Gastric Sleeve for $500 hundred USD, and the Anesthesiologist for $150,? says Claudia who just had her surgery done.

Can you find good trained doctors with those prices they are offering you? Of course you don’t!! You have to realize that because you are going to Mexico, these are not the regular or normal Doctor’s fees.  GNP and other insurance companies paid $950 USD for appendix removal and obese procedures cost much more than that.

Ask yourself:  How can someone have such cheap prices for your surgery without sacrificing the quality and the service that you deserve?  The only way that someone can come out with such cheap prices is by not paying someone in the chain: You don’t pay for the hospital, the Lap band, the stapler or for the doctors fees. Or they are getting the medical products in the black market, or the medications are made in China.

Have you ever stopped to think ….The Lap band or the staplers are about $2000 USD. How do they get the figures with those prices? How much is the hospital? How much is the hotel, flight, internet or other advertizing they do? How much is the driver or the taxies?  How much are the medications during and after the lap band or the Gatric Sleeve?  How much is the anesthesiologist, the surgeon’s assistant and all related services like the follow-up you need in order to succeed?

Are you going to sacrifice your success or your health because of promos of a cheap procedure? This could cost you a lot more than that…Look around for stories with poor outcomes, they are all over the internet and many of the doctors have a very high reputation…. Don’t let yourself be treated as merchandise. At some point of the chain you won’t get what you deserve or what you are expecting.

Kimball’s advice: Look carefully at the accreditation of the hospital concerned and do your homework before you board the plane. “Check out the real number of surgeries done, the success rates, the years of working in obesity” Woodman added. It’s also a key to ask the surgeon you talk to if he or she will perform the operation, not an assistant.

Arturo Rodríguez, MD

http://www.thebariatric.com

http://www.bandstersforum.com

Originally posted 2008-09-16 21:12:58. Republished by Blog Post Promoter

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November 21, 2009

Are you Talking about Several Lap Bands? The Hidden Story Behind the Lap Band…PART II

Filed under: Gastric Band surgery, Gastric Banding, Gastric band Procedure, Lap Band procedure, Lap band surgery, Obesity, Obesity surgery, Stomach erosion, Weight loss surgery — Tags: , , , , , , , , , — Dr. Arturo Rodriguez @ 7:12 am

Are You Talking About Several Lap Bands? The Hidden Story Behind the Lap Band…PART II

Since 2006, it has been reported world wide, that 200,000 Lap Band surgeries have been performed and that the Lap Band procedure is the fastest growing weight loss surgery in United States.  There are many different types and brands of lap bands available.  Take some time to read through the following details.

“Lap Band”

Inamed-Allergan Lap Band Models:

Lap Band Model 1: Lap Band 9.75 cm; maximum volume of 4 cc (high pressure balloon)

Lap Band Model 2: Lap Band 10 cm; maximum volume of 4 cc (high pressure balloon)

Lap Band Model 3: Lap band 11 cm; maximum volume of 9 cc (high pressure balloon)

These first 3 models of the Lap Band are almost out of the market or obtained for a very low price because of a high rate of complications such as slippage and de-banding.

Lap Band Model 4: Lap Band VG 11 cm; maximum volume of 10 cc (one inch without the low pressure balloon)

Lap Band Model 5: Lap Band AP 11 cm; maximum volume of 14 cc (360 degree low pressure balloon)

“Realize Band”

The Swedish Band was introduced in 1985.  As of 2007 in the United States, it’s now referred to as the Johnson & Johnson Realize Band, and is known as the Quick Close in Mexico. The changes made to the Realize Band and Quick Close have been to the fastening mechanism and to the port, but the length of the Lap Band or the balloon have not been altered.  Other Lap Bands available in the Latin and European markets are a lot less expensive, are not FDA approved and do not meet the minimum quality standards. By using these non FDA approved bands, the Lap Band procedure can be inadequate.

Why is the complication rate in the United States higher than in the rest of the World?

Facts:

Since June 5, 2001 the Gastric Band or Lap Band, as it is known in the United States, was FDA approved for use as an alternative for weight loss (small model). 

The only FDA approved Lap Band Model used for the first 3 years was the Inamed 9.75 cm (First out of five generations of the Lap Band).

In Mexico, this first Lap band Model hit the market in 1995.

The trials for getting the Inamed Lap Band approved by the FDA were done by surgeons with little experience in Lap Band technique and the very important Lap Band follow up and after care.

Many Bariatric Surgeons still have a poor conception of the Lap Band Procedure due to the inadequate results of the first trials.

The trials were performed with the short lap band model and without a comparative study with other Lap band devices, therefore the reports received from the Lap Band Centers, regardless of weight loss and complications, were collected incorrectly, falsely or insufficiently.

