Gastric banding is a restrictive operation in which a band is surgically inserted in the stomach to decrease the organ's size in order to restrict food intake and promote weight loss. This procedure has been FDA approved since 2001 to assist obese patients who require major weight loss and to help relieve their obesity-related health problems. Gastric banding is a commonly performed type of bariatric surgery.
In recent years, an investigational procedure called gastric banding with plication has been introduced. In this surgery, in addition to the placement of the gastric band, a portion of the stomach is folded over itself and sutured in place. So far this combined procedure has proven even more effective than gastric banding alone.
Candidates for Gastric Banding
Gastric Banding is typically recommended for people with a body mass index, or BMI, of 40 or higher. Those with a BMI of 35 or higher who also suffer a serious obesity-related health problem, such as high blood pressure, diabetes, arthritis, or severe sleep apnea, may also be candidates for this surgery. Patients for any type of bariatric procedure are carefully screened both physically and psychologically prior to surgery.
In most cases, a candidate for gastric banding must be between the ages of 18 and 65. Candidates for this surgery are assessed in terms of criteria which may include the following: a history of inability to lose weight with diet, exercise and medication, medical disorders which may interfere with surgery, and personal commitment to making substantive lifestyle changes.
Benefits of Gastric Banding
There are several benefits to gastric banding over some other types of bariatric surgery. These involve both effectiveness and safety.
One great benefit to gastric banding is the fact that the gastric band can be adjusted. It can be loosened if the patient is experiencing discomfort and tightened if there is insufficient weight loss. While gastric banding may not result in as large a weight loss as some types of bariatric surgery, such as gastric bypass, it is considered a safer procedure.
Efficient Weight Loss
Gastric banding can help many obese people lose about one-third to one-half of their excess body weight after one year. Moreover, weight loss should continue for up to three years. When gastric banding is combined with plication, weight loss results may be even greater. Not only will the patient's everyday quality of life be greatly enhanced by serious weight loss, but previous medical problems may diminish or even disappear as a result.
Less Chance of Malnutrition
Gastric banding results in much less risk of malabsorption of nutrients than some other bariatric surgeries. Even with plication, gastric banding is primarily a restrictive, rather than malabsorptive procedure, since it does not alter the normal digestive process in the small intestine.
The gastric band can be removed from the patient during a relatively simple procedure. This assures that if there are complications, such as extreme discomfort, excessive weight loss or malnutrition, the surgery can be reversed.
Conditions which may improve, or even disappear entirely, as a result of gastric banding may include: cardiovascular disease, hypertension, sleep apnea, and gastroesophageal reflux.
The Gastric Banding Procedure
In many cases, gastric banding procedures can be performed laparoscopically, using tiny instruments through small incisions. This is considered the least invasive method and the safest weight loss surgery, with very few possible complications. When performed laparoscopically, gastric banding is referred to as LAGB, laparoscopic adjustable gastric banding.
During the banding procedure, an inflatable band is placed around the upper part of the stomach. The upper pouch created will limit the amount of food that can be eaten, since the patient will feel full very quickly. A small opening in the pouch permits the food to travel to the rest of the stomach and small intestine, so there is little danger of malabsorption of nutrients. As mentioned, the gastric band can be adjusted by the physician through an injection port in the abdominal wall either to promote more weight loss or to relieve discomfort. This adjustment may need to be done periodically.
The Risks of Gastric Banding
Any surgery, however safe, carries certain risk which may include: excessive bleeding. blood clots, adverse reactions to anesthesia or medications, breathing problems, damage to adjacent organs or the development of a hernia at the incision site. Risks particular to the procedure of gastric banding may include:
- Nausea or vomiting which are usually mild and temporary
- Slippage or erosion of the gastric band
- Gastritis, heartburn, or stomach ulcers
- Adhesions in the belly leading to blockage
While rare, gastric banding may result in poor nutrition if it causes problems with food absorption.
Recovery from the Gastric Banding Procedure
Gastric banding usually requires only a day of hospitalization, but full recovery will probably take about 6 weeks. Food will have to be reintroduced gradually to the patient's diet, beginning with a liquid diet and then soft foods. After several weeks, the patient will be eating normally, but will have to remember to eat small quantities of food at a sitting so as not to become uncomfortable or vomit.
While gastric banding provides faster, easier weight loss than traditional diet and exercise alone, it is necessary for the patient to make healthy lifestyle changes if the positive effects of the surgery are to be long term. Not only will overeating make the patient feel ill, it will expand the band and defeat the purpose of the procedure. It is necessary that the patient participate in ongoing counseling or psychotherapy after surgery to ensure that the positive effects of the surgery are lasting.