About Gastric Band
Memorial Health Bariatrics performs the adjustable gastric band surgical procedure. This procedure is growing in popularity because it has fewer risks than gastric bypass surgery.
In this procedure, the surgeon places a silicone ring around the upper stomach to create a very small (20 cc) stomach pouch. The silicone ring is attached to a small reservoir that is implanted under the skin. When the band needs to be tightened or loosened, this reservoir is accessed with a needle through the skin.
This is a restrictive procedure that works by making the stomach smaller. Patients feel full with much less food and lose their appetite if the band is appropriately adjusted.
The average excess weight loss after the adjustable gastric band is slower than with the gastric bypass. One year after surgery, weight loss can average 40 percent of excess body weight. The weight loss continues slowly in years two and three. By the end of the third year, the weight loss is 75 percent, which equals the results with gastric bypass.
Studies show that after 10 to 14 years, 50 to 60 percent of excess body weight loss has been maintained by some patients.
Laparoscopic Adjustable Gastric Band
In almost all patients, the adjustable gastric band surgery can be performed laparoscopically. When a laparoscopic operation is performed, a small video camera is inserted into the abdomen. The surgeon views the procedure on a separate video monitor. Most laparoscopic surgeons believe this gives them better visualization and access to key anatomical structures.
The camera and surgical instruments are inserted through small incisions made in the abdominal wall. This approach is less invasive because it replaces the need for one long incision to open the abdomen. A recent study shows that patients having had laparoscopic weight loss surgery experience less pain after surgery, resulting in easier breathing and lung function and higher overall oxygen levels. Other realized benefits with laparoscopy include fewer wound complications such as infection or hernia, and a quicker return to pre-surgical levels of activity.
Risks of Gastric Band
It is important to remember that there are no ironclad guarantees in any kind of medicine or surgery. There can be unexpected outcomes in even the simplest procedures. The adjustable gastric band has fewer risks than the gastric bypass, but there are still some potential complications.
In this procedure, the stomach size is reduced by placing a small band around the upper stomach. If the band is too tight, patients develop vomiting. If the band is too loose, you will not lose weight. The key to success with the band is appropriate adjustment when you need it. As you lose weight, the band will loosen and it will need to be tightened by adding saline into the port to maintain the needed satiety. If you do not come in for adjustments, you will not lose weight with the band.
On occasion, the band will slip on the stomach, changing position. This complication requires laparoscopic surgery to return the band to the appropriate position. There have been rare cases where the band erodes through the stomach from being too tight and needs to be removed. Infection of the band is rare but can occur. Although the band has been tested in thousands of cases, on rare occasions a port or piece of tubing may malfunction and need to be replaced.
Weight loss from the band occurs due to a reduction in calorie intake. We recommend you take a regular vitamin to replace what you may not get in your new diet. Unlike gastric bypass, you will still absorb vitamins normally so special vitamins are not needed.
The effectiveness of the procedure may be reduced if the diet is not followed after surgery. Your success depends on following diet and adjustment instructions.
Patients who undergo adjustable gastric band are at increased risk of developing blood clots in their legs that can travel to their lungs. Early walking, the use of compression boots, anti-embolism stockings, and small doses of blood thinning agents help lower this risk.
Other Post-Surgery Issues
Patients who undergo bariatric surgery must make a lifelong commitment to eat healthy, exercise, and adhere to strict dietary guidelines. The lifestyle changes can seem overwhelming at first and can strain relationships within families and between married couples. To help patients achieve their goals and deal with the changes surgery and weight loss can bring, Memorial Health Bariatrics offers support groups, counseling, and continuing education.
Ultimately, the decision to have the procedure is entirely up to you. After having heard all the information, you must decide if the benefits outweigh the side effects and potential complications.
This surgery is only a tool. Your ultimate success depends on strict adherence to the recommended dietary, exercise, and lifestyle changes.
After Gastric Band
After insertion of the adjustable gastric band, you will stay overnight at Memorial Health University Medical Center. After you recover from your anesthesia, you will start a liquid diet that you will follow for two weeks. You will begin doing simple exercises from your bed just four hours after surgery. You will have some discomfort after surgery and will receive pain relief as needed.
Before you leave the hospital, you will undergo a barium swallow to make sure you are able to eat. A small percentage of patients develop swelling at the band site and need to stay in the hospital for an extra day or more.
You will return to Memorial Health Bariatrics after two weeks, four weeks, monthly for the first year, then every three months for the next one to two years, then annually. At each of these visits, we will check your weight, measure certain parts of your body, check your strength, and perform other tests as needed. These check-ups are necessary to help us ensure that you are healthy and are following your diet and exercise guidelines.
You will be asked to attend a support group regularly. Research has shown that adequate support is a vital part of weight loss success. We offer meetings at least twice a month in Savannah in the Mercer Auditorium located in the Hoskins Center on the Memorial Health campus. We also hold a monthly meetings in outlying communities.
You will also meet with an exercise physiologist and dietitian. You will be given telephone access to a nurse 24 hours a day, seven days a week. Additional counseling will be available if necessary.
Changing the Way You Eat
The modifications made to your gastrointestinal tract will require permanent changes in your eating habits. Some of the changes include:
- When you start eating solid food it is essential that you chew thoroughly. You will not be able to eat steak or other chunks of meat if they are not ground or chewed thoroughly.
- You are not to drink fluids while eating. You need to wait 90 minutes after eating before drinking any fluid.
- Omit desserts and other items with sugar listed as one of the first three ingredients.
- Omit carbonated drinks, high-calorie nutritional supplements, milk shakes, high-fat foods, and foods with high fiber content.
- Avoid alcohol.
- Limit snacking between meals.
- Take vitamin supplements as directed by your doctor.
Returning to Work
Your ability to resume pre-surgery levels of activity will vary based on your physical condition and the nature of the activity. Many patients return to full pre-surgery levels of activity within six weeks of their procedure. Patients who have had a minimally invasive laparoscopic procedure may be able to return to these activities within a few weeks.
Birth Control and Pregnancy
It is strongly advised that women of childbearing age use at least two effective forms of birth control during the first 16 to 24 months after weight loss surgery. A woman's ability to become pregnant returns within a week or two after you start to lose weight. The added demands pregnancy places on your body and the potential for fetal damage make this requirement very important.