Adjustable Gastric Band – Introduction
Adjustable gastric banding by laparoscopy is a common surgery to help with weight loss. The surgeon places a band around the upper part of the stomach to create a small pouch to hold food, thus limiting the amount of food which can be eaten by making the person feel fuller after eating just small amounts of food.
After surgery, a bariatric specialist doctor may adjust the band to make food pass slower or faster through the digestive system. Indicators and suitable candidates for this type of weight loss surgery may be:
√ Patients with severe obesity for 5 years or more, which is not under control through diet and exercise.
√ Patients who are ready to make lifestyle changes and follow doctor orders, diet and regular exercise.
√ Mentally stable people.
√ No dependence on or addiction to alcohol or illegal drugs.
This surgery may be recommended if the BMI (Body Mass Index) is 40 or more, or if the patient suffers from a serious medical condition such as sleep apnea, type 2 diabetes, high blood pressure, and heart disease.
Considerations before gastric banding
These are the typical steps done before adjustable gastric banding:
√ Complete medical history and physical examination of the patient.
√ Blood tests.
√ Nutritional as well as mental counseling.
√ Consulting the primary physician about other medical problems such as diabetes, high blood pressure, and heart or lung problems and their control.
√ Quit smoking as this habit can slow the recovery and increase risks.
√ Patient should inform if she is or might be pregnant.
√ If the patient is taking any blood thinning agents such as warfarin, aspirin they should be stopped approximately a week before the surgery.
On the day of surgery:
√ Do not eat or drink anything after midnight the night before the surgery.
√ Take the drugs the doctor told to take with a small sip of water.
√ A consent form regarding the surgery is signed by the patient.
The procedure: Adjustable gastric band
Gastric banding is done under general anesthesia, so that the patient will be asleep and unable to feel pain during the operation. The surgery is performed by inserting a tiny camera and small instruments in the abdomen, 2 to 5 small ports or surgical incisions are taken in the abdomen. This type of surgery is known as laparoscopy.
After this, a band is placed around the upper part of the stomach to separate it from the lower part, thus creating a small pouch with a narrow opening that goes into the larger, lower part of the stomach.
The length of the operation may take as little as 30 to 60 minutes if the bariatric surgeon is highly experienced and there are no complications throughout the surgical procedure.
When the patient eats after having this surgery, this small pouch will fill up quickly, thus the patient will feel full after eating just a small amount of food. The food in the small upper pouch will slowly empty into the main part of the stomach.
What happens after surgery?
In most cases, patients can go home the day after the surgery and begin their normal activities 1 or 2 days after treatment. Liquids or mashed-up foods are advised for 2 or 3 weeks after surgery, then regular foods are added to the diet. By the end of week 6 after surgery, most patients can start eating regular foods. The gastric band is made of a special rubber (silastic rubber), and on the inside it has an inflatable balloon which allows the band to be adjusted. The doctor can decide to loosen or tighten it in the future to eat more or less food.
Then, the band is connected to an access port under the skin of the abdomen, where it can be tightened by placing a needle into the port and filling the balloon (band) with water.
The bariatric surgeon could make the band tighter or looser any time after the surgery, in cases such as:
√ Eating problems
√ Not enough loss of weight
√ Vomiting after eating
Possible risks and other considerations
Some of the possible risks associated with gastric banding are:
√ Gastric band eroding through the stomach.
√ Slipping of gastric band out of place.
√ Gastritis (inflamed stomach lining), heartburn, or ulcers.
√ Infection of the port, which may need surgery.
√ Injury to stomach, intestines, or other organs during surgery.
√ Scarring in stomach, which could lead to a blockage in the bowel.
√ Inability of the surgeon to reach the access port to tighten or loosen the band (minor surgery is needed to fix this problem).
√ Vomiting from eating more than the capacity of stomach pouch.
Typical results of adjustable gastric banding
Weight loss via adjustable gastric band surgery is not as considerable as with gastric bypass. The average weight loss is about one-third to one-half of the extra weight the patient is carrying, this may be enough for many patients. As a rule of thumb, patients may even keep losing weight for up to 3 years after surgery if doctor instructions are strictly followed.
IFSO – International Federation for the Surgery of Obesity and Metabolic disorders.
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