GASTRIC BAND

* WHAT IS THE GASTRIC BAND?..........................................[GO]

* CAN IT BE APPLIED IN EVERY OVERWHEIG CASE?.................[GO]

* WHAT PROBLEMS CAN CAUSE THE GASTRIC BAND?...............[GO]

* WHAT STEPS ARE HAD TO GIVE FOR THE APPLICATION OF THE GASTRIC BAND? ...............................................................[GO]

* Risks and complications of the surgery of the obesity by means of GASTRIC BAND...................................................[GO]

* WHAT COLLATERAL EFFECTS ENTAIL THE BAND?..................[GO]

* WHAT SERVICES INCLUDE THE PROGRAM?...........................[GO]

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What is the GASTRIC BAND?

One is a directed procedure to facilitate the loss to him of weight, by means of the positioning of a silicone band around the stomach, whose capacity will diminish until a size of 25-30 CC. With it, one will feel very quickly satiated and it will be easy to him to lose weight.

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CAN BE APPLIED IN ANY CASE OF OVERWEIGHT?

No es The indiscriminate application of the gastric band is not recommendable since it involves certain risks. He is only advisable in case that a repetitive failure with the dietetic , farmacológicos treatments takes place, and of modification of conduct.
In this situation, the gastric band limits the amount to him of food that can take from once, being used to to him eating less. However, with the passage of time , if it eats systematically more than what the size of the residual stomach allows , this one will increase progressively. With it, not only it will be able to eat every time more, but that can give rise to important complications.

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WHAT PROBLEMS CAN CAUSE THE GASTRIC BAND?

• Although this surgery is made through small incisions (laparoscópicamente), is a surgery with risks. Risks and complications exist that derive from that it is the operation, but risks and complications also derived from the obesity in himself. The patients are due to interrogate to themselves on if the benefits compensate to them with respect to risks, complications and sequels of this surgery.

“ the decision is personal, to the time that medical. ”

We can inform into the risks and of helping to him to predict the probable benefits him that the surgery for You will represent. However, the final decision is hers. In order to make an intelligent decision, the patient needs to know the details very well concerning the inevitable operation, risks, benefits, sequels, changes that will prevail in their style of life … Is necessary as much an exhaustive information, as a time of reflection. Remember that, unlike the intragastric ball, the gastric band is in principle definitive. A reoperación, as much to clear it as to modify or to replace this technique by another one, involves always greater risk than the first operation.

The objective number in approximately losing a 40% of its overweight in about 2 years. Thanks to it, are demonstrated a diminution of the global risks for the health that involves the obesity; specially arterial hypertension, cholesterol and triglicéridos and diabetes. In addition, one will be far better, will be increasing progressively its possibilities of making sport at least or a good daily physical exercise.

In principle, we recommended 800-1000 calories during the first month, to continue with 1200 calories in the successive thing.

Like with a intragastric ball, it is going to feel less appetite, and when it eats, one will feel still more quickly satiated. It is fundamental to know when it is on the verge of being satiated, and to immediately let eat.

On the contrary, its stomach will undergo a progressive adaptation, with increase of its receiving capacity, that will partly invalidará the benefit of the gastric band, to the time of which it favors the erosion of the wall of the stomach and possible serious complications. Also, the important thing is not only what it eats but HOW eats. It must eat perfectly slowly and chewing foods, for which he is essential to enjoy a good set of teeth.

The guarantee of good results demands one narrow collaboration between the patient and his medical equipment. Due to it, we have designed a rigorous plan of visits and activities, that we requested to him follows faithfully. You will arrange by another part of a contact telephone to be able at any moment to make us of your problems and restlessness contributor.

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THAT STEPS ARE HAD TO GIVE FOR THE APPLICATION OF THE GASTRIC BAND?

The plan to follow from now on is the following one:

a) In the first place, and unless already one has taken these steps by the previous application of a Intragástric Ballon, it must go to our psychologist, who will help to decipher his nourishing upheavals him, and he will support to him in the control of the dietetic regime that is to take, until obtaining that their habits have modified the sufficient thing like not undergoing new ponderales increases.

b) We will ask for an analytical study to him - including hormonal balance if it does not have it already made.

c) With these data, you will return to the consultation with at least a relative or friend, and we will jointly read the informed consent, that we will have to sign all - including the witness.

d) Fact this, we will fix place, date and hour for the operation.

e) Previously the procedure, it will be visited by the anestesiólogo. It will review the analytical study and other made examinations to him, as well as the previous information. If it considers it opportune, it will ask for some complementary examination to him. It will explain the habitual procedure to him.

f) After the intervention, it will happen to the Unit of Postanestesia Recovery where it will remain hours in principle, modifiable to criterion of the doctor responsible for the Unit. On the following day, it will be allowed him to take liquid, and if everything goes well, it will be able to leave Discharge. It will have a telephone number so that, 24h to the day, can call with any doubt. It will call to Consulta to request appointment in the following week to the operation, or before if it creates it advisable

g) Next, it will be mentioned to him in the consultation for pursuit with a weekly frequency during the first month. It will be come to the inflation of the band, sometimes under radiation control, as of the 6 weeks. One week will be visited to him again later.

h) From then, it will have to return periodically to the consultation for revision, with a quarterly frequency in principle, although it has to commit itself to consult any anomaly that can relate to the presence of the band.

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¿Risks and complications of the surgery of the obesity by means of gastric band??

It is precise to be conscious that the surgery always involves risks, and that being an obese patient, these risks are increased.

