Laparoscopic band placement
for
treatment of morbid obesity
video lapband video gastricbypass
A frequently used standard to measure overweight is the Quetelet Index or the Body Mass Index. This is the weight in kilograms divided by the length in meters (kg/mē).
| QI or BMI | Standard |
| 20 - 25 | normal |
| 25 - 30 | overweight |
| 30 - 40 | obesity |
| 40 - higher | morbid obesity |
In case of a BMI of 40 or higher there is an absolute indication for bariatric surgery ( surgery that concerns the obese). If the BMI is between 35 and 40 there is also an indication if concomitant problems occur like diabetes, high bloodpressure etc. that require treatment by a specialist.
One has to be aware that every operation has complication risks, like bleeding, infection, pneumonia, thrombosis, pulmonary embolism and more special for the lapband a perforation of the stomach, slippage of the band, infection of the port-a-cath, torsion of the port-a-cath so adjustments cannot be done etc. Severe complications can lead to intensive care unit treatment. The mortality risk of the procedure is about 0.01percent.
The drawing shows the place of the working channels (incisions of 0,5-1,5cm) and the pictures show an overview of the real thing and the operating team.
At the upper part of the stomach the position of the band is chosen. The drawing shows the future size of the stomach: the balloon. An opening is made at the right part of the stomach.
Also an opening at the left side is made.
Then a bigger opening is made a little bit more right to the stomach and then a passage is made behind the esophagus from right to left.
The passage has been made.
The band is pulled behind the stomach from left to right and then closed. Suturing of the stomach over the band takes place in order to prevent slippage of the stomach through the band.
The situation immediately after the operation shows the little scars. Showering is permitted. Special dietinstructions are given.
An x-ray three months after the operation. The band can be clearly seen.
Good instructions after the operation are essential. To ensure this there is a close cooperation with the bariatric centre Ra-medical in Beverwijk. See for further information www.maagband.nl
Other bariatric surgical procedures are also available as for instance the gastric bypass. This is a succesfull operation but in carries a higher complication rate during and immediately after the operation. An example can be seen in the (shortened) video of dr B Dillemans, Bruges, Belgium.