Bandsters:

I read this from a doctor's instructions on a Pre-Op Diet on the internet. Specifically, regarding the liver. What scares me about what it says is how fragile the liver is and how it can easily bleed. If that wasn't enough...during surgery...its "held by surgical instruments" (read below). I'm not sure about you....but the thought of my liver being held by surgical instruments....is kind of scary !

"The liver can become enlarged and contains abnormally large deposits of fat when a person is very obese. Due to its location in the body, it is in the way of the surgical area, and can cause problems for laparoscopic placement of the Lap-Band. This enlarged liver must be held out of the way by surgical instruments. An enlarged liver is more fragile than normal and will bleed easily when touched or manipulated.

When the liver bleeds, it can be difficult to control and increases surgical risk. Extra care is required when the liver is enlarged, which can increase the time a patient spends under anesthesia, and prolong recovery. For the safety of the patient, if the liver is considered too large or fragile, [doctor's name removed] may need to postpone or cancel the surgery until it is determined there is a reduced risk to proceed with the operation."

How come the average bandster doesn't know this about how fragile the liver and how it bleeds very easily (and during surgery) it is held by surgical instruments. I'm getting a little antsy as my surgery is 2 months away !

Thoughts/Opinions?

That is the reason that you are required to do the preop diet. It helps to shrink the liver and makes it less fragile and easier to move out of the way.

Here is a good video that I found on YouTube...that actually highlights the liver while doing the surgery. It litterally covers the stomach.

http://www.youtube.com/watch?v=t-K7ZdFW4sc

I knew that. My liver has been man-handled before, and I'm just fine

I knew that. My liver has been man-handled before, and I'm just fine

I actually felt better after the video..... seems like liver is out of place the entire time after surgery.

You must follow the diet before to reduce that fatty liver- at worse they have to stop or cut you open, but that is very very rare. water water water to flush it all out and clean that liver... Everthing has risks, but what is your outcome if you dont have the surgey.. I am glad i had it done. its a 45 min operation at best, so they know what they are doing/

They have to tell you all the risk and yes it is scarey... you will be asleep when they are moving it, not sure you would be asleep when you have a stroke or a heart attack, or when you do that insulin shot..... everyone is concerned but you need to trust your Dr.

My Doctor and everyone else at the Center spoke at great lengths about the liver and how working around it can be very difficult and that shrinking the liver as much as possible prior to surgery would make the risk more minimal and his job easier. They explain that liquid diet is not meant to be punishment. It is meant to help ensure a safe surgery.

Yep...they told me about it too...that's why it was so important not to cheat on the Pre-op diet.

I was fully aware of this before my surgery and the reason for the pre-op diets to shrink it.

You asked why the "average bandster" wasn't aware of this- I think they are. If nothing else, this is a perfect example of why we are responsible for educating ourselves on the procedure and effects of it before ever going into the operating room.

Keep mind I a squemish person. Anytime a surgery is shown on House or Greys Anatomy I change the station. I watched multiple Lap Band surgeries on You Tube. There is NOOO blood. They do the cutting with a cauterizing tool. I was watching and they flipped this organ out of the way with this spatula type thing. Just flipped it right out of the way!!! I said "Self what was that?" It was the LIVER. Watching the surgery really made me feel so much better about having surgery.

My doctor's release said if they found a tumor I gave them permission to have it tested and if it turned out to be malign to remove it!

It s called a liver retractor. I too watched the actual surgery on YouTube and I was glad I did. There was so much talk about the liver that I told my husband to ask the surgeon how my liver looked- was it fatty, etc. He actually took a picture of it for me and one of the Lap Band in place and it looked just like I thought it would. I think the others are right in that the pre-op diet is there to increase the safety of the surgery. Yes, it was hard to stay on it, but I did because what could be any more of motivator than decreasing your risk of surgery?

All I remembered from initial visit presentation was they said over and over "YOU COULD DIE" . So they were very informative of the risks with lapband surgery, as with any surgery.

My knee surgery was also risky, removing my ovary, appendix, tonsils, and lead in my hand were risky. Even having my babies was risky. Could have died or had complications with any of those procedures. I'm on the highway 2 hours a day 5 days a week going to and from work, that's pretty darn risky! Heck, living is risky! Living overweight is more risky!

But they help to reduce the risk of an enlarged liver with the pre-op diet to shrink it. My surgeon said he has stopped the procedure on sevaeral patients before because of enlarged livers.

I didn't watch the video, but generally they use retractors to keep organs out of the way so they can visualize the needed organs/area of concern. Imagine a retractor as an extra hand for the surgeon. It cups the organ, doesn't pinch or squeeze the tissue. The liver is highly vascular. That is why they want it out of the way so it is not accidentally nicked during surgery.

My doctor was very clear about the risk of the surgery and that the liver is in the way. If your doctor didn't tell you about the risks you need to ask them some more questions. Like many others have said, the whole reason for the preop diet is to shrink the liver.