Inamed’s first three Lap Band models were short in length, very rigid and had a small high pressure balloon, resulting in more complications than the Swedish Lap Band.

The reports coming out of the United States indicate Lap Band slippage and erosion rates were higher in the USA vs. the rest of the world, because the only model used was the first Lap Band (9.75 cm).

In the end, we knew long before that poor quality and the rudimentary design of the Lap Band were responsible for the inadequate weight loss achieved and complications such as slippage and erosion because of the rigidity of the Lap Band, the small circumference and the high pressure balloon.

Promoters and brokers conceal this information to American patients traveling to Mexico for the Lap Band Surgery because they receive (and still receive) great deals and prices for selling the Lap Band (any model) across the border, resulting in high profits for them with no regard to the patient’s outcome.

 

Arturo Rodríguez, MD

http://www.thebariatric.com

http://www.bandstersforum.com

Originally posted 2008-10-11 08:04:24. Republished by Blog Post Promoter

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November 14, 2009

My Life with the Lapband

Filed under: Gastric Band surgery, Gastric Banding, Gastric band Procedure, Lap Band procedure, Lap band surgery, Lapband, Lapband mexico, Lapband procedure, Lapband surgery, Obesity, Obesity surgery, Weight loss surgery — Tags: , , , , , , , , , , , , , , — Dr. Arturo Rodriguez @ 6:07 am

Tricia

My Life with the Lapband

My Journey…

Boy how time flies! 

As I approach my 5th year Bandiversary, I started thinking how the Lapband has changed my life or how I had to change my life to live with the Lapband.

First off, I thank God every day for showing me there was an option and giving me the opportunity to have the Lapband procedure.

Like most in my situation, I tried every diet that always ended in failure. I almost got to the point where I wouldn’t want to diet because I KNEW I would gain the weight back and probably gain more. It was a horrible vicious cycle that I lived in for years.

Living with the Lapband was a continual learning process for a while. I tested foods to see what I could eat and what gave me difficulties. I tested out drinking with meals and not drinking with meals. Unfortunately, I had to learn the hard way on a lot of these issues, but the key is I learned and now the changes that I have made in living with the Lapband are part of my normal way of living. I don’t even think about it anymore.

One of the most frustrating things about the Lapband is obtaining proper restriction level. On one hand, I wish doctor’s would be a little more aggressive with the fill amounts, on the other hand, I think that working your way up to the proper restriction level is the way to go to avoid getting filled too tight which can be very uncomfortable and dangerous. I think that more discussion needs to be made about preparing one’s self for life after the lapband which includes the cost of adjustments/fills and the expectation of how many fills it may require to achieve proper restriction.

For self payers, many people use all their financial means to pay for the actual Lapband surgery and then don’t have the funds to get adjustments afterwards. This creates frustration because you just paid a lot of money and went through surgery and now want to lose the weight. Sounds reasonable……. But many feel like they wasted money when they don’t lose weight after the surgery or they feel like they can eat like they could before the surgery which is true until the band is adjusted properly.

So if someone is scheduled for lapband surgery and they ask me about the band, I make a point of preparing them for after surgery. I also try to tell them that their patience level will be tested to the max until they get their bands filled properly. I’ve heard this said by many and it’s so true “It took us a long time to become this overweight, we’re not going to lose it all overnight” It may take some time to lose weight with the Lapband, but with a little patience and following some very basic rules, you will lose weight and you will be successful.

Things that have changed for me after I was banded…

I don’t drink with meals. I found that this flushes food from my small upper pouch into my lower pouch which enables me to eat more food. This kind of defeats the band doesn’t it? I don’t want to eat more food, because this little thing called weight gain occurs if I do.  Not drinking with meals was probably the hardest thing for me to get used to, but now I don’t even think about it.

I still take small bites and have slowed down while eating. I found that taking smaller bites and slowing down while eating actually fills me up quicker. I also don’t look like I’m inhaling my food anymore, which was a very unattractive habit that I got into pre-band.

I listen to my band. It tells me when to stop eating. Oh, I’ve tried to argue with my band in the past and tell it that I could eat more even when it warned me that I have had enough, but for some reason the band was always right. I paid a small price for trying to fight the band. I would feel horrible until the food passed through the band. Sometimes I would PB (not pleasant) and learned very quickly that it’s just not worth fighting the band. It knows best, so now I listen to it.

I try to stick to protein foods first. I’m not always good at this, but it’s something that I feel is very important for Lapbanders. I have also found that when I eat protein foods first like chicken, fish, etc… then I don’t require as much food to feel full and I stay fuller longer. Not to mention the benefits to my health for eating protein.

Since I can’t eat as much as I used to, my food choices have changed. Before the band, I would eat horribly. It’s because I could eat a lot of anything I wanted. So if I wanted to snack on chips before dinner, no problem. I would still be hungry enough at dinner to eat it, and then have enough room for dessert after wards.

I now chose quality over quantity. I do this because I know I can’t eat a lot, so what I DO eat becomes very important. I have found that if I eat chips now, I will fill up on them, and I won’t feel hungry to eat what I should be eating. Then I end up feeling awful because “foods” like chips drain my energy if I try to use them as my source of nutrition. Don’t get me wrong, I still eat things like chips, but I make a point of not eating them when I’m hungry because I know that I will fill up on them and won’t eat what I need to be eating. So I will have junk food occasionally, but usually with my meal and have very little.

I don’t eat dinner late in the evening. I have a cut off time for dinner. I make sure that I don’t go to bed for about 3 hours after I eat. I also don’t drink a lot of fluids at night and I religiously take 2 Pepsid AC chewables before I go to bed. I believe that these things have decreased my chances of having acid reflux at night.

So yes, the Lapband has totally changed my life. With 155 pounds gone I’m feeling terrific! I feel that the minor things that I have changed in my life (with eating) due to the band are so minor and so worth it to help insure that I keep this weight off. Don’t get me wrong, I don’t struggle to keep the weight off, which is fantastic, but I believe that the minor changes that I have made have contributed to this.

The Lapband won’t do it all. You’ll need to help it some, but once your band is adjusted properly, the band will work for/with you instead of you working for the band.

Life is wonderful!Tricia before Lapband
Tricia after Lapband

Starting BMI 43

Current BMI 20

Tricia
Banded July 16th, 2004
Lost 155 pounds

Dr. Arturo Rodriguez

http://www.thebariatric.com

http://www.bandstersforum.com

Originally posted 2009-03-11 18:21:38. Republished by Blog Post Promoter

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November 12, 2009

Lapband Surgery in Mexico…The Obvious Choice

Filed under: Gastric Band surgery, Gastric Banding, Gastric Sleeve Mexico, Gastric band Procedure, J & J Band, Lap Band, Lap Band procedure, Lap band surgery, Lapband, Lapband mexico, Lapband procedure, Lapband surgery, Obesity surgery, Realize Band, Weight loss surgery — Dr. Arturo Rodriguez @ 8:37 am

Lapband Surgery in Mexico…The Obvious Choice

With health care costs skyrocketing in the United States, more and more medical procedures are being performed abroad. Mexico is quickly becoming a very popular country for medical procedures especially for those people who do not have insurance.

Lap Band Surgery is a surgical procedure which helps extremely overweight people return to a more healthy weight. The Lap Band is a silicone ring which is placed between the new upper pouch and the lower part of the stomach. The surgery is performed under general anesthesia and takes approximately 25 minutes. The Band is adjustable, reversible and requires no stapling, cutting or rerouting of the intestinal tract. The recovery time is usually 3-7 days and patients are given an extensive post op instruction manual which includes pain management, surgical site care and customized diet instructions. The Lap Band Surgery is also the only adjustable, reversible, surgical weight loss procedure that is approved by the FDA.

Lap Band Surgery is one of the many procedures being done more and more in Mexico. For people with no insurance, Mexico offers this medical procedure at a fraction of the cost of the United States. Lap Band Surgeons in Mexico have also been in the field of laparoscopic gastrointestinal surgery far longer than American surgeons.

Weight loss can be a very sensitive subject so privacy is another reason many choose to have the Lap Band surgery done abroad. Once you’ve had the procedure you can rest and recuperate in an exotic atmosphere without friends or family members knowing about your procedure.

There have been over 400,000 Lap Band Surgeries performed worldwide. Mexico is one of the few countries that work with the patient to assure easy transportation in and out of the country and at many of the facilities there are packages which include transportation to and from the hospital and a two or three night stay at a nearby hotel for two. The follow up fill procedures can either be done in Mexico at the medical facility where the initial surgical procedure was performed or your surgeon will work with you to find a surgeon in your area that will work with you at a reasonable cost.

Another great benefit to having surgery abroad is the tax benefit. Medical expenses, including travel, are tax deductible so many people get a large portion of their out of pocket expense refunded to them at tax time.

