The system of gastric banding is also called Lap Band in reference to the surgical technique (laparoscopic) and the product (an adjustable band or ring, made of silicon elastomer) being used. This band is filled with saline solution and placed around the upper part of the stomach, implanted by a minimally invasive procedure (laparoscopy).
When the band is placed in position, a small stomach or gastric sac is created above it, leaving a larger one below. In this way, the small stomach above the band regulates and greatly reduces the stomach's capacity to store food, making the person feel satisfied with a small amount of food, and with a significant and lasting feeling of satiety.
The size of the opening between the two parts of the stomach controls the flow of food from the top to the bottom.
The size of the stomach and its capacity for storing food can be modified by adjusting the band, adding or removing a small amount of saline solution through a device connected to it and placed under the skin during surgery. After surgery, the surgeon may modify the amount of saline solution through the device using a very thin needle; in other words, the gastric band can be adjusted without the need for another surgery.
It is designed to limit the consumption of food, causing the body to make use of its fat reserves to obtain the energy it needs, resulting in significant weight loss. An advantage of the gastric band is that it can be adjusted according to the needs of each individual. This procedure is the least invasive of surgeries that reduce the amount of food the stomach can ingest. It is also reversible.
Several studies of patients with gastric banding have shown a loss of excess weight between 50 and 70% in the first year after surgery.
ADVANTAGES OF THE GASTRIC BAND
Small incisions, minimal scarring, reduction in hospitalization time and recovery period, completely reversible, adjustable, and does not permanently alter the patient's anatomy. The digestive process is not altered and so there are no nutritional deficiencies even with a significant loss of weight. Significant improvements in health are also achieved, as well as better management of diseases such as diabetes, hypertension, degenerative joint disease and others.
FREQUENTLY ASKED QUESTIONS ABOUT THE GASTRIC BAND
WHAT IS THE GASTRIC BAND?
The gastric band is a surgical procedure for the treatment of obesity in all its degrees. This procedure consists of placing a ring (prosthesis) at the entrance to the stomach, which restricts the entry of food to this organ.
HOW DOES THE GASTRIC BAND WORK?
It is a restrictive procedure because it reduces or restricts the entry of food into the stomach, causing weight loss and giving a significant percentage of control over diseases associated with obesity.
WHO IS A CANDIDATE FOR THE GASTRIC BAND?
Candidates for this procedure are those patients with a body mass index (BMI) of 30 kg/m2with associated diseases, or of 40 kg/m2and no associated diseases.
ARE ANY ADDITIONAL STUDIES REQUIRED FOR THE GASTRIC BAND?
In addition to having the BMI indicated above, the candidate should submit to a study protocol prior to surgery which consists of assessments by the bariatric surgeon, as well as by specialists in endocrinology, psychiatry, internal medicine and nutrition. Once the protocol is completed, the gastric band can be put in place.
HOW IS THE GASTRIC BAND PUT IN PLACE?
The procedure is performed by minimally invasive surgery which consists of making small incisions in the abdomen, where working ports are placed for introducing the instruments used to put the band (prosthesis) in place at the entrance to the stomach.
WHAT DOES FOLLOW-UP AFTER GASTRIC BAND SURGERY CONSIST OF?
All the specialists do checkups on a regular basis to monitor weight loss, medication and vitamin supplements. This follow-up continues until the patient has changed their eating habits and can continue with their care on their own.
WHAT ARE THE ADVANTAGES OF HAVING THE GASTRIC BAND?
It is a reversible procedure; in other words, it can be removed if the patient makes that decision. It is adjustable, because the degree of restriction can be modified. It does not involve cutting the stomach or small intestine. It is associated with weight loss and disease control in a significant percentage of patients, although less than with the bypass or gastric sleeve.
ONCE I REACH MY IDEAL WEIGHT?
The band will not be removed unless indicated, such as in the case of a complication. In fact, once you reach your ideal weight the band will continue in action, helping ensure that you don't regain weight.
ARE FREQUENT VISITS TO MY DOCTOR NECESSARY AFTER GASTRIC BAND SURGERY?
Checkups with your doctor are a very important part of the follow-up to the gastric band procedure. Patients are generally evaluated weekly or biweekly for the first month and then with scheduled follow up appointments during the first year.
WILL I HAVE TO FOLLOW A DIET IF I HAVE A GASTRIC BAND?
You will learn to eat wholesomely, differently from how you have been accustomed to eating, since your previous habits caused you to gain weight until surgery was necessary. You will have the option of eating a variety of healthy foods, as well as chewing properly and eating slowly.
WHEN AND HOW OFTEN WILL I NEED TO HAVE THE GASTRIC BAND ADJUSTED?
As patients lose weight, the gastric band settings change, and so periodic adjustments need to be made. Those adjustments are made in accordance with the patient's weight loss. In most cases the first adjustment is made six weeks after the gastric band is put in place, or in case there is:
1.Decrease in weight loss.
2.Hunger between meals
Every adjustment of the gastric band must be made in an x-ray room by either the attending physician or trained personnel who can observe the band's location and condition.