This section will attempt to answer some of the commonly asked questions in relation to patients who have undergone laparoscopic gastric banding or sleeve gastrectomy

1. Is vomiting likely to occur?

There should be no vomiting after either laparoscopic gastric banding or sleeve gastrectomy. If persisting vomiting occurs, it needs to be investigated. It may be simply related to a lapband that is too tight or the patient is eating too fast or due to too large a meal.

However, more serious problems also need to be ruled out, such as lapband complications (gastric prolapse, erosion), or a stricture problem following sleeve gastrectomy. The important thing is that if vomiting occurs, it should be reported to your obesity surgeon so that it can be assessed and dealt with as required.

2. Will I become constipated?

Constipation is likely to occur, considering the reduced amount of food ingested, including less fibre. Laxatives can be used if required, but in the long term it would be better to consider regular use of a bulk forming laxative, such as Metamucil. Most patient do not seem to experience significant problems.

3. Do I need vitamins?

After either the lapband or sleeve gastrectomy surgery, it is advisable to add a multivitamin supplement, including iron and folate, to your diet. While losing significant weight, you will need to ensure that you do not become vitamin deficient.

Normally this is unlikely to happen as the only difference after surgery is the reduced amount of food you can eat (both operations are “restrictive”), while its quality should be unaffected.

4. What about other tablets?

There usually is no problem for post operative patients to continue to take their usual prescribed medications. For those patients who undergo a sleeve gastrectomy procedure, this is even less of a problem, particularly if anti-inflammatory therapy is needed.

5. How much food can I eat when I dine out?

Due to the reduced stomach capacity after both the lapband and sleeve gastrectomy procedures, you will only be able to eat an entrée size meal. The food should be eaten slowly and chewed well. Stop if you feel full, even if you have only eaten what you might think was a less than standard meal, as the food preparation may affect its consistency.

6. What about the hunger sensation?

Both the lapband and sleeve gastrectomy produce reduced hunger, after surgery. The lapband position excludes an area of the stomach which produces a substance called Ghrelin, which stimulates appetite. In this way, it is thought that it reduces the hunger sensation. The sleeve gastrectomy actually removes this area of the stomach, as part of the operation, thus having the same effect.

7. Which is the better operation?

Both the lapband and the sleeve gastrectomy procedures are good obesity operations. They can both be performed laparoscopically and they are both restrictive, but their similarities end there. The lapband is the least invasive of obesity procedures, being adjustable and reversible, but it needs a degree of maintenance and there are some problems associated with it.

The sleeve gastrectomy is more of a “set and forget” type of operation, but it is irreversible. The gastrectomy would probably appeal more to those patients who live in more remote areas of the country, who find regular trips to the specialist a problem.
However, patients can only make an informed decision as to which operation most suites their needs, after discussing the topic with a qualified surgeon.