The Bariatric Team

http://www.thebariatric.com

http://www.bandstersforum.com/

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November 4, 2009

The success rate of Lap Band Surgery

Filed under: Bariatric diet, Gastric Band surgery, Gastric Banding, Gastric band Procedure, J & J Band, Lap Band, Lap Band procedure, Lap band surgery, Lapband, Lapband mexico, Lapband procedure, Lapband surgery, Obesity, Obesity surgery, Realize Band, Weight loss surgery — Dr. Arturo Rodriguez @ 6:46 pm

The success rate of Lap Band Surgery

Lap band

Over 58 million Americans today or overweight or obese; this number increases everyday and now we are even seeing childhood obesity. Weight gain can be attributed to many different factors such as genetics, some medications, poor diet and lack of exercise. Fast food is often the answer for a quick meal and is often habit forming. By eating fast food, you are poisoning your system and allowing for extra fat to accumulate on your hips, buns, thighs, and stomach’s. Extra body fat is not only unattractive, but it is very harmful to our health. Many diseases are triggered because of extra body fat such as diabetes, hypertension, heart problems, and back and joint problems.

There are many different diets and diet products available to us that promise fast results in the safest possible way. Unfortunately these diets and pills do not work for most of us. There are however, other options such as surgery. One of these revolutionary surgeries is the Lap Band. Before you commit to getting surgery, you must meet a few qualifications and you must understand this as any other  surgery.

Qualifications

• You must be at least 18 years old.

• You must weigh at least twice your ideal body weight or 100 pounds more than your ideal body weight.

• You must be overweight for at least five years.

• You must have tried other serious weight loss attempts.

• These serious attempts only have had short term success.

• You must not be suffering any type of disease that may have caused your obesity.

• You must be willing to change your lifestyle greatly including eating habits and lifestyle.

• You must be willing to be monitored by a specialist.

• You cannot drink alcohol in excess.

If you meet all of these qualifications, you may be a suitable candidate for the lap band surgery.

 

What is the Lap Band?

The lap band only has a mortality rate of 0.2% and a 3% early complication rate. The lap band surgery starts by the doctor making four or five small incisions in your skin. The band is then placed around the upper part of the stomach, dividing it into two unequal parts. The upper part is your stomach and the band restricts your food intake and makes you feel full faster, in turn, that creates weight loss.

The Lap band is inflatable; saline solution is injected into the band system about six weeks after the Lap band has been placed and continues until the patient feels full after eating small amounts of food. The procedure lasts less than an hour and patients usually go home the next day. Recovery time is about seven days.

 

Success rate

The success rate really depends upon the person’s ability to change his or her lifestyle if they can stick to a certain diet. The most recent study shows that about 70 to 80% of people that have had the lap band surgery have successfully lost most of their unwanted body fat and have been able to keep it off for five years.

Only you and your doctor can decide if lap band surgery is for you. Research it thoroughly before you commit to having the surgery. It is one of the safest and most effective ways for morbidly obese patients to lose weight. Even those that did not lose all of their excess body fat experienced better mobility, higher self esteem and good overall health.

The bariatric Team

http://www.thebariatric.com

http://www.bandstersforum.com

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October 23, 2009

Lap Band Leaks: What You Should Know

Filed under: Gastric Band surgery, Gastric Banding, Gastric band Procedure, Lap Band procedure, Lap band surgery, Lapband, Lapband mexico, Lapband procedure, Lapband surgery, Obesity, Obesity surgery, Revision Surgery, Weight loss surgery — Tags: , , , , , , , , , , , , , , , , , , , , , , , , — Dr. Arturo Rodriguez @ 4:31 pm

Lap Band Leaks: What You Should Know

A Lapband leak is suspected when a patient that previously had adequate restriction feels a change in the amount of restriction. This can happen suddenly or over a period of time, depending on the size of the leak. If there is a leak of the lap band, the band will not be able to be adequately filled and will not provide restriction, or function properly.  There are four types of lapband leaks that can occur to the lapband once it is placed, based on the location: (1) Leaks at the lapband balloon, (2) Leaks at the lapband tube connections, (3) Leaks at the body of the tube, and (4) Port membrane leaks.

(1) Leaks at the Lapband Balloon

Leaks in the lap band balloon can be unintentionally caused by needle punctures during surgery, or may occur over time in certain factory weak points of the balloon.

figure-101

Leak at Lapband balloon http://www.thebariatric.com

Figure 1.0  In the figure above, you can see the lap band (white rectangular shape), which has been filled with contrast fluid.  The arrow points to a small amount of fluid that has moved outside the band from a small leak in the balloon of the lap band (VG).   

Lapband Leak

Lap-Band Leak http://www.thebariatric.com

Figure 1.1 This is another image of a lap band balloon leak.  A thin line of contrast fluid can be seen outside of the lap band, surrounding both the band and the tube.

