تعريف
Vertical banded gastroplasty is surgery to treat obesity. It causes weight loss by decreasing the amount of food you can eat.
أسباب هذا الإجراء
The surgery treats severe obesity. Doctors use a calculation called body mass index (BMI) to determine how overweight or obese you are. A normal BMI is 18.5-25.
This surgery is a فقدان الوزن option for people with:
- BMI greater than 40
- BMI 35-39.9 and a life-threatening condition, such as heart disease or diabetes
- BMI 35-39.9 and severe physical limitations that affect employment, mobility, and family life
The success of vertical banded gastroplasty depends on your commitment. If lifestyle changes are made and maintained, the benefits of bariatric surgery include:
- Weight reduction
- Improvement in many obesity-related conditions, such as glucose intolerance, diabetes, sleep apnea, high blood pressure, and high cholesterol
- Improved mobility and stamina
- Enhanced mood, self-esteem, and quality of life
- Reduced risk of dying from cardiovascular disease (such as heart attack, stroke) and other causes
المضاعفات المحتملة
If you are planning to have gastroplasty, your doctor will review a list of possible complications, which may include:
- Vitamin deficiencies—You will take a multivitamin daily for the rest of your life.
- نزيف
- العدوى
- Blood clots
- القيء
- Breakdown of the staples, allowing stomach juices to leak into the abdomen
- Slipping or wearing away of the band
- Enlargement of the pouch
- Irritation of the throat due to acid reflux
- Hernia formation
- Complications of general anesthesia
- Death, occurs in less than 1% of patients
تشمل العوامل التي قد تزيد من خطر حدوث مضاعفات ما يلي:
- التدخين
- Recent or chronic illness (such as kidney disease)
- مرض السكري
- Old age
- أمراض القلب أو الرئة
- Bleeding or clotting disorders
ما يمكن توقعه
قبل الإجراء
Each bariatric surgery program has specific requirements. Your program will likely include the following:
- Thorough physical exam and review of medical history
- Attempts to فقدان الوزن (about 10%) through medically approved dietary means
- Ongoing consultations with a registered dietitian
- الصحة النفسية evaluation and counseling
المؤدية إلى الإجراء الخاص بك:
- Talk to your doctor about your medicines, herbs, and dietary supplements. You may be asked to stop taking some medicines up to one week before the procedure, such as:
- الأسبرين أو غيره من العقاقير المضادة للالتهابات
- Blood thinners such as warfarin (Coumadin)
- clopidogrel (Plavix)
- Do not start any new medicines, herbs, or supplements without talking to your doctor.
- رتب لتوصيلة من وإلى المستشفى.
- Arrange for help at home as you recover.
- قد يتم إعطاؤك المضادات الحيوية.
- You may be given laxatives and/or an enema to clear your intestines.
- The night before, eat a light meal. Do not eat or drink anything after midnight unless told otherwise by your doctor.
- Shower or bathe the morning of your surgery.
التخدير
General anesthesia will be used. You will be asleep for the surgery.
وصف الإجراء
To prepare you for surgery, a nurse will place an IV line in your arm. You may receive fluids and medicines through this line during the procedure. The doctor will place a breathing tube through your mouth and into your throat. This will help you breathe during surgery. You will also have a catheter placed in your bladder to drain urine.
The doctor will make an 8-10 inch incision to open the abdomen. Surgical staples will be used to divide your stomach into two unequal portions. The upper portion will be a small pouch. It will empty through a tiny opening into the lower portion. The small pouch can hold only ½ to 1 cup of soft, moist, and well-chewed food. A normal stomach can hold 4-6 cups.
Next, a plastic band will be wrapped around the tiny opening. This will prevent it from stretching. This band can be adjusted after surgery. The incisions will then be closed with staples or stitches.
مباشرة بعد الإجراء
The breathing tube will be removed. You will be taken to the recovery area.
كم من الوقت سيستغرق ؟
About two hours
كم هو مؤلم ؟
Anesthesia will prevent pain during surgery. You may have pain and/or soreness at the incision sites. Your doctor can give you pain medicine to relieve the discomfort.
متوسط الإقامة في المستشفى
You will be in the hospital for 2-5 days. Your doctor may choose to keep you longer, however, if complications arise.
الرعاية ما بعد الجراحة
في المستشفى
أثناء تعافيك في المستشفى ، قد تتلقى الرعاية التالية:
- Pain medicine will be given as needed.
- Your diet:
- Day of surgery—You will not eat or drink anything.
- Day after surgery—You will likely have an x-ray to check for leaks from the stomach pouch. You will drink a special liquid while x-rays are taken.
- If this x-ray is normal, you will be given 30 milliliters (mL) of liquids every 20 minutes.
- If leaks are found, you will receive nutrition through an IV until the leaks are fixed.
- On the second day after surgery—You will have1-2 tablespoons of pureed food or 1-2 ounces of liquids every 20 minutes.
- You may be asked to do the following:
- Use an incentive spirometer to take deep breaths every hour to prevent breathing problems.
- Wear elastic surgical stockings or boots to promote blood flow in your legs.
- Get up and walk in the hall daily.
في البيت
Be sure to follow your doctor’s instructions. You will need to practice lifelong healthy eating and exercising habits. After your surgery:
- اسأل طبيبك حول, عندما هي آمنة للاستحمام, السباحة, أو نقع في الماء.
- You may be out of work for 2-6 weeks after surgery.
- Do not drive or lift anything heavy for at least two weeks.
- You should walk as soon as possible, with a goal of exercising daily.
- You may have emotional ups and downs after this surgery.
- You will meet regularly with your healthcare team for monitoring and support.
Your new stomach is the size of a small egg. It is slow to empty. This will make you feel full quickly. Nutritional steps include:
- You need to eat very small amounts and eat very slowly.
- You will begin with 4-6 small meals per day. A meal is two ounces of food.
- For the first 4-6 weeks after surgery, all food must be pureed.
- Once you move to solid foods, food must be well chewed.
- When making food choices, ensure that you are getting adequate protein.
- Eating too much or too quickly can cause vomiting or intense pain under your breastbone. Most people quickly learn how much food they can eat.
- This procedure does not cause nausea and diarrhea if sweet or fatty foods are eaten. In fact, some people gain back weight because they continue to consume soda, ice cream, or other high-calorie foods. To promote ongoing فقدان الوزن, avoid high-calorie foods.
- تأكد من اتباع تعليمات طبيبك.
You may need to take medicines, as directed by your doctor, which may include:
- مضادات الحموضة
- Pain medicines
- Vitamin and mineral supplements
استدعاء الطبيب
After you leave the hospital, call your doctor if any of the following occur:
- علامات الإصابة, بما في ذلك حمى وقشعريرة
- احمرار أو تورم أو ألم متزايد أو نزيف مفرط أو إفرازات من موقع الشق
- ألم لا يمكنك السيطرة عليه بالأدوية التي أعطيت لك
- دم في البراز
- ألم، حرقان، إلحاح، أو تكرار التبول، أو نزيف مستمر في البول
- الغثيان و/أو القيء المستمر
- ألم و/أو تورم في قدميك، أو ساقيك، أو ساقيك
- السعال، ضيق التنفس، أو ألم في الصدر
- Any other concerning symptoms
في حالة الطوارئ ، اتصل على المساعدة الطبية على الفور.