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Adjustable Laparoscopic Gastric Band Surgery

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22/12/2006

Adjustable gastric band, or Laparoscopic Gastric Band surgery is a "restrictive" operation, meaning that it limits food intake and does not interfere with the normal digestive process.  In this procedure, a silicone band is wrapped around the upper part of the stomach, creating a small stomach pouch.  The lower, larger part of the stomach sits below the band. The two parts of the stomach remain connected through a narrow chanel created by the band.  The band restricts the amount of food you can eat at a single meal.  Food can still pass from the upper to the lower stomach, however, it moves through the new chanel very slowly, so that you feel full longer.  The procedure is performed laparoscopically, using 5 small skin incisions.



An important aspect of the Lap-Band is that it can be easily adjusted after surgery.  The inner lining of the band contains a balloon that can be inflated with saline (salt-solution), allowing the surgeon to narrow or widen the opening and thus control how much food can pass through to the lower portion of the stomach (imagine a small blood pressure cuff wrapped around the upper portion of your stomach).  This is accomplished by using a fine needle to gain access to a small reservoir that is positioned under the skin and fat of the abdomen at the time of surgery. The reservoir, in turn, is connected by a thin tube to the saline-filled sac.  The reservoir is  not visible; it can only be feltwhen you push on your abdomen.

Advantages:

  • Gastric banding is the safest form of bariatric surgery, with a rapid recovery time.

  • Weight loss ranges from 50 to 65 percent of excess body weight over the first two years and is maintained for up to 5 years. 

  • It is the least invasive operation of all the weight loss surgeries available.  Since there is no cutting or re-connecting of stomach or intestines, there is no risk of intestinal leak, dumping syndrome, or food intolerance.

  • Patients who have the Lap-Band do not feel hungry.

  • There is no malabsorption of medication or protein, meaining that you absorb every nutrient that you eat. This is particularly important in young women who want to get pregnant. Although Lap-Band patients do not need any vitamin or mineral supplements, we recommend a multivitamin once a day.

  • The majority of existing obesity-related health problems are improved, or even cured, such as diabetes, high blood pressure, sleep apnea, and high cholesterol.

  • Since the band is an implantable device, its effect can be completely reversed just by taking it out.

  • The surgery takes approximately one hour to perform and requires only an overnight hospital stay. Patients can return to work in three to five days.

  • It is adjustable - without the need for more surgery, just a ten minute visit to the clinic. The band needs to be tightened as the patient loses weight - roughly every 6-8 weeks.  In some circumstances (e.g., pregnancy and certain illnesses), the patient may need to eat more, in which cases the band can be loosened.

Disadvantages

  • You must re-learn how to eat.  If you eat too fast or too much, or if you don't chew your food enough, you will vomit.  Some foods - such as steak, white meat chicken, and doughy bread - will not pass through the opening.
  • Success depends on your commitment to keeping follow-up visits to your surgeon, every 6-8 weeks for the first year to have your band adjusted.  Band adjustments are made in response to the amount of weight you lose, your appetite, your eating habits, and the symptoms you experience.  This is the only way to assure significant long-term weight loss. 

  • Because the Lap-Band is an implantable device, it does carry a small risk of slippage (causing complete blockage of the gastric pouch) or erosion into the stomach. 

  • Other technical problems can arise. In a few cases, the tube may kink or the reservoir may twist, which may require minor surgery.

  • The Lap-Band is not a perfect solution, and it will not result in weight loss if you start eating an excess amount of chocolate or high-calorie drinks, such as ice cream, milk shakes and soda.


 

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SPIRE Hospital, Bristol. 
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Contact: Claire Trenberth - 0117 9804051
claire.TRENBERTH@spirehealthcare.com
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