Lapband Leak

Lapband Leak http://www.thebariatric.com

 Figure 1.2 The lap band balloon can be seen in the centre of this image (rectangular shape, slanted to the left). In this case, there is a larger leak of contrast fluid which is more easily visible around the lap band balloon (arrow).

figure-13

Lapband leak seen during surgery http://www.thebariatric.com

Figure 1.3 In this case, there was a leak in the lap band balloon, and surgery was required to remove the band.  During surgery, the leak was very clearly seen when fluid was pushed through the lap band, to reveal the location of the leak.  (The arrow points to the line of fluid leaking from the  AMI band). 

(2) Leaks at the Lapband Tube Connection

Leaks can occur within the Lapband tube connection if there is a break or fracture of the tube next to the metal connector. Breaks or fractures may be due to physical movement over time, when considering the materials of the connections (metal and silicone).   If the “fracture” is complete, it can be easily diagnosed with an x-ray film (plain film), without needing to inject contrast fluid. 

figure-20

Lapband plain x-ray film http://www.thebariatric.com

 Figure 2.0 Above, we can see the lapband port in the lower, right corner, with the tube extending to the left in the x-ray image.  There is a complete fracture (break) in the tube.  The distal end of the tube is near the port, which means the tube may still be in the abdominal wall.

Lapband leak

Lapband Leak http://www.thebariatric.com

Figure 2.1 Above, we can see the lapband port near the bottom of the x-ray image, with a complete fracture (break) in the tube, which is curled up at the top of the image.  This shows that the tube is likely still inside the abdominal cavity.

figure-22

Port of a Lapband leak http://www.thebariatric.com

Figure 2.2 Above is a photo of the lapband port that was removed during surgery from Figure 2.1. 

 If the “fracture” is incomplete, it is necessary to inject contrast inside the system in order to diagnosis the problem.

figure-23

Figure 2.3 This shows an incomplete fracture, with the tube in place.

figure-24

Port of a Lapband leak http://www.thebariatric.com

 

Figure 2.4 This is the port removed from the above case (Figure 2.3).

l

Port of a Lapband leak http://www.thebariatric.com

 Figure 2.5 In this plain x-ray film, the port can be seen in the bottom right corner. There is a slight bend in the tube at the connection point (upper right corner of the film).

lapband leak

 Figure 2.6  As a leak was suspected, contrast fluid was passed through this lapband port.  A large amount of contrast fluid is seen at the bend, in the top right (the connection point).

In some cases, it is not possible to indentify a leak with x-rays. Therefore, the diagnosis of a leak may need to be done at the time of surgery.

Lapband leak

Lap-Band Leak http://www.thebariatric.com

Figure 2.7 In this x-ray with contrast fluid, there is no evidence of a leak.

Tube leak near the port

Tube leak near the port http://www.thebariatric.com

Figure 2.8 This leak was not demonstrated with x-rays.  As the leak was suspected, surgery was required to find the location of the leak.

(3) Leaks at the Body of the Tube

These lap band leaks are usually iatrogenic. This means that the leak was caused by an unintentional needle puncture, during a fill that was done without using fluoroscopy to guide the needle. These kinds of leaks are very common in office fills. Even in the best hands, there is always a risk of puncturing the tube during a lap band adjustment. This is one of the reasons that we always recommend fills to be done under fluoroscopy.

Lapband tube puncture

Lapband tube puncture http://www.thebariatric.com

  Figure 3.0  A leak can be seen in the body of the tube, close to the connection. This leak was made with a needle at the time of an adjustment (office fill).

Lapband tube puncture

Lap-band Tube puncture http://www.thebariatric.com

Figure 3.1  The leaking portion of the tube was removed during surgery.

(4) Port Membrane Leaks

This type of leak usually occurs when the patient has received many fills, or when the adjustment was done using a standard needle. Only Huber (non-coring) needles (Figure 4.2) should be used to perform fills or adjustments.  The silicone membrane of the port may be damaged if any other type of needle is used.

figure-40

Lap-band Port Leak http://www.thebariatric.com


      Figure 4.0 The lapband leak is just in front of the port, where contrast can be seen.     

Port Membrane Leak

Lap-band Port Membrane Leak http://www.thebariatric.com

Huber Needle

Huber Needle http://www.thebariatric.com

 Figure 4.1 During surgery, we can see a leak at the port membrane as seen by the bubbles that are produced when the port is placed in water.                                

Figure 4.2 Huber (non-coring) needle.

