Essay: What is involved in a Gastric Banding Operation?

ABOUT:
Laparoscopic Gastric Banding or Lap Band surgery is a surgical procedure to help with a person’s weight loss. It is typically performed on patients who are severely obese and have not been able to lose weight through the correct diet or exercise and is recommended if you have a BMI (body mass index) of 35 or more (or a have a serious medical condition that could improve through the surgery and weight loss). This type of surgery uses a laparoscope (“thin, lighted tube put through a cut (incision) in the belly to look at the abdominal organs” – Web MD, 2017) to place an adjustable belt around the upper section of the persons stomach to help regulate their eating habits. The gastric band is made of silicone and can be adjusted by adding saline to the band to fill (tightening). The access port is placed under the skin and is connected to the band, this is then used to either add or remove saline from the gastric bad (tighten or loosen)
Gastric Banding limits the amount of food the stomach can hold by restricting the overall size of the stomach, therefore, the food passage to the intestine is slowed down. Through this slow passage of food, the gut signals to the brain a feeling of fullness and satisfaction with the consumption of less food (as it takes the food a lot longer to travel through the digestive system). It allows the person to east much less while still enjoying the foods they like and feeling stratified with the meal, by portion control and hunger control.
LAPAROSCOPIC GASTRIC BANDING PROCEDURE
Three small incisions are made into the abdomen to allow for specialised devices (i.e. Laparoscope) and surgical instruments to pass through. The camera, laparoscope, allows for the surgeon to monitor the process of the surgery through high-resolution video that is transmitted onto the screen. The silicone gastric band is then inserted through one of the three small incisions, it is then placed around the upper part of the stomach (Figure 1) and is secured into place with sutures (stitches), this creates a small pouch with a narrow opening. An injection port, which is connect via tubing, is attached to the lap band and is placed onto the “muscle layer of the abdominal wall” (Dr. Kuzinkovas, 2017). This band can either be filled or emptied through the access port (Figure 1), however, immediately after surgery the band is left unfilled until the patient has recovered, and can be adjusted four to six weeks after the initial procedure.
Part E: advantages and disadvantages of Gastric Banding operations
Talk about why people are fat https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3382055/ physiology
There are many advantages and disadvantages when it comes to the Gastric Banding Operation and having the Gastric Band in General. Some of which are mentioned below;
ADVANTAGES:
Along with successful weight loss, gastric banding can help with related weight comorbidities such as hypertension, diabetes and sleep apnoea. Generally, people that receive gastric banding lose around 35% to 45% of their excess weight and achieve long-term weight loss. If needs be, the surgery can also be reversed at any time add the stomach usually returns to its “normal” size afterwards. Unlike other gastric surgeries, gastric banding does not interfere with the person’s food absorption and makes complications such as vitamin deficiency uncommon, and is safer than many other forms of weight loss surgery. It also does not involve stapling the person’s stomach, bypassing part of their intestine or even removing parts of their stomach. AS this is a relatively quick surgery it does also meanin that they would only spend around one night in hospital and would have a rather speedy recovery time
DISADVANTAGES:
In some cases, it is found that the gastric band can erode through the stomach and would need to be removed, similarly the stomach can slip through the band due to reasons such as ignoring the rules of eating and signs of fullness are not followed, and the patient would require immediate surgery. As the pouch can only hold limited food, the patient could experience vomiting from eating more than the pouch can hold. Re-operation may be necessary if an infection develops within the port area (in the abdomen) and can also affect the band. Another problem that could occur is leakage, the gastric balloon is made of a very fragile material and if too much fluid is injected into the band, leakage could occur – this can also happen through the connecting tube. One of the main disadvantages that can occur from rapid weight loss from using the gastric band is excessive skin, this can become a problem as rashes or other skin condition could develop under the fold, and is typically aesthetically unpleasing to the patient. Although uncommon, the patient could also acquire nutrient deficiency as they are reducing the amount of food that they are consuming, resulting in an imbalanced diet and need for multivitamin supplements.
Although the gastric banding should help with the patients “feeling of fullness” it does not change their mind set towards food and what foods they consume, and they could start developing dysfunctional eating patterns (unbalanced diet). This could mean, as mentioned before, they develop nutritional deficiencies, and worst case scenario, the gastric band surgery could become futile and could see them return to their previous state of health or weight. Many people believe this will help them digest food a lot quicker, but the surgery does not alter the person’s metabolism it only restricts the capacity of the stomach. This means that patients are not experiencing a shift in their food preferences, “away from sugary or fatty foods”.Part F: Should the cost of gastric banding be covered by Medicare?
There has been a massive debate throughout the years over whether or not Gastric Band surgery should be covered by Medicare. Dr Leibman, avid stakeholder in the current debate, believes that the weight loss surgery should be covered under the national health system for people who fall under the obese and morbidly obese category. The current surgery costs just under $5,000 for the people that can afford it or who “are covered under private health care (Dr Leibman, 2006). It is believed, in the current state, that only hundreds of overweight patients have the surgery in Australia every year, but, if the surgery was available to all patients that are over a certain BMI* (body mass index) the number could increase to hundreds of thousands. Dr Leibman believes that the public perception of this surgery is to look “trim, taut and terrific”, however, the surgery would allow at-risk patients to receive life changing results in both their weight and their health.
Australia’s current population is around 24.13 million, with 53.6% being categorised as overweight and 18% of these people being considered obese. For a person to be considered overweight they need to have a BMI greater than or equal to 35, and for them to be considered obese they need to have a BMI greater or equal to 30, with 18.5 – 24.9 being considered a normal weight. According to the Australian Medical Association, in 2005, it cost the Australian Government $21 billion dollars to deal with obese and overweight adults in “direct health care and direct non-health care costs”. It costs another $35.6 billion in “government subsidies”, with the total amount rising to over $56 billion. Currently, for one person to receive lap band surgery it could cost them around $4,900. To find the total amount it would cost the government to perform lap band surgery on either obese or obese and overweight people, the population of Australia needs to be multiplied by the percentage of overweight people, and again multiplied by the total cost of lap band surgery per person.
Total cost for obese patients to receive Gastric Banding surgery
Total cost for obese and overweight patients to receive Gastric Banding surgery
The cost of surgery for obese and overweight patients outweighs the cost to only deal with only obese patients. It costs the government a total of $56 billion dollars to deal with the issue and $63,375,032,000 to give both obese and overweight patients Land band surgery, and although it would cost around seven more billion dollars to deal with initially there would be no need for other costs and the rate would significantly decrease. The initial cost would be very. However, if the government and Medicare was unable to spend this amount of money, it is cheaper for them to only operate on obese patients at $21,282,660,000 which is over $35 billion less for the initial year, and similarly the rate of obesity should decrease. Through the evidence shown above, Medicare should cover the cost of Gastric Banding surgery for only obese patients as it would not only save lives, but it would also save the government $35 billion in the first year alone.