Let us know of two convenient dates for the procedure, these
can be in the same week, one will be confirmed according
to availability, keep in mind that is a 4 day protocol.
Depending on your daily activities, you may be incorporated
by day 5 with some restrictions. Planning your surgery 2
weeks in advanced, is recommended.
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It is very important to Know relevant data of our patients
as soon as possible, please read the preliminary clinical
history carefully, answer it so we can be familiar with
your specific case, e mail reply is preferred, but you may
fax it to the phone number: 011 (52 664) 634 7672,
this document will be completed after a physical examination.
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When you know your diagnosis and find yourself eligible
for gastric band placement, it is time to start making changes,
don’t wait until the gastric band is in place to try
new food habits, for example, you may start with kicking
pizza, chocolates, ice cream, milkshakes, and other soft
and liquid calories out of your diet.
5 days prior to surgery, a “yogurt diet” is
indicated, these changes will make the adaptation to new
food habits easier and will improve the technical feasibility
of the gastric band placement.
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Smoking interferes with the blood coagulation process, Lung
capatity is also impared and bronquial hipersensitivity
is more likely to occur. No smoking two
weeks prior your surgery is mandatory.
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Pulmonary and respiratory physiology shifts from normal
in the obese patient, who is characterized by shallow respiratory
movements and CO2 retention. Respiratory exercise is suggested
during the week prior to surgery in order to improve the
patients pulmonary condition,
The Volumetric Incentive Spirometer is available online
at:
The
Volumetric Incentive Spirometer is available online at:
And instructions for its use at
How
to use an incentive spirometer
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Bring a valid ID such as your driver license or birth certificate
along with your valid international passport.
Adult companion is strongly suggested.
If you are flying, arrive to the San Diego Lindbergh International
airport, make arrangements so you can arrive around 10:30
AM. Let us know the airline you are flying, the flight number
and the time of arrival.
If you are driving, please ask for detailed directions.
Laboratory examination requires 6 hour fast and will be
performed around noon.
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Travel as light as possible, the surgery protocol is only
4 days and the patient will spend 2 of these in hospital
clothes.
Do not bring jewelry or highly valued belongings.
Do not bring travel bags to hang on shoulders, use wheeled
luggage.
Bring comfortable clothes, jeans, boots, belts are not recommended.
Check weather information in advanced www.wheather.com
Bring your personal hygiene products.
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Our transportation service will be waiting for your party.
Be sure to reply your complete flight itinerary, including
airline, flight number, terminal and arrival hour. Our hostess
will be waiting for you in the baggage claim area carrying
a board with our logo and your name.
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If you have arranged your transportation, you can either
park your vehicle in the USA or drive to our offices, let
us know your choice, so we can provide detailed directions.
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We believe that, when a person chooses the adjustable gastric
band system for weight control, as well as performing any
other surgery, has the right to know about complications
and their treatment, regardless of how low the incidence
is. Some of these complications are considered “universal”
because are not related to the adjustable gastric band system
and may occur in any surgery.
The most feared complications commonly
occur because of the patient’s lack of information
and wrongfull follow up, including extreme band adjustments,
that is why we insist in post operative comunication.
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Conversion is the shift from laparoscopic band placement
to traditional “open surgery”.
This shift was not uncommon the first years of the procedure,
the causes were “technical difficulties” related
to lack of adequate medical instruments, excessive obesity
and since it was a new procedure, lack of skills.
Now a days conversion is extremely rare, since longer instruments
are available and obesity surgeons are very skilled. Patients
with a BMI of 55 or more are more likely to be converted
(1% or less).
A conversion is not consider a complication of the procedure.
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Is the collection of lymph around in the dissected fatty
tissue, not rare in thick abdominal walls, regardless the
surgical procedure (C-section, Appendectomy, etc), most
of them heal spontaneously with medical recommendations,
if not, the lymph collection can be aspirated. In the worse
case, the adjustable port is temporary sealed and removed,
leaving the band with a standard adjustment and once healed
is placed again to take advantage of the bands adjustability.
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Minimal incidence, since the procedure is performed with
every precaution, and when the patient is discharged an
antibiotic is prescribed, but if infection is identified,
thanks to the size of the incisions, the only countermeasure
is to continue with the antibiotic for one more week and
continue with wound cleansing. When infection hapens in
the port incission, removal of the Titanium chamber may
be necessary, a new chamber may be implanted in the following
months..
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The the band does not slips, it is the stomach that slips
towards the band, you can compare this to a “hernia
effect”, this complication never arises by itself,
there is always an increase in the stomach pressure secondary
to patient improper behavior. The patient experiences obstruction
and the real herniation of the stomach needs surgical correction.
Slippage is term also used for Aesophageal dilation, this
complication occurs, again when the patient is not following
rules and eating more than what is suggested, the patient
experience a loss of the “fullness” sensation.
The initial treatment is to “unfill” the band
and wait for the aesophagus to heal.
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Diseases such as acid reflux disease, severe gastritis,
esophagus and gallblader disease along with its acute symptoms
are often misdiagnosed as rejection and are conditions that
require prompt identification and treatment.
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Maybe the most common complications, esophagitis is the
inflamation of the esophagus tissue. The patient experiences
symptoms such as reflux, chest pain, shoulder and occasionaly
periods of shortness of breath. The first approach to this
condition is to reinforce food habits to the patinet and
use antiacid medication, if the condition persists it is
advisable to deflate the system until healing occurs.
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In rare cases, the band may erode the stomach tissue this
is a slow process and occurs months after the placement.
The patient may or may not experience pain, may either experience
painfull eating or no “fulness” sensation.
The diagnosis is confirmed by endoscopy and the treatment
of choice is the band removal.
In most cases, this complication can be prevented. The displacement
of the band across the gastric wall is due:
Either to the system being overfilled (wrongful adjustment)
Premature band adjustment.
Or patient breaking post – operative suggested food
habits
Or infection in any part of the system
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Obesity treatment, either if its surgical or clinical, has
to be followed for a period of 3 years. Patients need to
know how to eat and will be provided with information for
his/her new lifestile on weekly basis until week number
8, after that the person with adjustable gastric band should
eat 1000 calories a day the first year and 1200 calories
a day the second year. Menus and diets will be provided
as well. For best results, the patient must be in contact
with obesity choices at least:
Every 15 days for the first 3 months
Every month for the next 6 months and
Every 3 months for the next 3 years.
Always inform your surgoen and nutritionis if new symptoms
have occur.
But feel free to contact us
at any time if you need it.
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