Final Thoughts

Every day, the lap band manufacturers are improving the design and functionality of the gastric bands in order to prevent complications such as leaks. However, there is always a small risk of leaks over time. Many types of lap band leaks can be avoided by careful handelling the gastric band at the time of the surgery and by doing the lap band fill or adjustment under the fluoroscopy guide, and finally by using the right non-core  needle. 

Arturo Rodriguez, MD
Bariatric Surgeon
Susana González, MD
Radiologist
http://www.thebariatric.com

Originally posted 2009-03-07 23:31:38. Republished by Blog Post Promoter

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

Filed under: Bariatric diet, Gastric Band surgery, Gastric Banding, Gastric Sleeve Mexico, Gastric band Procedure, J & J Band, Lap Band procedure, Lap band surgery, Lapband, Lapband mexico, Lapband procedure, Lapband surgery, Obesity, Obesity surgery, RYGB, Realize Band, Roux-n-Y, Weight loss surgery, gastric bypass, gastric sleeve — Dr. Arturo Rodriguez @ 4:31 pm

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/

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October 17, 2009

Lapband Slippage: Causes & Prevention

Filed under: Gastric Band surgery, Gastric Banding, Gastric Sleeve Mexico, Gastric band Procedure, Lap Band procedure, Lap band surgery, Lapband, Lapband mexico, Lapband procedure, Lapband surgery, Obesity, Obesity surgery, Revision Surgery, Weight loss surgery, gastric sleeve — Tags: , , , , , , , , , , , , , , , , , , , — Dr. Arturo Rodriguez @ 2:21 am

Lapband Slippage: Causes & Prevention

A Clinical Study

A clinical study was done in Germany to review complications following lap band surgery. Thirty-five hospitals were involved in the study, with 4138 patients that underwent gastric banding over a five-year period.  Lap Band long-term complications were described in 8.6%  of all patients.  The most common complications included: pouch dilation or enlargement (5.0%), lap band slippage (2.6%), and Lapband migration or erosion (1.0%).   (Stroh,C  Manger, T “Complications after adjustable gastric banding”, Chirurg, 2006, Vol 77,pag 244-250)

Normal Lapband x-ray

 Normal Lap Band X-Ray Under Fluoroscopy

lapband-enlarged-pouch

  Enlarged Lap Band Pouch    

What is Lap Band Slippage?

One of the long-term complications of lap band surgery is called “Lapband slippage” and can be defined as “when the Lapband and the stomach pouch are both prolapsed.”  This means that the lap band has shifted position and the enlarged stomach pouch has also shifted or twisted so that food does not go through the lapband into the rest of the stomach. This may result in pain, discomfort, decreased appetite and inability to eat or drink, and vomiting. Lapband Slippage does not happen immediately but may take several months to develop. 

Huge-lapband-pouch

Large Lap Band Pouch

Lap Band Slippage generally develops in a progressive manner. As food intake is increased, the stomach begins to stretch and grow and the patient may stop losing weight or start to regain weight.  At this point, patients may only exhibit an enlarged stomach Lap band pouch.  This can be medically treated by deflating the lap band to release pressure and slow the growth of the pouch (successful in 70% of cases, or surgical treatment can be considered). However, if the enlarged lapband pouch continues to grow, the lapband progressively rotates until both the lap band and the enlarged pouch become prolapsed, resulting in Lap band slippage.  This is followed by functional stenosis (narrowing) of the stomach.  

lapband-slippage

 Lap Band Slippage

Lapband Slippage Symptoms typically include progressively worsening reflux, vomiting and epigastric complaints, which may increase to sudden near-total dysphagia (inability to swallow or eat anything, including saliva).

Risk factors or causes of lap band slippage include surgical technique, model of the  lapband used, early consumption of solid foods, early inflation or filling of the band, consumption of carbonated or sparkling beverages, and frequent vomiting.

Treatment for lap band slippage requires surgical intervention. The lapband must be repositioned or removed, based on the operative findings and condition of the stomach pouch. If appropriate, the surgeon and patient may elect to choose another type of bariatric procedure such as a Gastric Sleeve. 

How Do I Prevent Lap Band Slippage?

In order to decrease the risk of developing lap band slippage, it is important to follow the recommended diet following surgery and to avoid introducing solid foods too early.  In addition, the fills should not be started before 6 weeks post-operatively and these Lap band fills should be very gradual.  We also recommend that fills should be done under fluoroscopy, even if you are asymptomatic (no symptoms of lap band slippage), to be able to monitor the position of the lapband, and the size of the stomach pouch and condition of the esophagus. This will allow for early diagnosis of an enlarged stomach pouch or possible lap band slippage.

