Obesity has been declared by the united nations as a global phenomenon at the origin of 2.8 million deaths per year.
To combat this problem, there are various methods of dietary, medical, but also surgical, among which we cite the installation of gastric band.
It is a surgical procedure at the level of the stomach, which is in the a ring is modular and thus reduce the capacity of the stomach.
In fact, the gastric band will allow us to divide by four the capacity of the stomach, which may only contain what is the equivalent of a litre.
This is a technique called restrictive pure, but adjustable, in fact, thanks to this technique, the amount of food ingested will be reduced and the patient will feel satiety quickly.
The fitting of a gastric band may be indicated in several cases :
- Obesity massive with a body mass index BMI ≥40 kg/m2
- Severe obesity with a BMI ≥35 kg/m2 is associated with a complication which can be relieved by surgery (diabetes, high blood pressure, sleep apnea…..)
- Failure of attempted weight loss through diets and medication.
Before the procedure of placement of a gastric band
It is vital to properly prepare the patient prior to the intervention, the choice of the realization or not of a gastroplasty, and proper technique are elements that will be extensively studied in consultation between the patient and a team of multidisciplinary.
Once the fitting of a gastric band is validated, the surgeon will prescribe you a preoperative including blood work, endoscopy, œsogastroduodénale (this is a technique that allows to study the walls of the digestive tract) as well as an assessment of respiratory and cardiac function.
A visit to the doctor anaesthetist will be set to choose the type of anesthesia as well as the molecule adequate.
To avoid thromboembolic events it will be recommended that patients not to take certain drugs (aspirin) in the 10 days preceding the intervention, as well as the pill a month before the intervention.
The tobacco is likely to delay the healing process, so it will be recommended to stop smoking at least two weeks before and after the intervention.
The procedure of placing the gastric band
Anesthesia
The intervention of poses gastric banding surgery takes place under general anesthesia.
The patient must be fasting on the day of the operation.
The procedure requires a hospital stay of 2 to 3 days.
The operative time
The principle of the fitting of a gastric band, is to lay a ring of diameter editable around the upper part of the abdomen to delineate a small pocket.
Thanks to this technique restrictive, as the volume of the stomach decreases, the feeling of satiety appears quickly and the food is flowing very slowly following the dynamic of an hourglass.
This technique does not disturb the digestion of food.
The time of the operation is one-hour average.
The operation is performed most often by laparoscopy, it is a technique that allows us to ask the ring without opening the abdomen it limit the sequelae of postoperative and allows a better social reintegration.
The gastric band is to be connected to a box, placed under the skin, which allows you to control the diameter of the ring by tightening or loosening.
After the procedure of placing the gastric band
Postoperative course
Following the placement of a gastric band, it is to be expected pain weak as a general rule, the surgeon will prescribe a painkiller to be adequate.
Possible Complications
Some complications can occur following the placement of a gastric band they may appear a few days, a few months or a few years after the laying of the ring.
These complications are usually mechanical :
- Complications related to the case : displacement, infection, the tube that connects the case to the ring may break, the patient feels pain at the location of the box.
- Slip the ring leading to vomiting or even an impossibility to feed.
- Complications at the level of the esophagus (reflux esophagitis…)
- Lesions of the stomach due to a migration of the ring
In some cases, it is necessary to remove the ring.
However, in Tunisia, the fitting of a gastric band is carried out only after the validation of all parameters ensuring the success of the intervention and the stability of the results, this operation is carried out in institutions with well fitted by qualified surgeons.
Recommendations
After insertion of a gastric band in a work stoppage of two weeks is necessary.
It is imperative to follow the dietary advice.
In a first step, the patient’s diet should be liquid, then it switches to a power semi-liquid (mashed) to gradually regain a solid feed and avoid, and vomiting, and pain.
The patient will have to follow new eating habits
- To ingest them slowly in small quantities
- Take the sit-down meal
- Stop eating as soon as a feeling of satiety
- Avoid nutritional deficiencies and, therefore, vary its power
- Avoid soft drinks
Follow-up postoperative
Following an installation of gastric band, it is necessary to comply with the instructions of the surgeon and introduce himself to the visits of convalescence which allow to evaluate the outcome of the intervention.
The first consultation will take place the day after the procedure.
After leaving the clinic, a nurse will be mandated to ensure the further care if necessary, to the hotel.
The surgeon will listen even after the start, and may ask the patient if he wishes to a colleague who represents it.
Result
The weight loss is rapid, especially in the first months, and then it slows down gradually.
The weight stability is reached after 12 to 18 months postoperatively.
The conditions that accompany obesity, such as diabetes, regress.
The gastroplasty gastric ring allows for a loss of 40% to 60% of the excess of 2 to 4 pounds per month.
Rate
The price of a placement of a gastric band in Tunisia is, on average, of the order of 2950 €
Intervention Price Stay Gastric band 3500 € 4/ 3
