Bariatricheskaya surgery – Vertical banded gastroplasty – laparoscopic surgery
Description laparoscopic vertical band gastroplasty
Vertical banded gastroplasty – operation, used for the treatment of obesity. Weight loss is due to reducing the number of Food, which the patient can eat.
The reasons for performing a vertical band gastroplasty
The operation is used for severe obesity. Doctors use indicator, called the body mass index (BMI), to determine the degree of obesity. Normal BMI – 18.5-25.
Vertical banded gastroplasty – the possibility of weight loss for people with the following indicators:
- BMI greater than 40;
- BMI 35-39.9 and life-threatening diseases, such as heart disease or diabetes;
- BMI 35-39.9 and with severe disabilities, which impact on employment, mobility, family life.
Успех операции вертикальной ленточной гастропластики зависит от дальнейшего образа жизни. With the right approach would be a significant improvement in health:
- Long-term weight reduction;
- Disappear many obesity-related diseases (eg, glucose intolerance, diabetes, sleep apnea, high blood pressure, Lower Cholesterol);
- There will improve mobility and increase strength;
- Improve mood, self-esteem, quality of life;
- It will reduced risk of death from cardiovascular disease (eg, heart attack, stroke) and other reasons.
Possible complications when performing laparoscopic vertical band gastroplasty
Before, how to perform the operation, you need to know about possible complications, which may include:
- Vitamin deficiencies – You will need to take vitamins lifelong;
- Bleeding;
- Infection;
- The formation of blood clots;
- Vomiting;
- Disconnecting staples, causing leakage of gastric fluids into the abdominal cavity;
- Slipping or erase staples;
- Irritation of the throat due to acid reflux;
- Herniation;
- Complications of general anesthesia;
- Death – occurs in less than 1% patients.
Factors, that may increase the risk of complications include:
- Smoking;
- The presence of chronic diseases (eg, kidney disease);
- Diabetes;
- Old age;
- Heart or lung disease;
- Bleeding or clotting disorders.
How is laparoscopic surgery vertical band gastroplasty?
Preparing for Surgery
Each method of bariatric surgery has specific requirements. Before performing the current operation, probably, You need::
- A thorough medical examination and analysis of the medical history;
- Attempts to lose weight (about 10%) through the use of diet drugs;
- Consultation with a dietitian;
- Evaluation of Mental Health.
Before surgery:
- The patient may be asked to stop taking certain medicines a week before the procedure,:
- Aspirin or other anti-inflammatory drugs;
- Blood thinners, such as warfarin, clopidogrel (Plaviks);
- Do not take any new medications or supplements without consulting your doctor;
- It is necessary to organize a trip to and from the hospital;
- It is necessary to organize a home help for the recovery period;
- Before the operation may need to take antibiotics;
- We need to take laxatives and / or an enema, to cleanse the bowel;
- On the night before the operation, you can only have a light meal. Do not eat or drink anything after midnight, unless otherwise indicated doctor.
- We need to take a shower or bath in the morning before surgery.
Anesthesia
During the operation using general anesthesia. During the operation, the patient is asleep.
Description of the procedure
To prepare the patient for surgery, Nurse enters venous catheter in the arm of the operated. The patient will be able to get through it fluids and medications during the procedure. The doctor will put a tube for breathing through the mouth into the throat. This will help the patient breathe during surgery. Also, a catheter is inserted into the bladder, to divert urine.
The doctor will make several small incisions in the abdomen. It will be pumped gas, to facilitate visibility inside. A laparoscope and surgical tools will be inserted into the incisions. Laparoscope – special medical tool with a tiny camera and a light source at the end of. It sends images of the abdominal cavity on a monitor in the operating room. The doctor performs, considering the operated area on this monitor.
Surgical staples are used, to divide the stomach into two unequal parts. At the top will be formed little bag, through a tiny hole in the bottom of the food which is passed on to the intestines. A small bag can contain only 100 to 250 gram soft, moist and well-chewed food. A normal stomach can hold up to half a kilogram of food.
Then the plastic strip is wrapped around the formed small hole, which will prevent it from stretching. This band may be adjusted postoperatively. The incisions will then be closed with staples or stitches.
After the procedure
The breathing tube is removed and the patient is sent to the recovery room for monitoring vital functions. Also on the need to introduce painkillers.
How long will the surgery?
About two hours.
Will it hurt?
Anesthesia prevents pain during surgery. Patients experience pain or soreness at the incision during recovery. Your doctor may prescribe medication, to ease the pain.
Time spent in hospital
The usual length of stay is 2-5 days. If complications arise, length of stay in the hospital can be extended.
Postoperative care after laparoscopic vertical band gastroplasty
In the hospital
While in the hospital, the following procedure:
- Provided painkillers;
- Diet:
- On the day of the operation can not be anything to eat and drink;
- The next day after the operation is carried out X-ray examination for leakage of gastric operated seats. To do this, the patient is given a drink a special liquid, then performed an x-ray. If the test is positive, every 20 min available on 30 ml of culture liquid. If leaks are found, the power will be produced by intravenous;
- On the second day after surgery, you can take 1-2 tablespoons of pureed food or 30-50 ml of fluid every 20 minutes;
- While in the hospital, patient, it is desirable to do the following:
- Use a spirometer, to take deep breaths. This helps prevent problems with light;
- It is necessary to wear elastic surgical stockings to improve blood flow in the legs;
- Slowly walk every day.
Nursing homes
Be sure to follow your doctor's instructions. It is necessary to immediately start a healthy lifestyle and get rid of bad habits.
After operation:
- We need to ask the doctor about, when it is safe to shower, bathe or expose the surgical site to water;
- The period of recovery after surgery for gastric bypass surgery – 2-6 weeks;
- It is impossible to drive or lift anything heavy, until the doctor says it's safe. It may take up to two weeks or more;
- After surgery possible emotional ups and downs of mood;
- We need to meet regularly with your doctor to monitor and support.
The new stomach is the size of a small egg, allowing you to quickly reach satiety. Thus, you need to take very small amounts and eat very slowly:
- We need to start with 4-6 meals per day 50-80 grams at a time;
- First 4-6 weeks after surgery, all food must be pureed into a puree;
- After the transition to solid foods it needs to be well-chewed;
- It is necessary to consume enough protein;
- If there is too much or too fast, This can cause severe pain or vomiting. When food intake is not necessary to hurry up;
- This procedure does not cause nausea and diarrhea in the consumption of sugary or fatty foods. Some people gain weight again, because they continue to consume sodas, ice cream and other high-calorie foods. In order to promote weight loss, should avoid high-calorie foods.
Maybe, will have to take medication, which may include:
- Antacids;
- Analgesics;
- Vitamin and mineral supplements.
It is necessary to go to the hospital in the following cases
- There are signs of infection, including fever and chills;
- Redness, edema, increase in pain, bleeding or discharge from the incision;
- Inability to relieve pain using painkillers;
- Blood in the stool;
- Problems with urination (eg, pain, burning, frequent urination, blood in urine) or inability to urinate;
- Constant nausea and / or vomiting;
- Cough, breathlessness, chest pain, or severe nausea or vomiting;
- Pain and / or swelling in the legs, ykrah, feet, sudden chest pain or shortness of breath;
- There are any other abnormal symptoms.