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Gastric restrictive surgery is a type of bariatric surgery or weight loss surgery. It limits the amount of food you can eat. This surgery may be used to treat severe obesity when diet, exercise, and medicine have failed.
In gastric restrictive procedures, the normal digestive process stays intact. None of the gastrointestinal tract is bypassed. There are two types of operations:
Because the size of the stomach is reduced so much, these procedures are called “restrictive.”
After having a restrictive procedure, you can only eat about three-quarters to a cup of well-chewed food. Eating more than the stomach pouch can hold may cause nausea and vomiting.
Restrictive procedures have fewer risks than gastric bypass procedures. But they may be less successful. That’s because continuous overeating can stretch the pouch so that it holds more food.
The types of gastric restrictive procedures include:
LAGB is most often done using a laparoscope rather than through an open incision. This method uses a few small incisions for the laparoscopic tools to reach the inside of the stomach. The surgeon does the surgery while looking at a TV monitor. Laparoscopic gastric surgery usually reduces the length of the hospital stay. It also reduces the amount of scarring, and often results in quicker recovery than an "open" or standard method.
Bariatric surgery is currently the best choice for lasting weight loss in people who are severely obese when nonsurgical methods of weight loss have not worked.
Potential candidates for bariatric surgery include:
Because the surgery can have serious side effects, the long-term health benefits must be greater than the risks.
People with a BMI of 60 or more or those who have already had some type of stomach surgery may not be able to have laparoscopic surgery.
Although not all risks are fully known, bariatric surgery does help many people reduce or get rid of some obesity-related health problems. It may help to:
Surgery for weight loss is not for everybody. But these procedures can be highly effective in people who are motivated to follow their healthcare provider's guidelines for nutrition and exercise after surgery.
There may be other reasons for your healthcare provider to advise a gastric banding procedure.
As with any surgery, complications may happen. They may include:
In LAGB, the band can erode into the stomach or slip. This can block the flow of food through the band. Rarely, stomach juices may leak into the stomach and emergency surgery may be needed. The most common long-term complication with LAGB is that the stomach pouch enlarges.
Laparoscopic banding procedure has fewer risks because there is no incision made into the stomach wall.
There may be other risks based on your specific health condition. Be sure to discuss any concerns with your healthcare provider before the procedure.
Restrictive gastric surgery requires a stay in the hospital. Procedures may vary based on the type of procedure done and your healthcare provider.
These operations need you to be asleep under general anesthesia. Your healthcare provider will discuss this with you before.
Generally, the following process happens:
After the procedure, you will be taken to the recovery room. Once your blood pressure, pulse, and breathing are stable and you are alert, you will be taken to your hospital room.
You may get pain medicine as needed, either by a nurse or by giving it yourself through a device connected to your intravenous (IV) line.
You will be encouraged to move around while you are in bed, and then to get out of bed and walk around as your strength improves. The first time you get up, ask the nurse to help you, so you do not fall or faint. It is important for you to move around soon after your surgery to prevent blood clots.
At first, you will get fluids through an IV. That evening or the next day, you will be given liquids such as broth or clear juice to drink. As you are able to take liquids, you may be given thicker liquids, such as pudding, milk, or cream soup. This is followed by foods that you do not have to chew, such as hot cereal or pureed foods. Some surgeons recommend a liquid diet for 1 to 2 weeks. Your healthcare provider will instruct you about how long to stay on liquid until it is time to progress to eat pureed foods after surgery. By 4 to 6 weeks after your procedure, you may be eating solid foods.
You will be instructed about taking nutritional supplements to replace the nutrients lost due to the reconstruction of the digestive tract. You will also be encouraged to maximize protein intake, often with protein drinks.
Before you are discharged from the hospital, follow-up visits are arranged.
Report any of these symptoms to your healthcare provider immediately:
After surgery, your healthcare provider may give you other instructions, depending on your particular situation.
Once you are home, it will be important to keep the surgical area clean and dry. Your healthcare provider will give you bathing instructions. The stitches or surgical staples will be removed during a follow-up visit in a week or so.
The incision and stomach muscles may ache, especially with deep breathing, coughing, and exertion. Take a pain reliever for soreness as advised by your healthcare provider. Aspirin or certain other pain medicines called nonsteroidal anti-inflammatory drugs (NSAIDs) may increase the chance of bleeding. Be sure to take only recommended medicines.
Keep up the breathing exercises used in the hospital to prevent lung infections.
Gradually increase your physical activity as you are able. It may take several weeks or months to return to your previous levels of stamina.
You may be told to avoid lifting heavy items for a few weeks to months, depending on whether the operation was done laparoscopically or with an open technique. This will help prevent strain on your stomach muscles and surgical incision.
Weight loss surgery can be emotionally difficult because you will be adjusting to new dietary habits and a body in the process of change. You may feel especially tired during the first 4 to 6 weeks after surgery. Exercise and going to a support group may be helpful at this time.
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