This written information is a supplement to the oral information, essential and adapted to each individual patient who is requested to ask any question he might wish. This information is evaluated by means of a questionnaire including the satisfaction of the patients. Patients’ remarks were taken into account in the evaluation of these documents over a period of 17 years in the personal practise of Doctor Claret of the gastroplasty

Its advantages.

The possible insertion by laparoscopy; therefore by mini invasive surgery, with consequences, especially simpler respiratory consequences,

The possible adjustment in a post-operatory situation by a simple x-ray puncture, with the calibre of the ring thus adapting itself to the possibility of slimming and to feeding comfort of each patient.

The possibility in case of necessity, of removing the ring by laparoscopy, but it must be noted that the stomach rapidly takes back its usual volume and that the patient gains weight again.

Its drawbacks.

We refer to a relatively recent technique, the first American ring was inserted by laparoscopy, 10 years ago on September one 1993 (Belachew, Belgium, but in opening the belly, adjustable rings have already been in use for 17 years in the USA and Sweden.

On the whole the ring is well tolerated by the patient and to our knowledge at present it can be kept for life.
In fact, in case of the definitive ablation of the ring the patient gains back his weight, except if he manages to maintain strict dietary habits in a durable way.

Its risks.

In the near future, these are risks, which occur, in a peri- operative period with an obese patient (general complications of the phlebitis type, pulmonary embolism, etc...).

These are also the risks of the surgical procedure itself: risks linked to the instruments next to the stomach

 

 

 

(perforation) risk of bleeding, of infection near the reservoir- tank or the gastric banding.

The risk of death was estimated a few years ago at 1/1000, but numerous recent series have provided data concerning several hundred patients with a zero mortality rate..

In a post–operatory situation there can be a problem related to the tank-reservoir, which disappears in the following weeks but which might require its displacement at a later date, if it should persist. One must also watch over the overall functioning of the device (leaks, ruptures of the tubing, the reversal of the reservoir tank, which would require a new intervention).

There is also a risk of the dilatation of the gastric pocket and of the sliding of the ring around the stomach, which might require another surgical intervention by laparoscopy or opening (this risk seems to be diminishing presently thanks to the new way of placing the gastric banding).

This rare risk was described: the erosion of the stomach by the gastric banding, requiring the ablation of the gastric banding.

In the medium term, about two years after the intervention, because of the massive loss of weight, plastic surgery chiefly related to the belly, to the breast, to the thighs or to the arms is often envisaged.

Finally one must insist on the necessity of long term follow-up by a medical surgical team. A perfect collaboration is also necessary with the patient who must understand that in case of a slowing down of the slimming, “or a gain of weight,” it is not enough to simply tighten the ring again. Then, one must consult in order to find the causes (mechanic, nutritional, psychological etc).