The LAGB patient can expect a reduced hospital stay of one to two days; in some instances there may be an increased stay if the surgery required an abdominal incision or complications occurred. Patients may resume normal activities in one to two weeks; again, expect a delay if there is an abdominal incision or complications occur.
The LAGB procedure requires no cutting or stapling of the stomach and bowel and is considered the least invasive weight loss surgery available. The band is also adjustable and can be modified by inflating or deflating the inner surface with saline solution. The surgeon can control the amount of saline in the band using a fine needle through the skin. The adherence to monthly appointments for band adjustments during the first 6-12 months after surgery is very important to achieve optimal results. Once the band is adjusted properly, the duration between visits can be lengthened. The adjustments are made in the surgeon’s exam room and patients have minimal discomfort. Finally, should the band need to be removed, the stomach will return to its original form and function.
Side effects of gastric banding may include nausea and vomiting, heartburn and abdominal pain. A more serious side effect, for example, is slippage of the band and/or erosion, possibly requiring another operation or hospitalization.
People with certain stomach or intestinal disorders may not be candidates for gastric banding. Patients with a gastric band must choose foods carefully and take care to chew food thoroughly to avoid obstruction.
Non-Steroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen and many arthritis drugs that contain aspirin may not be taken after gastric banding.
Though gastric banding procedures can be reversed, patients should carefully consider all of the bariatric surgery risks and benefits before electing to have this surgery. The band leads to the least amount of weight loss compared with the gastric bypass, and the sleeve gastrectomy, has little effect on type 2 DM prior to weight loss, and has a high rate of re operation long term (10 years after surgery).
The advantages of Roux-en-Y gastric bypass include superior weight loss when compared to gastric banding and the sleeve gastrectomy, with excellent long-term weight reduction and resolution or elimination of co-morbidities (80 percent resolution of Type II diabetes after surgery). Early and late complication rates are reasonably low, and operative mortality ranges from 0.2 percent to 1 percent. The gastric bypass is curative for Gastroesophageal Reflux disease.
Disadvantages of Roux-en-Y gastric bypass include the potential for anastomotic leaks and strictures, severe dumping syndrome symptoms and procedure-specific complications, including distension of the excluded stomach and internal hernias. Roux-en-Y gastric bypass is technically more challenging to perform than the restrictive procedures, particularly when using the laparoscopic approach. However, in experienced hands, the conversion rate of laparoscopic Roux-en-Y gastric bypass to open is less than 5 percent. All patients need to take supplements of vitamins after surgery.
The sleeve gastrectomy is used as a primary bariatric procedure for weight loss. Initially it was used for selected patients who are not candidates for the band or gastric bypass due to severe medical conditions, extremely high BMI, or prior bowel surgery.
The sleeve gastrectomy leads to weight loss more than the gastric banding, but lower than the gastric bypass. It involves a major Transection of the stomach without any surgical work on the small intestine.
Certain patients regain weight after the sleeve gastrectomy. Patients may develop Gastroesophageal Reflux disease after the sleeve gastrectomy. Leaks after the sleeve gastrectomy are more difficult to treat compared to the gastric bypass. The sleeve gastrectomy is irreversible.