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The Particulars of Laparoscopic Surgery
Before Surgery:
In order to be considered for laparoscopic surgery, you will be carefully evaluated by your GP and your Surgeon. A detailed history will be taken of surgical, medical and dieting history. Studies may performed to assess a patient's health which includes his/her pulmonary, endocrine and cardiovascular systems.
A psychological evaluation is now considered advisable by GP and Surgeon, (as well as insurance companies on occasions) to determine what a patient's response will be; not only to weight loss, but change in the body image, as well as how he/she will adapt to permanent lifestyle change.
The potential patient is strongly encouraged to see a nutritionist, psychologist and exercise physiologist before the upcoming surgery date. This practice includes these consultations as part of its package; prepaid prior to surgery with no further costs to the patient post-operatively.
During surgery:
There are various laparoscopic surgical procedures which have evolved with an effort to bypass or "shunt" part of the stomach. The procedure that is performed at the Sunnybank Obesity Clinic is the placement of the Adjustable Gastric Band or LapBand.
- Approximately 4 to 6 small incisions, mostly 10-15mm long (one larger incision of 3-4cm is for the placement of the port site) are made in the patient's abdomen. These openings permit the surgeon to pass surgical instruments, a light source and camera into the patient.
- the patient's abdomen is then inflated with carbon dioxide gas. This allows the surgeon to achieve an excellent view of the patient's liver, stomach and intestines.
- In order to complete the surgery, special instruments about a pencil's width are placed into the patient's abdomen via these ports in preparation for the placement of the band.
- When a patient has had an adjustable gastric band placed, there is an immediate restriction placed on the stomach due to the band being placed around this organ. The band is then allowed to scar into place to ensure its correct placement is maintained. Whilst this scarring is occurring (during the first 8 weeks) the patient is on a modified diet. Initially on fluids for 3 weeks, soft foods for 2 weeks then slowly progressing to a near normal diet which allows it to start working to reduce meal size and transit time of food to produce weight loss and suppress appetite.
Surgery
- The procedure usually requires an overnight stay in hospital.
- Usually 1 week off work is all that is required but if the patient has a job that entails heavy lifting the/she may require two weeks.
- Post-operatively, specific eating guidelines will need to be followed. The patient will be guided by clear post operative instructions and dietician advices to clearly understand and adjust easily to these new guidelines. Exercise regimes are usually not recommenced until 4 weeks post op to allow the port to scar into place, though gentle exercise like walking is encouraged from the second week post op.
- The patient should be reviewed monthly during the first year by the Surgeon or his clinic staff until the goal weight is achieved. These visits are required check the status of the band, weight loss achieved, metabolism, general health and nutrition. Further follow-up after this time is less frequent though ongoing.
- There are many patients who may request plastic surgery anywhere from 1 to 2 years after their significant weight loss in order to remove any excess skin folds around your abdomen.
This information is a précis of information that can be obtained about LapBand surgery. Should you have further queries please do not hesitate to phone the Clinic on 07 3345 6667.
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