Pre-Op
Before surgery, the patient is prepared, including the use of laxatives or enemas to empty the bowels. The patient must fast for 24 hours before the surgery to ensure the stomach contains no solid or half-digested matter, and powerful antacids are taken to reduce the possibility of stomach acids being released into the body cavity after the initial incisions have been made.
Operation
After the patient is placed under general anesthesia, two methods can be used: laparoscopy uses specifically designed instruments and a laparascope (a camera at the end of a tube) to penetrate the stomach cavity; laparotomy is standard open surgery where the abdomen is cut open to reveal the stomach. In both cases, a hole is cut through the stomach near the top, where the esophagus pours into it. The edges of this hole are stapled closed to create a pouch in the top of the stomach roughly the size of an egg or golf ball. This pouch passes into the lower stomach section by means of a narrow passageway created by tightening a silastic gastric band through the cut hole and around one side of the stomach. This passageway is called the stoma and ensures the upper pouch of the stomach drains slowly to generate a feeling of fullness while restricting the amount of food the patient consumes. The silastic band prevents the stoma from widening over time and supports the staples set into the hole. Once the silastic band is in place, water is poured down the esophagus. If there are any leaks around the stapled hole, the tissue is cauterized to seal it. With the surgery complete, non-dissolving sutures are placed along the seams of the initial incisions.
Post-Op
After the surgery, the patient typically spends three to four days in the hospital for observation. They are allowed to resume normal daily function after three to four weeks. During this time, the patient's diet is composed entirely of liquids and graduates to semi-solids and solid foods by the end of the fifth week. Sutures may be removed in a physician's office or by a nurse practitioner based on the patient's rate of recovery. The average is a month after surgery.
