Adjustable Gastric Band

* Click here to view video.

Adjustable gastric banding is quickly becoming a very popular procedure for patients looking for bariatric surgery. Being only a restrictive procedure, the idea is simple: by placing a silicone band around the upper portion of the stomach, the amount of food that passes through is restricted, and therefore patients consume a smaller amount of food at one time. There is also a smaller stomach “pouch” that is created when the band is placed, so patients feel fuller for longer.

Because food passes slowly through the new passageway, the top part fills up releasing a chemical which tells your brain that you are full. Considering this fact, it is very important that the patient begins each meal with foods high in protein and nutrients to allow your body to still absorb the vitamins necessary to lead a healthy lifestyle. It is also important to remember that, unlike gastric bypass surgery, there are little side effects after eating foods high in sugar or carbohydrates, and it is truly up to the patient to use this procedure as a tool in addition to exercise and healthy eating habits.

The band is most commonly attached laparoscopically to a port.  Your surgeon will use this port to help control the size of the passageway by simply injecting, or removing saline from the band itself. This allows you and your surgeon to have a little more control over the amount of weight that you lose, while keeping side effects to a minimum.

Adjustments are usually done in the office sometimes using an x-ray machine. Your surgeon will inject a small needle into the port to either add or remove saline depending on the type of adjustment you need. This procedure is not painful for most patients, and some surgeons may use lidocaine to numb the skin and reduce any pain that may occur.

Adjustable Gastric Band-Filled and Unfilled Advantages

  • The primary advantage of this restrictive procedure is that a reduced amount of well-chewed solid food enters and passes through the digestive tract in the usual order. That allows the nutrients and vitamins (as well as the calories) to be fully absorbed into the body.
  • There is no cutting or stapling of the stomach or bypassing the intestines thereby eliminating many of the known associated operative risks of bypass surgery.
  • If for any reason the band needs to be reversed, this is readily done in the office by subtracting all the saline water out of the band via the port.
  • Five year studies in the U.S. show that patients can maintain 40-50% of targeted excess weight loss.

Risks

  • The band applied may lead to complications of obstruction or perforation, requiring surgical intervention.
  • The band system is a “foreign body” and there is a small risk that any part of it may become infected and may need to be removed.
  • Although patients may experience a sense of fullness after eating solid foods, some may not experience the necessary feeling of satisfaction that one has had “enough” to eat.
  • Because restrictive procedures rely solely on a small stomach pouch to reduce solid food intake, patients who ingest high calorie liquid nutrition may fail to lose weight and/or may re-gain weight.This is known as “soft calorie syndrome."
  • As is the case with all weight loss surgeries, readmission to a hospital may be required for fluid replacement or nutritional support if there is excessive vomiting and adequate food intake cannot be maintained.

Minimally Invasive Approach

During the procedure, surgeons usually use laparoscopic techniques (using small incisions and long-shafted instruments), to implant an inflatable silicone band into the patient’s abdomen. Like a wristwatch, the band is fastened around the upper stomach to create a new, tiny stomach pouch that limits and controls the amount of food you eat. It also creates a small outlet that slows the emptying process into the stomach and the intestines. As a result, patients experience an earlier sensation of fullness and are satisfied with smaller amounts of food. In turn, this results in weight loss.