Pulmonary Embolismo: This happens when a clot that forms in the leg gives off and arrives until the veins of the lung. Sometimes it can cause to sudden death or sensation of lack of air. Approximately 1% of the patients concern. We used prevention measures that include anticoagulant as well as average special compresivas. If it takes contraceptives, will have to suspend them 3 weeks before the operation. If it smokes, also it must leave it 3 weeks before the operation.

Hemorrhage: It happens in less than 2% of the patients, either during the operation by injury of bazo, or later, towards inside or by outside the stomach. Usually one stops cutting the anticoagulants, but in some occasions the reoperación can be necessary.

“Slippage” or sliding from the stomach over the band: this can happen in more of 10% of the patients. It has to do with the surgical technique, as well as with the excess of ingestion of the patients, mainly too much soon after the surgery, which forces the expansion of small reservorio gastric, that throws upwards of the rest of the stomach.

Erosion of the stomach by the band: like in the previous case, it can be associated to an excess of food, although when wanting also sometimes fill in excess the band. Sometimes the band ends up crossing the stomach, and even can be necessary a dangerous endoscopia or the surgery for its extraction. If is to retire therefore the band, the benefit of the surgery is lost completely. It happens in less than 5% of the cases.

Stones in the vesicle: A third of the obese patients who lose weight quickly is going to develop calculations in the biliary vesicle. For that reason, if it has vesicle, we will recommend a preventive treatment to him during the phase of fast ponderal loss (about 6 months).

Infections: The infections are rare but they can happen: as much pulmonías, as urinary infections or even of the surgical wounds mainly of the site where one is placed reservorio. This infection also can take place in the long term, forcing sometimes to the change location or even to its retirement, when it takes place due to the erosion of the gastric band before mentioned.

Conversion to “open” procedure: that is to say, to open surgery. This is not really a complication but that is a change of technique, motivated generally by the difficulties that the anatomy of the patient involves, mainly a great liver. It happens in approximately 1% of the prepared patients affluent, and the main disadvantage is the greater postoperating annoyances related to the great necessary incision in the obese patient.

Nutricionales problems: Unlike other techniques against the obesity, after a gastric band vitamin takings are not required of by life, nor is risk in principle of deficiencies, as long as the diet is taken care of.

Problems related to reservorio: Infections, intolerancias, ulceración of the skin by the pressure exerted by reservorio when losing thickness of fat, disconnection of the tube of reservorio can appear…. These in principle nonserious complications, are despite most frequent. Some can require operation.

Failure in obtaining the awaited loss of weight: One is due to aspire to lose with the gastric band 40% of the excess of weight in about 2 years. Later S ia to recover the weight, can be due either to a problem with the band, or to a failure in the discipline of the patient with respect to life habits, that is to say, diet and exercise. It is not necessary to forget that the surgery does not excuse the patient of a suitable discipline. If in the revisions east problem were observed, would be necessary first of all to review by means of endoscopia or radiology the position of the gastric band, as well as its correct inflation..

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WHAT COLLATERAL EFFECTS ENTAIL THE GASTRIC BAND?

1. YOU FEEL NAUSEOUS AND VOMITS. - These will take place inevitably before any dietetic excess by very small that this one is. It does not forget that the size of its stomach will practically be like the one of its thumb () First months are more frequent during the 2-3 until the patient becomes accustomed itself the new amounts, and to eat more slowly. It is very important for the future of the band that does not happen ideally and, that the change of habits has taken place before the application of the band for good future results. Also a good mastication is fundamental, and therefore, as we mentioned before, a good teething.

2. DEHYDRATION. - It will only happen if it is not taken care of to drink 2 ls of liquids the first days or if it vomits of form continued without treating. If this happens, consúltenos

3. INTOLERANCIA TO CERTAIN FOODS. - This is inevitable and leaves from the surgery: it would never have to return to take a fillet, nor bread of Vienna for example: if one forgets to chew very well these foods, they will be clogged the band in front of, it will have pain, and sometimes it will be necessary to extract the piece by endoscopia.

4. TENDENCY TO THE CONSTIPATION. - It will depend on his previous intestinal habit, but it will tend to estreñir itself by the diminution of the amount of foods. We will advise to him on the matter.

5. METEORISMO. - Many patients complain swelling of belly, or much air or flato. This is due to the change of form of the stomach, the difficulty of eructar, to that many patients swallow air, or to the own change of diet. It has treatment and usually it improves with time.

6. COLD. - Often minor takes place tolerance to the cold by the simple fact to become thin, by the metabolic changes that take place.

7. PLASTIC SURGERY. - It will already know that after a loss of important weight, “everything will fall”. Therefore, it will have to think about the convenience of operating with aesthetic aims, but not before the stabilization of the weight, that is to say, towards the 2 years after the surgery.

8. PREGNANCY. - It must hope to become stabilized: it does not anticipate a pregnancy up to 2 years after operating.

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WHAT SERVICES INCLUDE THE PROGRAM?

We wished to clarify to him that the amount paid for the procedure includes the following services:

Operation, EXCLUÍDOS the hospitable expenses or of any necessity of entrance or reoperación.

Revisions in consultation: weekly the first month, inflation of band to the 6 weeks, as well as subsequent to a same one.
Psychological support.

Lessons on good nourishing habits by specialist in dietetic.

Program of exercises by fisioterapeutas specialized: our “personal trainers”.

Availability of telephone consultation 24 h, and possible attention to some urgent problem related to the operation.

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