In Weigh Over my Head: Surgery update

Friday, February 10, 2012

Surgery update - copied from FB

Well, I talked to the Dr. today and we made a final decision. I am going the more conservative route. I will have surgery in a few weeks to fold over that growth on top of my sleeve. The dr. thinks that will help with my restriction and get me to the promise land. :) I will move on to other things later if I have to. I just feel like this surgery is my answer and I need to see it all the way through. The Dr. agreed and I am so glad he listened to me. I have 70 pounds to go to reach my goal. I hope this will help me get there. I am also upping my personal training to 3 days per week. I work out 5 days per week but only 2 of those days are with my trainer so I hope adding that extra day will really help my body to become stronger. I already feel the difference from before I started at the gym and the extra day can only help. This surgery is stil the best thing that I have EVER done for myself and I feel good about sticking with it. Even the freak things I have had happen are worth what I have in return. :) Thanks for your support.

7 comments:

tz said...: congratulations, that's great news! and good luck!; February 10, 2012 at 3:21 PM
Lori said...: Good luck. I hope this works for you this time. You've been through enough.
Lori; February 10, 2012 at 4:05 PM
Amelia said...: I am glad you and your doctor agreed and have come to a decision. Keep your chin up. You WILL reach your goal.; February 10, 2012 at 4:28 PM
Amanda said...: I always tend to favor the conservative approach myself. Sounds good!; February 10, 2012 at 5:41 PM
Lyn said...: I just want to say I am so super proud of all you have done and how you have changed your life. You have been willing to do that hard stuff, and plow through and be strong even when people have not always been supportive. I really admire you Lisa. I've been following you for a long time and you have come SO far. I wish you only the best with your next steps. Thank you for inspiring ME!; February 11, 2012 at 9:56 AM
Sarah said...: I love seeing that you are upping the personal training!

Sarah
notaneffingdiet.blogspot.com; February 12, 2012 at 9:13 PM
Kelly said...: I'm still rooting for you, Lisa. Hope the extra training really helps you.; February 14, 2012 at 1:19 PM

My Weight Loss Surgery - NOT THE BAND OR BYPASS!

Vertical Sleeve Gastrectomy (VSG) - Also known as Sleeve Gastrectomy, Vertical Gastrectomy

The Vertical Sleeve Gastrectomy procedure (also called Sleeve Gastrectomy, Vertical Gastrectomy, Greater Curvature Gastrectomy, Parietal Gastrectomy, Gastric Reduction, Logitudinal Gastrectomy and even Vertical Gastroplasty) is performed by approximately 20 surgeons worldwide. This forum is titled “VSG forum” to include the two most common terms for the procedure (vertical and sleeve). The earliest forms of this procedure were conceived of by Dr. Jamieson in Australia (Long Vertical Gastroplasty, Obesity Surgery 1993)- and by Dr. Johnston in England in 1996 (Magenstrasse and Mill operation- Obesity Surgery 2003). Dr Gagner in New York, refined the operation to include gastrectomy(removal of stomach) and offered it to high risk patients in 2001. Several surgeons worldwide have adopted the procedure and have offered it to low BMI and low risk patients as an alternative to laparoscopic banding of the stomach.

It generates weight loss by restricting the amount of food (and therefore calories) that can be eaten by removing 85% or more of the stomach without bypassing the intestines or causing any gastrointestinal malabsorption. It is a purely restrictive operation. It is currently indicated as an alternative to the Lap-Band® procedure for low weight individuals and as a safe option for higher weight individuals.

Anatomy

This procedure generates weight loss solely through gastric restriction (reduced stomach volume). The stomach is restricted by stapling and dividing it vertically and removing more than 85% of it. This part of the procedure is not reversible. The stomach that remains is shaped like a very slim banana and measures from 1-5 ounces (30-150cc), depending on the surgeon performing the procedure. The nerves to the stomach and the outlet valve (pylorus) remain intact with the idea of preserving the functions of the stomach while drastically reducing the volume. By comparison, in a Roux-en-Y gastric bypass, the stomach is divided, not removed, and the pylorus is excluded. The Roux-en-Y gastric bypass stomach can be reconnected (reversed) if necessary. Note that there is no intestinal bypass with this procedure, only stomach reduction. The lack of an intestinal bypass avoids potentially costly, long term complications such as marginal ulcers, vitamin deficiencies and intestinal obstructions.

Comparison to prior Gastroplasties (stomach stapling of the 70-80s)

The Vertical Gastrectomy is a significant improvement over prior gastroplasty procedures for a number of reasons:

1) Rather than creating a pouch with silastic rings or polypropylene mesh, the VG actually resects or removes the majority of the stomach. The portion of the stomach which is removed is responsible for secreting Ghrelin, which is a hormone that is responsible for appetite and hunger. By removing this portion of the stomach rather than leaving it in-place, the level of Ghrelin is reduced to near zero, actually causing loss of or a reduction in appetite (Obesity Surgery, 15, 1024-1029, 2005). Currently, it is not known if Ghrelin levels increase again after one to two years. Patients do report that some hunger and cravings do slowly return. An excellent study by Dr. Himpens in Belgium(Obesity Surgery 2006) demonstrated that the cravings in a VSG patient 3 years after surgery are much less than in LapBand patients and this probably accounts for the superior weight loss.

2) The removed section of the stomach is actually the portion that “stretches” the most. The long vertical tube shaped stomach that remains is the portion least likely to expand over time and it creates significant resistance to volumes of food. Remember, resistance is greatest the smaller the diameter and the longer the channel. Not only is appetite reduced, but very small amounts of food generate early and lasting satiety(fullness).

3) Finally, by not having silastic rings or mesh wrapped around the stomach, the problems which are associated with these items are eliminated (infection, obstruction, erosion, and the need for synthetic materials). An additional discussion based on choice of procedures is below.

Alternative to a Roux-en-Y Gastric Bypass

The Vertical Gastrectomy is a reasonable alternative to a Roux en Y Gastric Bypass for a number of reasons

Because there is no intestinal bypass, the risk of malabsorptive complications such as vitamin deficiency and protein deficiency is minimal.

There is no risk of marginal ulcer which occurs in over 2% of Roux en Y Gastric Bypass patients.

The pylorus is preserved so dumping syndrome does not occur or is minimal.

There is no intestinal obstruction since there is no intestinal bypass.

It is relatively easy to modify to an alternative procedure should weight loss be inadequate or weight regain occur.

The limited two year and 6 year weight loss data available to date is superior to current Banding and comparable to Gastric Bypass weight loss data(see Lee, Jossart, Cirangle Surgical Endoscopy 2007).

Let's Shrink!

Friday, February 10, 2012

Surgery update - copied from FB

7 comments: