Gastric Banding

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How Gastric Banding Works to Help You Lose Weight

During the gastric band procedure, the REALIZE Band or LAP Band (two different companies that make gastric bands in the US) is placed around the uppermost part of the stomach, dividing it into two parts: a small upper pouch and a lower stomach. When the band is properly adjusted the upper pouch can hold only about 4 ounces (1/2 cup) of food. As a result, you eat less food at one time, feel full sooner, and feel satisfied longer.  The inside of the band that fits against your stomach is lined with a soft balloon that is conected to a port that is implanted under the skin on the abdominal wall.   After surgery, saline (a safe fluid) is delivered into the balloon through the access port to control the degree of band tightness (control restriction). The degree of band tightness affects how much food you can eat during a meal and the length of time it takes for food to empty from the upper pouch to the stomach below (like a funel). When the band is adjusted to the proper tightness, you’ll feel full sooner and stay fuller longer thereby resulting in the consumption of smaller meals which will lead to weight loss.  No part of your stomach is stapled or removed during surgery, and your intestines are not rerouted, so you can continue to absorb nutrients from food in a normal manner.

insert band green zone chart.

Gastric Banding Benefits

Lower Risk of Surgery: Due to the lack of cutting and stapling intestinal organs the over all risk of surgery is less.  Like wise since no part of your stomach is stapled or removed during adjustable gastric banding surgery and your intestines are not rerouted, so you can continue to absorb nutrients from food.  However, other complications/risks not associated with other weigtloss procedures can occur and should be discussed fully with your surgeon prior to surgery (see risks below)

Improvement or resolution of many serious health problems: multiple studies have demonstrated the health benefits of significant weight loss.  With regards to gastric banding the following are improved or resolved:

  • Type 2 Diabetes Resolved  47 %
  • High Blood Pressure Resolved  43%
  • High Cholesterol Improved  75%
  • Obstructive Sleep Apnea Resolved  94%
  • Acid Reflux/GERD Resolved  32%  (can be worse if band is too tight)

Quality of life improvements: Clinical studies of laparoscopic bariatric surgery patients found that they felt better, spent more time doing recreational and physical activities, benefited from enhanced productivity and economic opportunities, and had more self-confidence than they did prior to surgery.

Significant Weight Loss After Surgery: gastric banding is shown to help patients achieve and maintain a healthier weight. Patients in a 3-year clinical trial lost a mean of 40% of their excess weight at 1 year and 43% at 3 years, were able to reduce their average body mass index (BMI) from 44 to 36 in the first year, and maintain their reduced BMI through their third year.  Average weight loss resulted in a BMI reduction of about 8.

Weight loss surgery cost savings over time: A recent study showed that bariatric surgery pays for itself in about 2 years.  One important reason is that weight loss surgery may help to improve or resolve conditions associated with obesity, such as type 2 diabetes and high cholesterol, so patients save money on related prescription drugs, doctor visits, and hospital visits.

Gastric Banding Procedure

During the surgery several small incisions (less than 1/2 inch) are created to gain access to the abdomen. Carbon dioxide (a gas that occurs naturally in the body) is introduced into the abdomen to create a work space for the surgeon. Then a small laparoscopic camera is placed through the incision into the abdomen.  The camera sends a picture of the stomach and abdominal cavity to a video monitor. It gives the surgeon a good view of the key structures in the abdominal cavity. A few additional, small incisions are made in the abdomen. The surgeon watches the video monitor and works through these small incisions using instruments with long handles to complete the procedure. The surgeon creates a small, circular tunnel behind the stomach, inserts the gastric band through the tunnel, and locks the band around the stomach.   The tubing from the band is then attached to the port that is then implanted under the skin on the abdominal wall.

Most of these operations are performed with several small incisions, however, we can also perform the operation using a single incision technique (SILS) in which only one incision is created.  The decision to perform a single incision (SILS) approach will be made with the patient prior to the time of surgery.

APS Band from Midtown Surgical on Vimeo.

Gastric Banding Risks and Related Complications

As with any surgical procedure, there are potential risks and complications that can occur in gastric banding. We’re committed to providing you with the information you need to make a well-informed decision about your surgery.  Although these problems rarely occur, we want you to know the facts.  Although gastric banding is generally considered safer then other weightloss procedures, there are several complications that are unique to gastric banding that the other operations do not share.   These risks should be fully explored with a surgeon that performs all of the available operations so that you fully understand all of the potential implications of having weight loss surgery and gastric banding in particular.

Potentially Serious Complications associated with gastric banding:

  • Migration of implant (band slippage) requiring reoperation
  • Pouch dilation requiring reoperation
  • Erosion of the band implant into the wall of the stomach requiring reoperation
  • Tubing-related complications (erosion of the tubing or bowel obstruction)

Other complications generally considered minor:

  • Band/tubing leak
  • Esophageal spasm
  • Gastroesophageal reflux disease (GERD)
  • Port-site infection
  • Development of gallstones
  • Weight gain, failur to loss satisfacotry weight

Things to Consider

  • Gastric banding surgery should not be considered until you have explored all available weightloss procedures with a surgeon who performs all available surgical weight loss procedures.
  • Long term (greater then 15 years) incidence of potential complications due to the band implant is not known.
  • The gastric band is meant to be left in place for life.
  • Weight loss surgery is not cosmetic surgery. The procedures do not involve the removal of fatty tissue by cutting or suction.
  • The success of weight loss surgery is dependent on long-term lifestyle changes in diet and exercise.
  • A decision to elect surgical treatment for weightloss requires an assessment of the benefits and risks as well as the meticulous performance of the appropriate surgical procedure by an experienced bariatric surgeon associated with a center of excellence hospital/program.
  • Patients are greater weights/BMI maybe not be good candidates for gastric banding due to insufficinet weight loss and maybe better suited for a gastric bypass then other operations due to the amount of weight loss that is expected.

If you’re considering gastric bypass surgery, we encourage you to attend one of our free weight loss surgery information seminars.  You’ll learn about the risks and benefits of surgical weight loss options, you’ll meet bariatric team members who will support you before and long after your surgery, and you may also hear from patients who have had weight loss surgery. There’s no pressure to make a commitment—and no better way to get the answers you’re looking for. Of course, family and friends are welcome, too.

Want to talk it over? We’re ready to help. Call our office at 706-481-7298 and one of our staff members experienced in all aspects of weightloss surgery will be happy to answer your questions.