Gastric restrictive surgery is a type of bariatric surgery or weight loss surgery and 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 this procedure, the normal digestive process stays intact; none of the gastrointestinal tracts 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 because continuous overeating can stretch the pouch so that it holds more food.
The types of restrictive procedures include:
LAGB is most often done using a laparoscope rather than through an open incision, using 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 and the amount of scarring and often results in quicker recovery than an “open” or standard method.
Bariatric surgery is currently the best choice for 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, the 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 physician’s guidelines for nutrition and exercise after the surgery.
There may be other reasons for your physician to advise a gastric banding procedure.
As with any surgery, complications may happen and may include:
In LAGB, the band can erode into the stomach clip which can block the flow of food through the band. Rarely, the 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, and procedures may vary based on the type of surgery done. These surgeries require you to be under general anesthesia; your physician will discuss this with you before.
Generally, the following process happens:
After the procedure, you’ll be taken to the recovery room. Once your blood pressure, pulse and breathing are stable and you are alert, you’ll be taken to your hospital room. You may get pain medicine as needed, either by a nurse or by administering it yourself through a device connected to your IV.
You’ll be encouraged to move around while you’re in bed, and to get out of bed and walk around as your strength improves; it’s important to move around soon after your surgery to prevent blood clots. The first time you get up, ask the nurse to help you so you don’t fall or faint.
At first, you’ll get fluids through an IV; that evening or the next day, you’ll be given liquids such as broth or clear juice to drink. As you’re 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 physician 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’ll be instructed about taking nutritional supplements to replace the nutrients lost due to the reconstruction of the digestive tract, and you’ll be encouraged to maximize protein intake, often with protein drinks.
Before you are discharged from the hospital, follow-up visits are arranged.
If you start developing any of the following symptoms, call your physician immediately: