Houston Obesity Surgery, Surgical Treatments

Informed Consent: There are potential risks and side effects associated with any operation, including bariatric (weight loss) surgery. You are advised to consult your own personal general practice physician prior to beginning this or any other program regarding weight reduction and its advisability for your particular circumstances and health. In addition, it is critical that you are completely transparent with Dr. Nowzaradan, his affiliates and the clinical staff regarding your goals, expectations, concerns and limitations. Before seeking surgical intervention for the treatment of morbid obesity you should have tried and failed with other more conservative methods of weight loss management; ones that include a combination of diet, exercise and behavior modification.	Lap Band System® Overview The Lap Band System® is actually the brand name of a specific FDA-approved, adjustable gastric band used in the generic procedure of gastric banding. This is a restrictive type of bariatric (weight loss) procedure, meaning that its physiological function is to limit your amount of caloric intake by causing you to feel full after consuming relatively small amounts of food. Unlike gastric bypass techniques, no part of the digestive system is bypassed, and unlike other restrictive procedures, there are no staples used nor are any parts of the digestive system removed. Although it has been restricted, the entire digestive system remains essentially intact, avoiding some of the post-surgical discomforts and relatively drastic long-term lifestyle alterations that other bariatric procedures require. The Anartomy of the Lap Band System® The gastric band is essentially an adjustable silicone band, belt, or ring that is placed around the upper portion of the stomach and held in place with sutures. Both sections of the stomach are functional, and, unlike with the Roux-en Y Gastric Bypass procedure, the stomach’s normal intake and outlet valves, and their full functions, are preserved. The restrictive band causes the stomach to be more difficult to fill and is responsible for the feeling of satiety (fullness) sooner.	Advantage of Adjustability The gastric band is adjustable. The silicone band is filled with a sterile saline solution. A filler tube connects the band to a port that is typically placed discretely under the patient’s skin on the top part of the abdomen. The band can be filled with additional saline solution to increase its size and restrictive function, if necessary. Conversely, solution can be emptied from the system if a reduced effect is required. The adjustment procedures can typically be performed simply and quickly in the doctor’s office.

Dr. Nowzaradan is a leader in the performance of surgical techniques laparoscopically. Today, surgeries of all types, not just bariatric, are performed using this less invasive technique. Dr. Nowzaradan has published numerous papers on laparoscopy. Prior to his accomplishments, many within the medical community thought his theories of laparoscopically performing various open procedures was impossible. Today, 15 years later, they are commonplace.	Laparoscopic Technique As with most weight loss surgeries, the Lap Band System® is typically performed laparoscopically. Instead of making long incisions and opening a patient, Dr. Nowzaradan makes a series of small incisions (about 1/2 inch to 1 inch in length) in the abdomen. At least one of these incisions is used to insert a temporary device, called a trocar, which allows Dr. Nowzaradan to introduce carbon dioxide gas into the abdomen, inflating it, thereby creating a larger workspace in the abdominal cavity. A tiny camera is inserted through one of the remaining small incisions. This sends a live, clear picture to a monitor in the operating room, that the doctor uses to guide delicate surgical instruments within the patient’s abdomen. These instruments are inserted through the final remaining incision(s). Once the placement of the band is complete, and the port in place, the excess abdominal gas is expelled, the trocars removed, and the incisions are closed.	Advantage of Laparoscopic Technique Laparoscopic procedures cause far less physical trauma to a patient than do open procedures, they are less invasive, result in more rapid healing and recovery times, and cause minimal scarring. Very few lap band procedures, less than 5%, require an open procedure. Duration of Lap Band System® Proedure The Lap Band System® surgery usually takes about an hour, typically requiring no overnight stay at the hospital. Patients can usually return to work within a week.

	Medical and Insurance Candidacy The Lap Band System® is generally considered a less expensive and less invasive form of weight loss surgery; however, it is also noted that weight loss with gastric banding is generally not as pronounced as with the Roux-en Y Gastric Bypass nor the Vertical Sleeve Gastrectomy. The medical candidacy requirements for a Lap Band System® are the same as those for any other bariatric procedure, although your specific insurance requirements may be easier to qualify for. After Surgery Once the surgery is complete, a patient will likely require a liquid diet for few a few weeks, slowly introducing soft foods, then solids. Post-surgical behavioral modifications are required in order to achieve optimum, long-term results from the lap band. For instance, regular exercise and a modification to your pre-surgical diet are highly recommended. Weight loss may be inadequate, or weight regain may occur if a patient returns to their previous dietary habits. An advantage of the Lap Band is that there are fewer restrictions to the types of foods you can eat, but since the quantity of food you should consume decreases, you must make the best use of the calories you ingest. Eat a well-balanced diet and consume foods that are nutrient-rich. Refer to the Nutritional Guidance page of this website for information.	Frequent office visits to Dr. Nowzaradan are crucial after surgery, especially during the first 18 months. These are typically routine visits monitoring your weight loss, so that band adjustments, if any, can be made. As is the case with all surgeries, some complications can result. These can be detected early and resolved with minimal inconvenience with frequent follow-up office visits. Post-surgical Complications Some potential post-surgical complications, such as infection and bleeding, would be present in any type of surgical procedure, but there are some potential complications that are specific to the gastric band. Band slippage, for instance, can cause heartburn, nausea or vomiting. This can usually be easily repaired with a laparoscopic follow-up procedure. Rarely, the band will erode within the body into the inside of the stomach. The band can also spontaneously deflates due to leakage originating from the band itself, the connective tubing, or the reservoir. If a patient does not alter his or her dietary habits and continues to eat similar quantities as before surgery, the stomach pouch can enlarge, causing a cessation to the hunger curbing effects of the band.