The adjustable gastric banding procedure uses the restrictive element of weight loss surgery. It involves placing an inflatable silicone band around the upper part of the stomach. The gastric band is inflated, which causes the upper stomach pouch to become smaller and restricts the amount of food that the stomach can hold at one time. The stomach is also narrower, so it takes more time for the stomach to empty. That means a person eats less food in one sitting and feels fuller longer, resulting in weight loss. The LAP-BAND became available in the U.S. in June 2001.
Advantages of Adjustable Gastric Banding
Disadvantages of Adjustable Gastric Banding
How Does Adjustable Gastric Banding Treat Obesity?
The adjustable gastric band is placed around the stomach pouch via a laparoscopic, or noninvasive, surgical procedure. First, the surgeon makes small, one- to two-inch incisions on the patient's outer abdominal cavity. Ports are placed into the incisions, and the surgeon is then able to use special laparoscopic instruments through the ports to perform the procedure. A small video camera is placed into your abdominal cavity via the ports, which enables the surgeon to view the cavity on a video monitor.
Once the camera is in place, the surgeon inserts the gastric band and slides it around the upper portion of the stomach. The adjustable band is tightened, much like a wristwatch, to create a new, smaller stomach pouch. As a result, patients experience fullness sooner during a meal and are satisfied with smaller amounts of food.
Adjustable gastric banding does not require a surgical incision, other than the very small incisions on the stomach, and it does not involve any stapling or stomach rerouting, which are used in other forms of bariatric surgery. Therefore, gastric banding is considered the least traumatic of all weight loss surgeries. By avoiding a large incision required with an “open” surgery, patients generally experience less pain and scarring. The mortality risk with gastric banding is also significantly lower than with other obesity surgical procedures. The risk of nutritional deficiencies is also reduced.
Patients typically spend less than 24 hours in the hospital, including overnight hospitalization, and can usually resume normal activities within one week, which is a much quicker recovery time than with other weight loss surgeries.
Adjustable Treatment
The LAP-BAND® or Realize Band is an adjustable silicone band with an inflatable inner surface. It is connected to an access port below the skin surface by a thin, kink-resistant silicone tube. The port enables the surgeon to adjust the size of the gastric band to meet individual weight loss goals by adding or removing saline to inflate or deflate the band. The more inflated the band, the smaller the stomach pouch, which impacts the amount and rate at which the patient can consume food. The surgeon determines the need for an adjustment based on the patient's weight loss, amount of food that can be comfortably eaten, exercise regimen and other issues concerning the patient's health, as well as the amount of fluid already in the band. Adjustments are performed during simple outpatient visits.
Reversible Procedure
No permanent changes are made to the patient's body during the gastric banding procedure, so it can be essentially reversed. If necessary, all of the components of the banding process can be removed from the body without causing any damage to the digestive organs. The stomach will generally return to its original form and capacity once the band is removed.
Expected Weight Loss
The amount of weight a person can expect to lose after adjustable gastric banding depends on several factors. There is no guaranteed amount of weight loss, but the average weight loss in recent clinical studies is approximately 45 to 55 percent of the patient's excess weight within two to three years of the surgery.
The effectiveness of the gastric band depends on the success of the surgical procedure and the ability of the patient to change his or her diet and level of physical activity.
The team at the Bariatric Center has committed to providing long-term care for patients. After surgery, gastric band patients must maintain scheduled follow-up visits. Patients may be required to have four or more visits during the first year following the surgery, which include reviewing the patient's progress and discussing any concerns or problems that may arise.
Following gastric banding, patients are encouraged to eat balanced diets and avoid problematic eating patterns that may have been typical in their pre-surgery lifestyles, such as social or emotional eating. The restrictive effect of the band produces feelings of satiety sooner and longer lasting fullness. This reinforces the patient's ability to be satisfied with smaller meals when solid food is eaten and well-chewed.
At the appropriate time, patients are also encouraged to increase their physical activity level, which is very important to weight loss, good health and improved quality of life.
Risks and Complications
Risks and complications, including death, are associated with all major surgical procedures. Although the laparoscopic technique used to place the gastric band around the stomach is considered minimally invasive and is associated with reduced complications during the operation, it is still a surgical procedure. Severe obesity increases the risks of some complications.
Risks and complications associated with the adjustable gastric band system can arise at anytime, from immediately after the surgery to years later. Complications include migration of the gastric band system, infection or leakage of the band or reservoir. Some patients may experience more nausea and vomiting than others. Rapid weight loss may also cause complications. There is also the risk that you may not lose weight or could even gain weight. In certain instances, the gastric band may need to be removed or replaced.
It is extremely important that you discuss the possible benefits and all the potential risks and complications of weight loss surgery with your surgeon.
