Gastric band surgery

Overview

Gastric band surgery, a type of bariatric procedure, involves placing a silicone band (known as the Lap-Band) around the upper part of the stomach. This adjustable and reversible method is designed to aid weight loss in obese individuals. By restricting stomach capacity and slowing food movement, the gastric band limits the amount of food that can be consumed in one sitting. The band, made of soft silicone, forms a ring that can be inflated or deflated through a port under the skin. Adjustments, achieved by injecting saline into the band via the port, tighten or loosen its grip on the stomach, creating a smaller upper stomach pouch that fills quickly during meals, promoting a feeling of fullness sooner.

Reasons for undergoing the procedure

If health issues associated with obesity have persisted despite conventional weight-loss methods, bariatric surgery might be a viable option. For those seeking a less invasive and more permanent procedure, healthcare providers might recommend the Lap-Band.

The gastric band boasts the lowest post-operative complication rate among bariatric procedures and does not involve stomach or intestinal division. Additionally, it can be removed if necessary. However, the Lap-Band generally results in less weight loss compared to other bariatric procedures. It also requires several regular follow-up office visits and adjustments, particularly during the first year.

Other bariatric surgical techniques, such as the roux-en-Y gastric bypass and sleeve gastrectomy, are currently more popular. Simply reducing weight can significantly improve obesity-related health conditions such as:

• Heart disease
• High blood pressure
• High cholesterol
• Non-alcohol related fatty liver disease
• Obstructive sleep apnea
• Type 2 diabetes

The effects of the gastric band on hormones and metabolism differ from those of previous weight-loss procedures. It is considered a strictly “restrictive” procedure, meaning the ability to eat at one time is essentially limited.

Risk

The use of gastric bands has a number of disadvantages. Firstly, compared to other bariatric procedures, it results in less weight loss. Frequent changes might also be necessary, particularly in the first year following installation.

Possible risk or complication includes:

• Blockage of an outlet, a blockage can result from food becoming lodged
• Constipation.
• Difficulty in swallowing.
• Erosion of bands, the band can wear out through your stomach due to friction from it pushing against your stomach or esophagus.
• Esophageal dilation and/or pouch dilation.
• Gastroesophageal reflux (GERD).
• Intolerant bands, a foreign implant in the body can cause negative reactions in certain individuals.
• Nausea and vomiting.
• Port problems, there are several ways in which the port your lap-band utilizes to be accessed and adjusted can malfunction.
• Slippage of the bands, throughout the procedure, the band is fastened into place. But the band might move out of place from here.

There might be further issues which appear in the future. This may include the following:

• Research indicates that there may be a 50% chance of problems following a gastric band.
• Up to 35% of surgeries to repair or remove the gastric band may need to be repeated.
• Compared to other bariatric surgeries, the gastric band has a higher failure rate because of insufficient weight loss or weight gain.
• Every surgery means higher risks and cost.

Procedure

Over the course of two years, the Lap-Band typically reduces extra weight by 40%. That implies you would drop 40 pounds if you were 100 pounds overweight. Depending on how much you modify your habits following surgery, the results may differ. Compared to other bariatric procedures, weight loss following a gastric band procedure is usually lower.

Bariatric surgery may be recommended by your healthcare provider if you have:

• A BMI of 40 or higher: Based on your height to weight ratio, the Body Mass Index (BMI) calculates your body fat percentage. An increased risk of diseases linked to obesity is linked to a score of 40 or above.
• A BMI of 35 or above with at least one disease linked to obesity: Class II obesity is defined as having a BMI of 35 or higher with at least one obesity-related condition. Class III obesity, or clinically significant obesity, is met when combined with a concurrent medical condition.

Before the procedure

To ensure that you are healthy enough for surgery, you will need to go through a medical examination. You might undergo imaging testing of your abdomen, blood tests, or physical examinations. You must give up smoking, excessive alcohol consumption, and narcotic usage in order to be eligible for surgery.

The process and recovery period are rather short, and similar to the majority of bariatric procedures, minimally invasive surgery techniques (laparoscopic surgery) are available for the installation of the adjustable gastric band. This means that your surgeon can accomplish the entire procedure with a few tiny “keyhole” incisions rather than a single, massive cut across your abdomen.

During the procedure

The following steps during the procedure includes:

• A general anesthesia will be administered to you, causing you to lose consciousness and sleep during the procedure.
• A single abdominal keyhole incision is made before a laparoscopic procedure. Your abdomen will be inflated with carbon dioxide gas by your surgeon using this initial keyhole to place a little pump. This makes it possible for your surgeon to see and provides enough space for the procedure.
• The laparoscope, a tiny lighted video camera, will be inserted by your surgeon. Your organs will be projected onto a screen by the laparoscope. Your surgeon will create more keyholes in your abdomen and access it with long, narrow instruments.
• The gastric band will be tightened by your surgeon to create a pouch around the upper part of your stomach. Your stomach will resemble an hourglass in shape, with a thin line separating the upper and lower halves.
• The adjustable gastric band has a hollow tube that can be filled with liquid. Using this port, a surgeon can add or remove fluid to change the gastric band’s pressure.
• The gastric band is fastened to a tiny plastic tube that passes through a port and slightly under your skin. Your surgeon will have access to the port following surgery so they can insert or remove fluid as needed using a specialized small needle.
• After everything is in position, your surgeon will seal the keyhole incisions and discharge the gas from your abdomen. The process takes between thirty and sixty minutes.

After the procedure

After gastric band surgery, your healthcare provider will offer personalized dietary guidance. Initially, you’ll start with a liquid diet and gradually progress through pureed, soft, and solid foods to allow your stomach to heal properly. Adjusting to smaller portion sizes is crucial due to your reduced stomach capacity, as overeating can lead to vomiting and nausea. Choosing nutrient-dense foods and chewing thoroughly are essential for adequate nutrition.

During the first year post-surgery, regular appointments with your healthcare provider are necessary for adjustments to your gastric band. These adjustments, often tightening the Lap-Band as weight loss progresses, help maintain your weight loss goals. Routine blood tests will monitor your nutritional status, and nutritional counseling may be recommended to establish healthy eating habits. Depending on your needs, supplements may also be advised to ensure optimal nutrient intake.

Outcome

The adjustable gastric band offers a primary advantage of lower immediate post-surgery risks compared to gastric bypass and sleeve gastrectomy. Unlike these procedures, gastric band surgery does not involve dividing the intestines or stomach. It is also reversible, allowing for removal if necessary.
While the Lap-Band is designed to be a lifelong solution, its long-term durability remains uncertain. Research suggests that approximately 35 to 40 percent of individuals may undergo removal of their gastric bands within ten years.

The removal of the gastric band may occur for a number of causes, such as:

• Complications such as esophageal dilation.
• Erosion of the band.
• Inadequate weight loss.
• Inflection.
• Obstruction.
• Severe heartburn or reflux.
• Slippage of the band.

Eventually, some patients proceed to a more successful long-term bariatric procedure.

In the first year or two following surgery, many gastric band users lose weight. After surgery, issues from the gastric band installation itself are uncommon, but they can occasionally arise later. If complications arise, the Lap-Band may need to be removed or re-operated upon. After being removed, some patients decide they want to have another bariatric treatment.

This is the choice that some people need to make the next big move toward meaningful weight loss and long-term improvement. It might be the ultimate goal of your weight loss quest, or just a stage in the process, depending on how it goes for you. Some individuals successfully teach themselves to alter their eating and lifestyle habits by using the Lap-Band. Some people might not lose enough weight or might not be able to keep it off over time. You will have other alternatives for treatment if this occurs.