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Laparoscopic Surgery for Obesity
There are two different approaches to obesity surgery: open
and laparoscopic. The open approach involves a 8 to 10 inch
incision to open the abdomen and perform the surgery in open
view of the surgical team. The laparoscopic approach enables
similar surgery by using five small incisions (1/4 or 1/2
inch long) instead of the one larger. In the laparoscopic
method, a small fiberoptic tube (the laparoscope), connected
to a video camera, is inserted through the small abdominal
incisions. This gives the surgeon a magnified view of the
patient's internal organs on a television screen next to the
operating table. The entire operation is performed "inside"
the abdomen, after gas has been used to expand it, with the
instruments inserted through the various smaller incisions.
The laparoscopic approach often takes significantly more
operating time than the open approach. VBG done laparoscopically
takes from 2 to 4 hours, versus 1 to 1-1/2 hours using an
open technique. A gastric bypass done laparoscopically takes
from 2-1/2 to 5 hours, versus 1-1/2 when done openly. The
amount of time the operation takes is not significant to the
outcome of the surgery, except it can increase the risk of
developing blood clots or wound infections. The longer time
on the operating table may affect patients with severe apnea
and perhaps should be avoided by those patients. In general,
whatever the method used, the patient's average stay in the
hospital is 3 days. Recovery at home after open surgery is
anywhere from 4 to 6 weeks. Recovery time is quicker with
the laparoscopic method, averaging 2 to 3 weeks.
We are proud to have been one of the pioneers of the laparoscopic
approach to the Gastric Bypass. Because of our 15 years of
experience in Obesity Management, we are highly confident
in our surgical skills and can offer a variety of other techniques,
such as the Vertical Banded Gastroplasty.
We offer patients surgical choices because it is important
to match the patient with the appropriate procedure. New procedures
are always being developed; therefore, your surgeons will
help you to determine which surgical approach will be the
most effective for you. Your satisfaction and overall health
are always our primary concerns.
Is Obesity Surgery for me?
You must be morbidly obese to considered for this surgery.
If you are 80 to 100 pounds or more above your ideal body
weight and are experiencing obesity-related medical problems,
you may be a candidate for surgery.
Laparoscopic Bariatric Surgery
Bariatric surgery is surgery to assist severely obese patients
with weight loss. The most common minimal access surgical
procedure is laparoscopic roux-en-y gastric bypass. This is
a procedure that bypasses most of the stomach and leaves the
patient with a small pouch that restricts the amount of food
that the patient can eat. Additionally the procedure reduces
the absorptive capability of the small intestine by a modest
amount. The combination of these two factors leads to successful
significant weight loss in a majority of the patients. Recovery
after this surgery involves a few (2-4) days stay in the hospital
and two to three days off work. An alternative bariatric procedure
is to place an inflatable silicone band around the top of
the stomach to limit the amount of food that a person can
eat. This band can be placed laparoscopically, and results
in a very short recovery of a few days. The patient and surgeon
make the choice of which procedure to use for weight loss
together.
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