Susana González, MD

Radiologist

http://www.thebariatric.com

Originally posted 2009-02-17 13:25:15. Republished by Blog Post Promoter

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October 2, 2009

Successful Weight Loss with Lap Band Surgery

Filed under: Gastric Band surgery, Gastric Banding, Gastric band Procedure, Lap Band procedure, Lap band surgery, Lapband, Lapband mexico, Lapband procedure, Lapband surgery, Obesity, Obesity surgery, Weight loss surgery — Tags: , , , , , , — Dr. Arturo Rodriguez @ 10:24 pm

Successful Weight Loss with Lap Band Surgery

Lap band surgeries are a type of restrictive procedure through which an inflatable band is surgically placed around the upper portions of the stomach, creating a small stomach pouch. This small pouch works to restrict the amount of food that can be eaten at any given time while increasing the amount of time it takes the stomach to completely empty itself. Many patients have reported successful weight loss with lapband surgery and outpatient nutritional counseling.

As a result of the lapband surgery, the patient will achieve a sustainable decrease in weight by slower digestion, reduced appetite, and limited food intake. This type of surgery is less traumatic than other types like the gastric bypass procedure. Unlike other permanent solutions to obesity, it is safe, adjustable, and reversible. The lap band provides a unique method for maintaining and achieving significant weight loss, enhancing the quality of your life, and improving your health.

During the lap band procedure, your surgeon will make a few tiny incisions into the wall of your abdomen. Using the latest laparoscopic technologies, a small adjustable silicone band is inserted and secured around the upper portions of the stomach. This lapband is then connected to specialized tubing which is then attached to an access port, which is located beneath the surface of the skin on the abdomen. This port is not visible to the naked eye, and allows the patient to make adjustments to the band as necessary.

The small pouch at the top of the stomach controls the amount of food that can be taken in at any given time. A small amount is permitted to pass through the lap band, thereby delaying the total emptying of the stomach. This process causes a sensation of fullness much sooner than normal. Eventually and over a course of time, hunger sensations decrease dramatically.

There are many advantages to lap band surgery as a method of treating obesity. Of all gastric surgery methods, lapband surgery has the lowest mortality rate. It is the least invasive surgical approach to weight loss as well. There is no stomach cutting, stapling, or intestinal re-routing. The lap band is reversible, adjustable, carries a low malnutrition risk, and has the lowest rate for operative complications among all similar procedures like gastric sleeve or gastric bypass.

Most patients that elect to have lap band surgery will not have to be hospitalized. In fact, the majority of all lap band patients go home the same day of their surgery. Normal activity can be resumed in as little as one week, while full recovery from lapband surgery takes about two to three weeks.

The Bariatric Team

http://www.thebariatric.com

http://www.bandstersforum.com

Originally posted 2009-02-02 12:30:05. Republished by Blog Post Promoter

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September 25, 2009

Have Lap Band Surgery for Less in Mexico

Filed under: Gastric Band surgery, Gastric Banding, Gastric Sleeve Mexico, Gastric band Procedure, Lap Band procedure, Lap band surgery, Lapband, Lapband mexico, Lapband procedure, Lapband surgery, Obesity, Obesity surgery, Plastic surgery after weight loss, RYGB, Roux-n-Y, Weight loss surgery, gastric bypass, gastric sleeve — Tags: , , , , , , — Dr. Arturo Rodriguez @ 9:41 pm

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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September 22, 2009

My Surgery Story–De-Banding and Gastric Sleeve

Filed under: Bariatric diet, Gastric Band surgery, Gastric Banding, Gastric Sleeve Mexico, Gastric band Procedure, Lap Band procedure, Lap band surgery, Lapband, Lapband mexico, Lapband procedure, Lapband surgery, Obesity, Obesity surgery, Realize Band, Revision Surgery, Weight loss surgery, gastric sleeve — Tags: , , , , — Dr. Arturo Rodriguez @ 9:17 pm

Subject: My surgery story -  de-banding and gastric sleeve   21/08/09

Gastric Sleeve

Gastric Sleeve

 

 

 
I just got back from Mexico, where Dr. Arturo Rodriguez performed the gastric sleeve surgery for me. (Warning… long post coming up!)Four years ago tomorrow, I had the Lap-Band surgery with Dr. Rodriguez.For a variety of reasons, the band didn’t work for me. I did manage to lose

about 40 pounds with the Lap-Band surgery, so the surgery was not

a failure, but I never did get good restriction. It seemed like I ran into

roadblock after roadblock, and I had a heck of a time trying to get good

follow up care in my community. My life changed over the past 4 years,

making it impossible for me to travel and be away from home to do fills,

so follow up care in Mexico wasn’t an option for me. I recently became

a midwife, attending women at homebirths, so taking time away from my

clients is not something I can do easily. Finally, a couple of months ago,

I decided to have my band removed and have the gastric sleeve done.

