Overview
Silastic Gastric Ring in Gastroplasty
In vertical banded gastroplasty, through the use of gastric staples, the stomach is divided into two sections - an upper (proximal) stomach pouch and a lower (distal) stomach section. A small gap (stoma) in the staple-line is left to allow digested food in the pouch to pass through into the distal stomach. Because the upper stomach pouch is so small (egg-size, compared to melon-size before the operation), the patient feels full very quickly and therefore calorie-intake is drastically reduced. However, because the muscular stomach wall has a tendency to stretch, the stoma can widen thus permitting greater food and calorie intake. To reduce this possibility, weight loss surgeons place a silastic ring as a sort of "collar" around the stoma, to prevent stretching and enlarging of the passage into the lower (distal) stomach.
Listing of complications following gastric bypass
Early:
- Leak
- Acute gastric dilatation
- Roux-Y obstruction
- Atelectasis
- Wound Infection/seroma
Late:
- Stomal Stenosis
- Anemia
- Vitamin B12 deficiency
- Calcium deficiency/osteoporosis
Silastic Ring Gastric Bypass:
Vertical Gastroplasty/Gastric Bypass The use of rings to control the stoma size, proven with Vertical Banded Gastroplasty, has led to their adoption by some surgeons as an addition to gastric bypass procedures, again to control the stoma size and prevent late stretching of the opening and, hopefully, improve the long term weight maintenance results. Both silastic ring and Marlex bands have been used. Usually the recommendation is for the ring circumference to be considerably larger than that use in primary obesity procedures, so that the limiting the effect only comes into play after some degree of stretching of the pouch has occured.
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