43772 Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device component only

Name of the Procedure:

Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device component only

Summary

This procedure involves the surgical removal of a specific component of an adjustable gastric restrictive device, commonly used in weight-loss surgeries. It is done through laparoscopy, which is a minimally invasive surgical technique that uses small incisions and a camera to guide the surgery.

Purpose

This procedure addresses issues related to adjustable gastric restrictive devices used for weight loss. The goals are to alleviate problems such as device malfunction, infection, or other complications associated with the device.

Indications

• Malfunction or slippage of the gastric band
• Infection around the device
• Inadequate weight loss or complications from the device
• Patient discomfort
• Erosion of the device into the stomach

Preparation

• Patients may be instructed to fast for several hours before the procedure.
• Pre-operative assessments could include blood tests, imaging studies, and a physical examination.
• Patients may need to adjust or stop certain medications prior to surgery.

Procedure Description

1. Anesthesia: The patient is given general anesthesia.
2. Incisions: Small incisions are made in the abdomen.
3. Insertion of Laparoscope: A laparoscope (camera) and other surgical instruments are inserted through these incisions.
4. Locating the Device: The surgeon locates the adjustable gastric restrictive device.
5. Component Removal: The specific component needing removal is detached and extracted.
6. Closure: Incisions are closed with sutures or surgical glue.

Duration

The procedure typically takes about 1 to 2 hours, depending on the complexity.

Setting

This procedure is generally performed in a hospital or an outpatient surgical center.

Personnel

• Surgeon (specializing in bariatric or gastrointestinal surgery)
• Anesthesiologist
• Surgical nurses and possibly a surgical technician

Risks and Complications

• Infection
• Bleeding
• Reaction to anesthesia
• Injury to surrounding organs
• Deep vein thrombosis (DVT)
• Hernia at the incision sites
• Need for additional surgeries

Benefits

• Relief from device-related complications
• Improved quality of life
• Resolution of infection or discomfort
• Potential for improved weight loss outcomes if a new device is to be placed

Recovery

• Patients might stay in the hospital for a few hours to overnight for observation.
• Post-procedure instructions may include pain management, wound care, and dietary guidelines.
• Most patients can return to normal activities within a week, but strenuous activities should be avoided for a few weeks.
• Follow-up appointments will be required to monitor recovery and discuss further weight management plans.

Alternatives

• Repositioning or adjusting the existing device
• Conversion to a different type of weight-loss surgery (e.g., gastric bypass or sleeve gastrectomy)
• Non-surgical weight-loss methods, like diet and exercise or medication

Patient Experience

Patients will likely experience some discomfort and soreness at the incision sites, and bloating or shoulder pain from the gas used during laparoscopy. Pain is usually managed with medications. The overall experience includes a quick recovery and minimal scarring due to the minimally invasive nature of the procedure.