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The word “morbid” means “disease” and this is why, when we say a person is morbidly obese, we refer to the disease that obesity causes. Overweight problems are medical, psychological, social, physical and economic ones. Different associated diseases are brought about by overweight: cardiovascular, pulmonary, hepatobiliary, metabolic, osteoarticular (women) and cancer-associated diseases. Click here for more information Extreme obesity, which includes severe, morbid and superobese patients, causes serious health alterations, and it is associated to other diseases that develop as a consequence of an exaggerated weight increase. Death rate among severe obese patients is increased under any circumstance from 2 to 3 times (moderate obesity) and up to 12 times (morbid obesity). Life span is reduced from 10 to 15 years. Medical treatments (dietary regimes, drugs) fail in the long term. Surgical treatment is the only method that succeeds in maintaining the weight loss in the long term and in improving associated diseases, quality of life and psychological aspects. Patients with a BMI ranging from 35 to 40 (Severe Obesity) with associated diseases, and those with a BMI>40 (Morbid, Super, Supersuper and Triple Obesity). Click here to learn more about BMI All surgeries are risky, and obesity surgery is not the exception to the rule. Nowadays, the risks are far less than those of severe obesity and its associated diseases, which you don’t have under control. Gastric Banding is the less risky among all bariatric surgeries. Click here for more details In simple and gastric restrictive surgeries, such as Gastric Banding, the amount of food to be eaten is reduced, because the stomach is smaller and so it is filled fast. You are “satiated” or full when you eat a volume of food which is similar to the size of a “tennis ball”, and therefore weight loss occurs. With Gastric Banding there are no problems concerning the nutrients absorption, it is not a malabsorptive surgery. The limit in the amount of food is determined by the band, and that’s why it is very important to control the foods’ quality, consistency and frequency, and this only depends on you and on our support.
The surgical time is approximately from 90
to 120 minutes.It is wholly performed through laparoscopy
way, unless some technical problem occurs. We have described the most commonly performed surgeries nowadays; up to this day, more than 40 different operations have been registered. We choose a simple technique because of the reasons we mentioned before. However, the three most commonly performed surgeries at present time, which are Gastric Banding (GB), Gastric By Pass (GBP) and Bilio-pancreatic Diversion (BPD), if correctly performed, should get the expected results.
The band’s silicone is of a rigid consistency, and so it prevents its particles from spreading out. It is not the same medical silicone as the one used in breast implants, which at first was liquid and then gel-like. In spite of it all, it has been proved that medical silicone is not harmful to health. If you suffer from a regular or significant hiatal hernia, with esophagus reflux symptoms, then this pathology will have to be repaired before the band is implanted, during the same surgery; both operations will be performed through laparoscopy. The only difference is that the surgery will take longer. If you have reflux symptoms the band itself will act as an anti-reflux mechanism, and the symptoms will disappear.
If you have symptoms, your gallblader can be removed in the same surgery (during Gastric Banding). However, if gallstones cause you no symptoms, it is advisable only to implant the band and after loosing weight (for more than a year) remove the gallblader via laparoscopy (the procedure becomes simpler when performed on a lean patient). Hernia occurrence is not an impediment to the placement of the trocars (tubes for introducing the surgical instruments) that are necessary for laparoscopy surgery; it is possible to implant the band and after weight loss (more than a year), incisional or wallhernia can be repaired by performing a new surgery, because the method becomes simpler (on a lean patient). If these diseases are further complicated during the patient’s evolution, then an emergency surgery will be needed. If those pathologies are found on the way to GB, then they can be corrected simultaneously. Having abdominal scars may indicate the adherence
between the intestine and the abdominal wall, though this is not
always the case. It is always necessary to start the surgery through
laparoscopy,
and if it is not technically possible, then it can turn into an
open surgery. If there are no further complications, then you can go back to your everyday activities within 48-72 hours. We recommend a special semi-solid diet during the first month so as to contribute to the band’s stabilisation. From then on, a quite free dietary regime can be followed, as long as the food quantity and its quality, as well as the eating behaviour are controlled.
As from the 1st week after the surgery, you can drive and have a normal sexual activity. As from the 1st week after the surgery, you have to start with the scheduled physical activity program, beginning with walks. Physical exercise needs continuity in order to be effective.
It depends on each patient’s needs. The 1st adjustment is usually made after 1 month, and the 2nd one, between the 2nd and the 3rd month. There are no rules that determine the number of adjustments needed, because some patients may lose weight even without any adjustment.
