Gastric banding operation

What is gastric banding?

Gastric banding is a type of weight loss surgery where the size of the stomach is reduced using a band so that only small meals can be eaten before you feel full.

The procedure involves placing an adjustable band around the upper part of your stomach to create a pouch. The pouch fills up quickly and the food passes slowly through a gap, formed by the band, into the rest of the stomach.  The food then passes normally through the rest of the digestive system.

The operation usually requires an overnight stay in hospital and is done under general anaesthesia. This means you will be asleep during the procedure.

Your surgeon will explain the benefits and risks of having a gastric band fitted, and will also discuss the alternatives to the procedure.

About the operation

The gastric band is usually fitted using keyhole (laparoscopic) surgery, but it can also be placed via open surgery. The operation takes 30 minutes to one hour, or more, depending on the technique used.

• In laparoscopic gastric banding (keyhole surgery), about five small cuts (1 to 2cm long) are made on your abdomen and chest. Your surgeon will insert a tube-like telescopic camera to view the area either by looking directly through this, or at pictures it sends to a video screen. The band is fitted using specially designed instruments passed through the other cuts. Afterwards, the skin cuts are closed with two or three stitches.
  
  
• In open gastric banding surgery, a single cut (about 15 to 25cm long) is made on your upper abdomen. Afterwards, the skin cut is closed using stitches and staples.

The size of the pouch needs to be adjusted by adding or removing fluid in the band. This is done through a tube that runs from the band to a “port” in your chest or lower abdomen. The port sits under the skin. The band is adjusted a few weeks after the operation, leaving time for the swelling caused by the surgery to settle down.

For the first 24 hours after the operation you will only be allowed to drink clear fluids. After this your surgeon or dietician may start you on a pureed diet for several days, although some surgeons advise a liquid diet for a longer period.

You are also likely to have some bruising, pain and swelling of the skin around the healing  wound(s). Once you return home, you may feel or be sick after eating, especially if you try to eat too much. Your restricted diet may cause some shortage of nutrients so you may need to take multivitamin tablets.

Gastric banding is generally a safe procedure. For most people, the benefits in terms of losing excess weight are much greater than any disadvantages. However, all surgery carries an element of risk.

Some of the complications specific to gastric banding are listed here.

• Wound infection. Antibiotics are given during surgery to help prevent this.

• For up to six weeks after the operation, it is possible to develop a blood clot (DVT) in the veins in the leg. In most cases this is treatable, but it can be a life-threatening condition. Compression stockings, intermittent compression pumps and blood-thinning injections are used to help prevent DVT.

• There is a risk that during the operation other organs in the abdomen may be accidentally damaged.

• There is a risk that the band may slip out of place, break or erode through the stomach wall. This may require further surgery or removal of the band.

• It is possible you may fail to lose sufficient weight or regain weight, and some patients have further weight-loss surgery.

• If you lose weight rapidly, there is a risk of developing gallstones in your gallbladder. These can be painful. Your surgeon may remove your gallbladder during surgery.

• The exact risks differ for every person – you should ask your surgeon how any risks apply to you.