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Gastric Banding

Gastric banding, also referred to as laparoscopic surgery, creates upper and lower sections of the stomach by placing a ring or band around it to "pinch" it. After gastric banding, the upper portion of the stomach fills with food, which then slowly descends into the lower portion of the stomach, creating a sensation of fullness after ingesting far less than usual.

Consequently, gastric banding is effective at reducing the amount of food patients eat without having to use staples on the stomach.

The Gastric Banding Procedure

In general, the gastric banding procedure lasts between one to two hours. Depending on the patient's health, the procedure can be performed on an outpatient basis or in the hospital. Here is a basic outline of the gastric banding procedure:

The doctor makes a small incision (1 cm wide) in the lower torso.
He places the gastric band device around the top of the stomach.

To connect and control the band, doctors insert a tube beneath the skin that connects to a reservoir. This setup allows doctors to adjust the band after surgery by releasing saline into the band itself, thereby altering how restrictive it is.

Gastric Banding

What to Expect after Gastric Banding Surgery

Because gastric banding dramatically changes the way your stomach (and digestive system) works, you will have to make some significant lifestyle changes after having the banding surgery. Postoperative gastric banding patients will need to follow a special diet that, immediately after surgery, will consist of liquids only or liquids and soft foods. This will continue until the patient has become accustomed to the device, and the stomach has healed completely.

Significant weight loss of 1 to 2 pounds per week, sometimes more, is the norm after undergoing gastric banding. While the results may be slower than those from gastric bypass, the long-term results look to be equally promising, particularly given that the banding procedure tends to encourage healthier overall eating habits.

A reduction of 40 to 50 percent of a person’s excess weight (the weight over an ideal body weight) is common two years after having gastric banding.

Risks of Gastric Banding Surgery

Given that gastric banding is a major surgery, it has a number of possible risks and complications, including:

problems caused by the band, erosion of the stomach tissue from rubbing with the band, gastritis
problems with the band itself, either through misplacement or slippage
productive burping, a complication in which a patient regurgitates some food (The patient may be able to correct this by eating smaller portions more slowly).

Sometimes, the passage between the banded areas may become blocked, causing a minor problem that may require further treatment.

Pros and Cons of Banding Procedures

The primary advantage of banding over other surgical weight loss alternatives is that it is far less invasive. With gastric banding, no part of the stomach or intestines is cut, removed or significantly altered. The band device can also be removed entirely, giving patients a more flexible option than gastric bypass surgeries.

Another advantage of gastric banding is that it doesn't cause malabsorption issues, meaning that patients won't suffer from nutritional deficiencies because the relevant part of the intestines is not bypassed, as it is in gastric bypass surgery.

Gastric banding also has a far smaller mortality rate: 1 in 2000, versus 1 in 200 mortality rate for gastric bypass surgery.

As with other bariatric procedures, gastric banding results in dramatic weight loss that will have a profound impact on other areas of the patient’s health. Cardiovascular problems, as well as stress on joints and body structures, are some of the other health problems that gastric banding can alleviate.

However, gastric banding does have some negative aspects. The need for consistent adjustment of the band device to reach the ideal restriction for desired weight loss can be irritating, at best, and physically exhausting, at worst. Band adjustments are done in-office by a radiologist, usually four to six times in the first year after the procedure.

To adjust the band, the patient swallows some liquid that will appear on the X-ray fluoroscope. This allows the technician to assess the condition, position and level of restriction offered by the band. As the technology advances, many offices are doing adjustments without the aid of the fluoroscope, making these visits much faster and easier.

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