Name of the Procedure:

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

Summary

In simple terms, this procedure involves a minimally invasive surgery where a surgeon repairs or replaces parts of a previously installed adjustable gastric band. This kind of surgery is done using a small camera and surgical instruments inserted through tiny incisions in the abdomen.

Purpose

The procedure aims to correct problems with an existing adjustable gastric band, which is typically used to help with weight loss in patients with severe obesity. The goal is to restore the functionality of the band to ensure effective weight loss and manage associated health issues like diabetes or high blood pressure.

Indications

• Slippage or displacement of the gastric band
• Erosion or damage to the gastric band or its components
• Inadequate weight loss or weight regain due to device malfunction
• Persistent and uncontrollable nausea or vomiting
• Band infection

Preparation

• Patients are usually required to fast for at least 8 hours before the procedure.
• Adjustments to medications, especially blood thinners, may be needed.
• Preoperative tests may include blood work, imaging studies, and an EKG.
• Patients will need to discuss their medical history and any current medications with their healthcare team.

Procedure Description

1. The patient is placed under general anesthesia.
2. Several small incisions are made in the abdomen.
3. A laparoscope (a small camera) is inserted through one incision, and other specialized instruments are inserted through the remaining incisions.
4. The surgeon inspects the adjustable gastric band and determines the necessary repairs or replacements.
5. The problematic component of the gastric band is revised, replaced, or repositioned.
6. The instruments are removed, and the incisions are closed with sutures or surgical staples.

Duration

The procedure typically takes between 1 to 2 hours.

Setting

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

Personnel

• Surgeon specializing in bariatric surgery
• Anesthesiologist
• Surgical nurses
• Possibly a surgical assistant

Risks and Complications

• Infection at the surgical site
• Bleeding
• Injury to surrounding organs
• Anesthesia-related complications
• Band slippage or erosion
• Need for additional surgery

Benefits

• Effective management and correction of issues related to the gastric band
• Improved weight loss outcomes
• Relief from symptoms like nausea or vomiting
• Potential improvement in obesity-related conditions such as diabetes and hypertension

Recovery

• Patients may need to stay in the hospital for 1-2 days post-surgery.
• Pain and discomfort are generally managed with medication.
• Patients are usually advised to follow a liquid diet initially, gradually transitioning to solid foods.
• Recovery time varies but usually takes 1 to 2 weeks for return to normal activities.
• Follow-up appointments with the surgeon to monitor the progress and ensure proper healing.

Alternatives

• Non-surgical adjustments of the gastric band
• Removal of the gastric band and consideration of alternative weight-loss surgeries like sleeve gastrectomy or gastric bypass
• Medication-based weight management or lifestyle modifications
• Each alternative comes with its own set of risks, benefits, and effectiveness that need to be discussed with a healthcare provider.

Patient Experience

During the procedure:

• The patient will be under general anesthesia and should not feel pain or discomfort.

After the procedure:

• Some pain and discomfort are common at the incision sites.
• Patients may experience swelling, bruising, and some abdominal pain.
• Pain management will be provided with medications.
• Instructions on wound care, dietary restrictions, and activity levels will be given to ensure a smooth recovery.