Gastric Band

Weight loss surgery or obesity surgery is growing in popularity in response to the growth in obesity levels in the UK. The most common procedure is the gastric band procedure. The gastric band, also known as the lap band, is placed around the top of the stomach therefore limiting the amount of food that can be consumed.

It is recommended for people who are morbidly obese (BMI over 40) or those with a BMI between 30 and 40 who also have a condition that poses a serious health risk such as diabetes, high blood pressure or hear disease.

Once the gastric band is in place it can be adjusted externally, either made tighter or looser, by the surgeon depending on how much food it is determined you should be eating. It is designed to remain permanently but it can be removed.

There are some complications with the gastric band operation and it is important to discuss it fully with your surgeon.

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Gastric Band Surgery

This involves the placement of an adjustable gastric band (made from silicone) that is placed around the upper part of the stomach. It creates a new smaller stomach pouch, with a small opening that leads to the larger part of the stomach below the band. Food pools in the small stomach pouch and creates a feeling of fullness.

The gastric band creates an opening between the smaller and larger stomach. The size of the opening controls the flow rate of food from the two areas. This means the band can be adjusted. To change the size of the opening, the inner surface of the band can be inflated with saline via a port. This is called a fill.

An ideal fill is tight enough to allow a reduction in hunger, increased fullness and cause steady weight loss whilst allowing adequate amounts of food to pass through the band to meet your baseline nutritional needs. People usually require several fills as the band needs very fine tuning to obtain optimum restriction.

Who is it suitable for?

• Those people who want lower risks during the initial operative phase, but are prepared to commit to more intensive and prolonged post-operative follow-up
• Those who are well-disciplined and willing to accept slower weight loss than with some other procedures, eg: Gastric Bypass

What are the advantages?

• No intestines are diverted or cut
• To a degree, patients are in control of their weight loss through the ability to have the band loosened or tightened
• Patients can see up to 85% cure or improvement in their Diabetes
• Patients can see up to 70% cure or improvement in their Hypertension (high blood pressure)
• Patients can see a reduction in Gastric reflux symptoms
• Patients don't have to take nutritional supplements
• Whilst designed as a life-long device, the band can be relatively easily removed if absolutely necessary. In effect making it reversible
• Patients don't experience dumping syndrome

What are the drawbacks?

• 5% of patients may not experience much weight loss. Currently there is no scientific way of predicting which patients will have reduced appetite with the band
• Patients can experience significant wind (flatulence)
• Some people will experience problems with the band that can require urgent surgical intervention, eg: port problems, tubing problems, Band Erosion (where the band actually wears a hole through the stomach lining), and Band Slippage (where the stomach below the band slips up through the band causing poor or lost blood supply to the stomach)
• Some patients have to have the band removed due to physical or psychological intolerance
• It's easier to 'cheat' with a Band than with some of the other surgical procedures, partly because soft or liquid diet can easily bypass the band as well as the absence of dumping syndrome, thus making it easier to consume carbohydrates (sugars) and fats
• Certain foods, eg: Chicken, rice, pasta, and bread have a tendency to block the band, especially if too much is eaten or it is not chewed properly. Blockage can increase the risk of band slippage. These types of foods must be eaten with great care and in moderation

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