Gastric banding with an adjustable band
Gastric banding with an adjustable band is the least invasive surgical method to treat obesity. The purpose of this surgery is to reduce the size of the stomach by placing a special band, which acts as a belt that tightens. Thus, the stomach is divided into two parts: upper and lower. The upper stomach pouch is smaller and it limits the amount of food the patient can eat. Therefore, a sense of fullness is achieved by a small amount of food, and this enables to reduce calorie intake.
The following special criteria are applied for the surgical treatment of obesity:
- Body mass index (BMI) ≥ 40 kg/m2;
- Body mass index (BMI) ≥ 35 kg/m2 with comorbid diseases (type 2 diabetes mellitus, hypertension, sleep apnea, arthrosis, infertility);
- Conservative weight loss methods applied were not effective;
- No history of endocrine disorders, which can cause obesity.
How Is the Surgery Performed?
During the surgery, a laparoscopic approach is employed under general anesthesia. A small incision at the belly button is placed, and a tiny laparoscopic video camera (laparoscope) is inserted through this incision. To introduce and manipulate surgical instruments, a few small additional incisions are placed. The abdominal cavity is inflated with CO2 gas, which creates a working space for a surgeon. The surgeon performs all surgical manipulations while watching them on a video screen.
A special band is placed around the upper part of the stomach between the cardia and the body. The tightened band gives the stomach an hourglass-like shape. The upper part of the stomach becomes about 100 mL in volume. The gastric band contains a reservoir that is filled with saline. The reservoir is connected to a small access port that is implanted underneath the skin. This allows the gastric band to be adjusted after the surgery by adding or removing some saline through the access port.
After such a procedure, the patient can eat a small amount of food at one sitting as the upper stomach pouch fills very quickly, and the tightened gastric band slows down the passage of food into the lower part of the stomach.
The band can remain in the patient’s body for the rest of his/her life.
What Should Be Known After the Surgery?
- It is very important to follow special eating guidelines especially during the first days, as well as to have regular follow-up visits during the postoperative period;
- After this restrictive approach, patients lose 0.5–1 kg per week on the average.