Laparoscopic Gastric Banding
In this procedure the capacity of the stomach is made smaller by placing an inflatable silicone band around the upper part of the stomach to create a new small pouch, which can hold only a small amount of food. The band slows down the passage of food from the pouch to the rest of the stomach, which will make you feel full faster and reduces food consumption and calories intake.
The band is inserted using a general anaesthetic laparoscopically (keyhole surgery using small incisions in the abdomen) to encircle the upper part of the stomach and is connected by a tube to a small port that is placed under the skin of your abdomen.
The gastric band is designed in a way that can be adjusted to change the size of the stomach pouch by injecting or aspirating saline into the access port. The first band inflation is done about 4-6 weeks after surgery.
Gastric banding surgery is indicated for the following groups of people:
- When appropriate non-surgical measures have been tried but failed to achieve or maintain adequate, clinically beneficial weight loss in patients whose:BMI is 40 kg/m2 or more
Or between 35-40 kg/m2 in association with other significant disease (for example, type 2 diabetes, heart disease or high blood pressure)
- It is also recommended as a first-line option (instead of lifestyle interventions or drug treatment) for adults with a BMI of more than 50 kg/m2 in whom surgical intervention is considered appropriate(National Institute for Clinical Excellence (NICE))
- In March 2011, The International Diabetes Federation (IDF recommended bariatric surgery to patients with BMI 30 kg/m2 (Asians from BMI 27.5 kg/m2) if their diabetes was poorly controlled.
However, the need for surgery to aid weight loss is dependent on discussion with the bariatric team who will provide you expert and comprehensive advice.
Our experience is limited to the years since 1993 when the first gastric band was fitted. However, a gastric band is designed to remain permanently. It is made?entirely of biocompatible materials, so the band can stay in the patient’s body without causing harm.
- Significant weight loss up to 40-50% of excess body weight within 2 years.
- Marked improvement or resolution in health conditions related to obesity, particularly type-2 diabetes (approximately 50% chance of resolution), hypertension (60% chance of resolution) gastro-oesophageal reflux, obstructive sleep apnoea (75% chance of resolution), asthma, liver disease, high cholesterol, and painful osteoarthritis.
- Improvement in overall physical and psychological health
- Compared with other types of weight loss surgery, adjustable gastric banding is fully reversible by keyhole surgery, adjustable, less invasive, takes less operating time (average, 25 minutes), can be performed as a day case procedure, does not interfere with absorption so vitamin deficiencies are less likely to occur as well as lower risk of dumping syndrome.
Although this operation safe and effective, within 5 years approximately 1-in-10 people might need another operation to fix a problem such as:
Pouch dilatation: this happens in up to 8 out of 100 people, and requires the band to be either re-positioned or removed. Band erosion: this happens in 1 in 100 people, and requires the band to be removed and the hole in the stomach closed. Port or tube leaking: this could be replaced with a new piece. Port infection: this requires the port to be removed and a new port to be placed 3 months later. Severe acid reflux, and rarely oesophageal (gullet) dilatation: this requires the band to be fully deflated and preferably removed. It is not advisable to have a gastric band if you already suffer with severe acid reflux.