It is not unusual that some patients have vomits. This is due to the fact that:
It is vital that you learn to eat in a different way than the one you were used to before the surgery. It is necessary that you make a radical change in your eating behaviour. Alcohol contains many calories; for example, a glass of whisky has 245 calories, a glass of wine has 150 calories and one of beer has 150 calories, so it should be avoid if possible. However, a glass of wine, champagne or beer once in a while, during a meal or a party, is not that harmful.
Anti-inflammatories or aspirins should be avoided, because they might irritate the stomach, cause gastric erosion and have consequences in the band’s function. If they are necessary, you should take them cracked, with milk and add some gastric protector. It is not advisable. Obese patients have lots of breathing difficulties and if they smoke, they will harm their lungs even more. Smoking is not prohibited, although it is necessary that they consider the “benefits” and the harmful effects of this addiction . Weight loss occurs mainly during the first year. If you comply with the change in your eating behaviour, and depending on your obesity category, a 65 % of our patients have lost more than a 50 % of their excess of weight (EWL % ). Average figures show that after the first 24 months, the EWL is 60 % (average range from 48 to 80). Click here for more information The organism itself usually stabilises its weight after 2 or 3 years by means of compensatory mechanisms. When you reach the desired weight, then it is possible to partially deflate the band, so as not to keep loosing weight. This enables you to eat more and different foods.
Weight loss is a long and hard process; only by understanding that a radical change in your diet or eating behaviour, that is to say, a new way of eating together with regular work out are needed, will you get successful results. If you want to, you can spoil the surgery by eating very soft food, drinking hypercaloric liquids, creams, etc., but then you wouldn’t be cheating your stomach, but yourself. If you do so, then why did you decide to undergo the surgery, to change your quality of life, to improve the associated diseases and to live much longer and in a healthy way? If you cannot control or change your eating behaviour by yourself, then we can help you together with our multidisciplinary team, which will have the necessary background for support, comprehension, advice and follow-up of your eating behaviour.
It is not usually necessary to add these nutrients after Gastric Banding, which is not the case with other surgeries. However, the support and follow-up of our multidisciplinary team may or may not prescribe vitamins after evaluating your nutrition state. The band does not affect pregnancy in a negative way. It is advisable not to get pregnant during the first year, because this is the time when weight loss is more significant. However, together with weight loss, menstrual irregularities disappear and fertility is improved; therefore, if you get pregnant and need to eat more, the band can be partially or totally deflated, preferably during the last pregnancy term.
It is difficult to predict what is going to happen. It depends on the weight loss, on the skin elasticity and on the muscular tone. Not all of the patients need it, but if skin “hangs”, then it means they have had a good weight loss, and a plastic surgery would improve their body structure as well as their self-esteem. Click here for more information Once you have had the band implanted, you cannot eat whatever you want, nor eat great amounts of food. We have already mentioned the need for a change in your eating behaviour. It’s up to you to choose the foods’ quality, consistency and the meals frequency. The diet should be balanced and healthy. You can count on the nutritionist´s support. Support during the pre-surgical phase is as important as the post-surgical one. Emotional conflicts, which may influence or originate obesity, are mainly a consequence of that disease. Our team includes psychologists and psychotherapists who are experts on obesity and have a long expertise. It is necessary that your psyche is gradually rearranged, and to achieve your emotional and psychological stability while you lose weight. You will be the first to be interested in achieving this, once you see the results, and our team will support you and help you to make it. Family, friends and the surgical team’s psychological support is important, because we all want to help you. Adjustable Gastric Banding is a simple surgery which does NOT alter the anatomy, physiology or the foods’ path to the stomach. It is a reversible surgery. In order to remove the band, it is necessary to perform a new laparoscopy. The stomach takes its original shape immediately, and there is no need to perform a new surgery to establish the transit again. It is not advisable to remove the band, because it works as a secure in limiting the intake of food. You would be at risk of regaining weight if there is not a radical and permanent change in your eating behaviour, accompanied by a psychological control.
Gastric Banding needs a strict follow-up and contact with the team in charge, so as to make a better follow-up, modify certain behaviours, indicate adjustments or disadjustments when necessary and detect possible complications early. This contact can be by phoning, faxing, mailing or e-mailing our Centre, especially for foreigners. Certainly. The Obesity Surgery Centre (CCO) has a list of patients who have agreed on speaking with you about their own experiences. You can even attend our support group meetings, where specialists, obese patients, relatives and operated patients get together. |