My best friend and I traveled to Mexico together and, of course, received

top quality service from Dr. Rodriguez and his staff. Once we got to the

hotel, we had a quick meal and a few margaritas before I had to begin my

pre-operative fast.

The next morning, the driver picked us up at the hotel and took us to Hospital

San Pedro. I had been there before for my Lap-Band surgery and my port

relocation surgery, so it was a familiar place for me. Shortly after I arrived,

the nurses took me back for my IV, weight check, vitals, labs, etc. Oh, and

by the way, since I work in the medical field, I took great note of their attention

to cleanliness and clean technique — no worries there (in case anyone

wonders about that). After the nurses were done, the anesthesiologist came

to visit me, as did Dr. Rodriguez. Next, I was wheeled into the operating room.

I got on the operating table, and the anesthesiologist put a mask over me.

The next thing I remember is waking up in recovery afterwards. I was SORE

and groggy, and I thought, “what have I done???”

Dr. Rodriguez had to work really hard on me during my surgery. De-banding

is not an easy task, and there were a lot of adhesions he had to remove. Also,

since I was previously banded, Dr. Rodriguez was very careful to make sure I

didn’t have any erosion, which could have caused life-threatening complications.

He also took extra care to be sure that the staple line in my stomach was

reinforced by sutures, and shot blue dye through my stomach to be sure

that there were no leaks. I am so thankful for Dr. Rodriguez’s skill as a surgeon.

I have trusted him with my life twice now, and I truly believe he is an outstanding

doctor. I would recommend him to anyone considering gastric surgery.

HE IS THE BEST!!!

Dr. Rodriguez had arranged for my friend and me to stay at the big suite at San

Pedro, which, by the way, happens to be a birthing room where they do

water births — my kind of place! The room had two hospital beds, two sofas,

several chairs, a kitchen, and a bathroom. It was extremely comfortable and lovely.

I am so thankful to Dr. Rodriguez for arranging for us to stay there!!!

OK, I’m being totally honest… the first day was hell. My throat was sore from

the tube being in there during the surgery. I threw up several times, was in pain,

and was really worried that I had made a bad decision. My back and arms

hurt a lot from being on the surgical table. I could barely move. Every movement

felt like torture. The pain meds gave me a horrible headache.

Second day was better, but it was still rough. I was throwing up less often and

was drinking sips of water. Still very sore, but doing better. On the third day,

Dr. Rodriguez was concerned about my difficulties with drinking, so he arranged

for me to have a barium swallow to make sure there wasn’t an obstruction.

Everything checked out OK, so he sent me to the hotel to recuperate. Day 4 was

spent just sipping water and Riopan, and there was no more throwing up. Late

that day, Dr. Rodriguez met us at the hospital to have my drain removed. THAT

was a really weird feeling! Once the drain was out, my soreness improved greatly.

One thing I found REALLY helpful in getting liquids down was I got some honey

straws. I discovered by accident that these work really well. If you have trouble

getting liquids down, it helps to just swallow, swallow, swallow until it moves down.

Well, with the honey straws, you have to work really hard to suck the honey out,

and that action, combined with the swallowing of the little bits of honey, works really

well in propelling the food downward. If you’re getting gastric sleeve surgery,

I suggest picking up a box of these to take with you to Mexico. My friend found

some at the plaza in Monterrey, but I’ve seen them at Target in the tea section

here in the US.

Day 5, we left the hotel and headed home. My advice to anyone traveling after

this procedure – GET A WHEELCHAIR! If you have a wheelchair, you will breeze

through customs and security and life will be a whole lot easier for you.

I’ve been home now for three days and I feel much better. I am able to drink about

60 ounces of water a day now, which is about half of what I used to drink, but it is

improving daily. I am not as sore as I was, but I’m still hurting a bit. My surgical

wounds are healing nicely, and I’m starting to feel more “normal” again. I’ve lost

12 pounds in this first week, which is also pretty cool. I’ve been drinking Vitamin Water,

chicken broth, and Italian ices. Dr. Rodriguez says I am to have clear liquids for 3 weeks,

and then full liquids for 3 months. Most people would think that would be hard,

but so far, I have absolutely no desire for food and do not feel hungry at all. I have

to really force myself to drink enough to stay hydrated, so that’s my toughest

work at the moment.

Anyway, I hope to hear more from people who have had the Gastric Sleeve.

I hope this post is helpful to any of you out there thinking about having it done.

Blessings,

Kim Pekin
Midwife
Purcellville, VA
www.gentlehomebirth.com
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