Gastric Band Surgery
Gastric band surgery, often referred to as laparoscopic adjustable gastric banding, involves placing a silicone band around the upper part of the stomach and filling it with saline to adjust the tightness to an optimal level – tight enough to slow down the passage of food through the stomach, but not too tight so that it blocks the passage of food completely.
Laparoscopic adjustable gastric banding works best in patients who tend to eat large portions of savoury food. We generally avoid this procedure in people who eat sweets or graze on foods that easily crumble up (cakes, biscuits, crisps).
The procedure is performed laparoscopically (keyhole surgery) because of faster recovery times, reduced post-operative pain, and a superior cosmetic result. The band is passed into the abdomen using special equipment, and is looped around the stomach a few centimetres below where the oesophagus (gullet) joins the stomach. Once the band is correctly positioned, it is fixed in place using sutures to minimise the chance of it moving post-operatively.
The band is connected via a small tube to an access port. This access port is hidden under the skin near your rib cage, just deep enough so that it can’t be seen. Injections of saline are made through this access port to gradually inflate or deflate the band to find the optimal tightness.
The gastric band aids weight loss in part by delaying the flow of food through the stomach which means that the top part of the stomach stretches after only a small amount of food is consumed (normally the top part of the stomach would only stretch when the stomach is very full). This stretching of the upper stomach is thought to stimulate nerve fibres which signal to the brain that it’s time to stop eating, thereby reducing appetite.
The aim is to achieve weight loss of about 1lb (0.5kg) per week through a combination of reduced portion size, early satiety, and improvements to the diet. Success with the laparoscopic adjustable gastric band requires a lot of hard work and motivation as patients need to re-educate themselves on how to eat. It is really important that band patients get good dietary advice and make the right changes to their eating habits so that they are aware of the problem foods and common pitfalls that stop patients achieving success. A good expected result is that patients would lose around 50% of their excess weight over two years.
The gastric band procedure is regarded as a very safe operation, with early post-operative complications being rare. No vitamin or mineral supplements are routinely required unlike some of the other procedures. The down side however is that late complication rates are reportedly very high; at least 20% of patients would require some kind of corrective surgery in the five years following gastric band insertion and in many units this figure is as high as 50%. Such complications include infection, band slippage (where the stomach moves up during retching and gets trapped within the band), and band erosion (where the band gradually works its way through the stomach wall).