Laparoscopic Adjustable Gastric Band

Transcription

1 Laparoscopic Adjustable Gastric Band Dr. Isaac Samuel Bariatric Director Dr. Mohammad Jamal Bariatric Surgeon Lynn Gingerich - Bariatric Physician Assistant Debi Heitshusen Bariatric Nurse Coordinator Amy Lukas Bariatric Dietitian Chris Melichar- Program Assistant/Insurance

2 UIHC Bariatric Program is a Center of Excellence COE Designations: American Society for Metabolic & Bariatric Surgery (ASMBS) Wellmark BC/BS BCBS - Blue Distinction United Resource Network Aetna The designation underscores the program s s excellence in patient education and outstanding clinical outcomes.

3 The Lap Band is implanted using laparoscopic surgery a procedure that involves smaller incisions and less tissue trauma than open surgery resulting in shorter hospital stays, faster recovery, smaller scars, and less pain than open surgical procedures.

4 Time Off Hospital Stay one night Return to Work weeks After one month first adjustment 3-44 adjustments 1 st year

5 Effects of gastric banding on Obesity related conditions Type II Diabetes resolved 47.8% High Blood Pressure resolved 43.2% High Cholesterol resolved 78.3% Sleep Apnea resolved 94.6% Acid reflux/gerd resolved 32.3%

6

7 The Lap Band is made of strong, flexible silicone and has a soft balloon that fits around the stomach. The amount of saline in the balloon controls the tightness around the stomach. The balloon s s tightness affects how much food you are able to eat during a meal and the length of time it takes for food to leave your stomach pouch to travel through your digestive system. How does this help you achieve your weight loss goals and improve your quality of life? You ll feel fuller sooner and stay fuller longer with the Band. The band s s tubing is connected to the Port. The port is made from an implant-grade medical plastic and silicone. It is usually fastened (or sutured) on the left or right side, about 2 inches below the rib cage. The exact location will depend upon your body shape and your surgeon s s decision..

8 The band works on three ways: 1.) It limits the amount of food that is consumed 2.) It delays the emptying of the new stomach pouch 3.) It creates the sensation of fullness for a long period of time after eating

9 Average weight Loss Food digestion happens through normal digestion, and healthy weight loss occurs at a target rate of: 1-22 pounds per week Patients in a 3-year 3 year clinical trial lost an average of 40% of their excess weight at one year and 43% at three years.

10 The Lap Band is adjustable so if the rate of weight loss is not acceptable, the band can be tightened to make you feel full after eating less food. Additionally, if weight loss is occurring too quickly, the band can be loosened so that more food is needed to feel full.

11 How can a person eat so little and survive? nerve endings in the pouch signal fullness our bodies only need 500 calories a day to survive (with supplements)

12

13 Recommended Plan in Preparation for Obesity Surgery Start working on your diet and behavior modifications today!

14 See dietitian for a low fat, low calorie diet. Keep a daily food & exercise Journal. Write down what you eat & how much of it you eat. Try to stay within what the dietitian has given you per day. Please be truthful. Please, bring your food diary back to every visit until surgery so we can review it with you.

15 Drink glasses of water every day Water is the key to the surgery!! It helps you lose the weight and it helps you keep it off Never compromise your water intake

16 Beverage Restrictions No Pop (diet or regular) N0 Juice (calories, phosphate, carbonation) 1 can of regular pop or 8 oz. juice per day is equal to 17# wt gain per year. Phosphate binds with calcium which may lead to osteoporosis Carbonation stretches out your pouch eat more weight loss stops No Alcohol it will cause gastritis and eventual ulcers in your pouch

17 You must start an exercise plan We would like you to do 30 minutes of exercise every day. For those of you who suffer from a lot of joint pain, we suggest that you start water aerobics minutes of swimming is a wonderful workout and will not put any stress on your joints. Whatever you do (swimming, walking, biking, treadmill, gym) increase your heart rate

18 STOP SMOKING For those of you who smoke, we encourage you STOP smoking as soon as possible. We want your lung function in the best possible shape going into surgery. You have to be smoke free for 3 months prior to surgery.

19 ALWAYS chew your food to mush before you swallow. It is very important after the surgery that all of your food be chewed to mush before you swallow or you will vomit. The band is non forgiving and you will pay the price.

20 DO NOT drink with your meals STOP drinking 30 minutes before you eat DO NOT drink while you eat WAIT to resume drinking for 30 min. after you are done eating and you have the full feeling

21 Band Adjustments Because your doctor wants to make sure that your stomach heals completely from the surgery, your first band adjustment won t t usually occur until weeks after your surgery.

22 Band Adjustments Most patients have their first adjustment after eating solid food for one week. The exact timing will depend upon your progress. Remember, the Lap Band provides some restriction even when it is empty. If you are losing 1 to 2 pounds a week and feeling satisfied with an appropriate portion of food, you may not need an adjustment at this time.

23 The purpose of an adjustment is to ensure that you feel satisfied when you eat and that you are losing weight gradually, about pounds per week. The adjustments are done by your doctor or another healthcare professional by adding sterile saline to the band through the port. Adjustments can also involve removing saline from the band through the port. When filling the band, saline travels from the port through the tube and into the band, making the band fit more snugly around your stomach.

24 Avoid: REMEMBER raw vegetables, fruits with skin, nuts, popcorn, tough meats, stringy foods, and crusty bread (bagels and pretzels) These may block your Stomach outlet

25 Eat approximately 4 ounces (1/2 cup) of food at each meal and note that protein will stay in your upper stomach longer than other foods. Do not snack between meals. Drink fat free skim milk. Eat slowly, take small bites and chew your food well Do not drink with your meals

26 No nonsteroidal medication (Advil, Motrin, Ibuprofen, Aleve, Aspirin, Arthritis medication) for the rest of your life. No continual use of steroids (Prednisone, Cortisone, Medrol) Daily use of either of these medications can cause ulcers in your pouch. Tylenol products only

27 Supplements Chewable Multivitamin with iron Daily

28 RISKS associated with gastric banding Band erosion, band slippage Tubing-related complications (port disconnection, tubing kinking) Band leak Esophageal spasm Gastroesophageal reflux disease (GERD) Inflammation of the esophagus or stomach Port-site infection or port displacement

29 Realize Band U.S. Clinical Trial N=276 Key Serious Adverse Events Band slippage 9 (3.3%) Band erosion 1 (0.4%) Port displacement 7 (2.5%) Low reoperation rate due to few complications Band replacements 2 Band revisions 10 Band explantations 4 Port revisions/replacements 27 Average % excess weight loss (EWL) at 2 and 3 years post-surgery surgery 45% and 43 % respectively

30 Ensuring your success with the Lap Band requires hard work, dedication to your new lifestyle, and support from your loved ones. To help you along the way, the REALIZE Personalized Banding Solution includes Realize mysuccess an online tool that will help you and your doctor set goals and continuosly watch your progress together - for up to 3 years

31 Review Test Click on the ICON link below and answer the question to record your participation ICON