Weight Loss Surgery - Lap Band, Gastric Bypass and Sleeve Gastrectomy » Gastric Bypass Surgery

Strategies for Success

Judy C. Dohm — Sun, 21 Mar 2010 01:47:06 +0000

I just came back from a Seattle WLS convention and am preparing for our Houston event. We talked at length about what helps us be successful and what things undermine our success and we came up with some strategies for success.

• Never grocery shop on an empty stomach!

• Stay on the perimeter of the store – the inside isles are filled
with processed foods you don’t need! dairy, meat, fresh fruit, fresh
vegetables and good whole grain breads are on the perimeter.

• Use a white board on your fridge – when my kids lived at home I
posted daily what was for dinner and what was available in the fridge for snacks. If you know what is in there and have a variety of healthy snacks – you won’t be as tempted to fall off the wagon.

• 5- P’s – Poor Planning Predicts Poor Performance – translated -
plan your menus a week ahead- buy what you need to complete those menus. Be flexible enough to be able to switch Thursdays 10 min grilled chicken and veggies to Wednesday if you run short of time on a particular day. Start your meal preparation in the morning when you are rested and have eaten your breakfast. We live in a world where time gets away from us too easily – if the salad is made, the veggies prepped and a meat or protein dish prepped – your odds of sticking to your plan are significantly increased than if you walk in the door after a day from hell with hungry kids, a crabby husband and the pizza fridge magnet screaming your name.

• Don’t allow trigger foods into your home! You don’t keep alcohol
or drugs in front of an addict – don’t put pizza, chips, ice cream in your
home – this will actually help your children have healthier relationships
with food!

• Make sure you are well rested by setting boundaries on your
evening time. Don’t allow other people or events to intrude on your down time. Boundaries are important and successful people establish boundaries and guard them.

• Give yourself adequate time to eat with your family in a
stress-free environment. When you slam down food in a car with cranky kids is when you will PB or eat beyond full and be in pain.

• Get adequate exercise, walking the dog, cleaning your yard,
gardening, biking, hiking, – time doing any activity with children or
friends outside of your home.

• Don’t be afraid to ask loved ones for what you need – you don’t
have to be in this alone, your children/husband can help by peeling veggies, helping with chores if you explain to them that being overwhelmed is a trigger for heading off your path.

• Be kind to yourself – keep the voices in your head gentle and kind
- change is the result of being kind to yourself, self criticism defeats
you.

• Write up a disaster recovery plan – what you can do to put
yourself back on track – mine is a long list of small daily goals that are
achievable – results are cumulative.

More Revision Surgery After Lap Band or Gastric Bypass

Shibal Burns — Mon, 25 Jan 2010 08:22:59 +0000

More Revision Surgery After Lap Band or Gastric Bypass

Bariatric surgery, even in the best of hands, is not a panacea, and while most patients report a favorable outcome following the surgical procedure, a significant subset of patients may experience complications or not fail to achieve their ideal body weight as expected.

In these circumstances, a follow-up surgical procedure, known as a bariatric surgery revision, may be necessary to either achieve the ideal body weight, help resolve co morbidities, or manage the complications of the first surgery.

A comparison of the between the Roux-en-Y gastric bypass and lap band surgery becomes exceedingly relevant when considering a bariatric surgery. Whether there are more revision surgeries required after lap band or gastric bypass is therefore an important consideration.

Both of these surgeries are radically different in terms of their mechanism of action. Gastric bypass has a dual mechanism of action, being restrictive as well as a malabsorptive procedure, while the lap band surgery is only restrictive. The former, therefore, has been found to be more effective over time. The weight loss however is slower, and steadier with lap band surgery. The final weight loss is achieved by the end of three to four years after lap band surgery, and by the end of eighteen to twenty four months following the gastric bypass procedure.

Approximately 5 to 10% of patients who have had a gastric bypass reportedly require a revision surgery over 5 years. The reasons for the same vary from complications, unsatisfactory weight loss, or weight regain.

The revision rate following lap-band surgery is reported to be approximately 10% during the first two years. The reasons for the same include device-related problems, slippage or unsatisfactory weight loss.

Collated data from multicentric trials indicates that the excess body weight loss following gastric bypass surgery ranges from 69 to 84% at one year, while the same following a lap band procedure is 45 to 55%. Given that a weight loss less than 50% of the excess body weight constitutes surgical failure, it is evident that the rates of revision surgery following lap band surgery are higher than that following a gastric bypass.

Even though the incidence of early complications following gastric bypass has been reported to be higher than those following lap band surgery(4.2% and 1.7% respectively at the end of first week) the complication rates of the two procedures become comparative by the end of one and a half years (8 and 9.1% respectively).

Experts believe that long-term failure and complications after this time are rare with gastric bypass, while a significant number of lap band patients experience problems which may require a re-exploration or conversion to a different surgical procedure.

However, given that the safety profile of the lap band surgery is significantly better than that of the gastric bypass, and the former is a reversible technique, several patients as well as bariatric surgeons are opting for it. However, when making a choice, the decision must be made keeping in mind the relative rates of revision surgery following each of the surgical procedures.

Gastric Bypass Surgery

Ruth Rosa Lenox — Tue, 14 Apr 2009 12:49:56 +0000

Gastric Bypass Surgery

The Gastric Bypass Surgery (GBS) combines both restrictive and malabsorption processes. The creation of a small stomach pouch causes restricted food intake and construction of bypasses of the duodenum and other segment of the small intestine causes malabsorption, which decreases ability to absorb calories and nutrients from food.

There are two types of GBS.

The first type is known as Roux-en-Y Gastric Bypass (RGB).This surgery was the first performed in US and today it is most popular Gastric bypass surgery all over the world. A small stomach pouch is created by stapling part of the stomach together or by vertical branching. Thereafter, a Y-shaped section of the small intestine is attached to the pouch to allow food to bypass the duodenum as well as the first portion of the jejunum. Now it is possible to perform this surgery by laparoscopic technology.

Another type of GBS is called extensive gastric bypass or biliopancreatic diversion. This type is more complicated than RGB. The lower portion of the stomach is surgically removed. The remaining pouch is connected directly to the final segment of the small intestine .As a result both duodenum and jejunum are bypassed. This type is not very popular as it has a risk for nutritional deficiencies.

People who undergo gastric bypass surgery are at risk for Pouch stretching. The stomach may stretch back to its original size before surgery. Sometimes the breaking of staples can reverse the procedure. Leakage of stomach contents into the abdomen can cause acid eat other organs.

Some people complain of Dumping Syndrome. It occurs when stomach contents move too rapidly through small intestine. It causes nausea, vomiting, weakness, sweating, faintness and diarrhea after eating. Gallstone can occur in response to rapid weight loss. The limited absorption of vitamin B-12 and iron can cause anemia. The lack of calcium absorption causes osteoporosis.

But, the benefits of the surgery definitely outweigh the risks. More than 75% of the patients are expected to lose 75-80% of their excess body weight .About 70-80% of the patients stop taking medication for hypertension. Other conditions such as sleep apnea, asthma, joint pain, arthiritis, fatigue, shortness of breath are drastically improved if not completely resolved.