
Adjustable gastric banding is a surgical procedure that is performed on obese people for achieving weight loss. Here is a brief overview about the procedure, which is also known as lap banding surgery.
A type of bariatric surgery, adjustable gastric band procedure is usually recommended for obese people with a body mass index of more than 40. Those with a BMI between 35 to 40 are also considered for this procedure, if they are suffering from weight-related diseases or disorders, like gastroesophageal reflux disease, sleep apnea, metabolic syndrome, diabetes, etc. If it is found that weight loss in such people can help improve their health problems, then they are considered as potential candidates for this surgery.
What is Gastric Banding
In adjustable gastric banding procedure, a silicone band with an inner ring is placed around the stomach to restrict food intake. The insertion of this band is done through a laparoscopic procedure under general anesthesia. In some rare cases, the surgeon may go for an open surgery. Sometimes, the laparoscopic procedure may transform to an open one, if the situation demands so.
Procedure
A silicone band is placed around the stomach in such a way that it creates a pouch-like structure at the upper part of the stomach. The band is attached to a port, through a very small tube. The port is placed just beneath the skin, and it is through this port that saline is added to the inner ring of the band. A specialized, non-coring needle is used to add or remove saline from the band, through the port. The ring can be inflated or deflated by adding or removing saline. Inflation of the ring causes tightening of the band, which restricts passage of food; whereas, deflation loosens the grip and allows faster food movement. The ring is not inflated during the surgery.
During the first six weeks that follow the procedure, the band is kept empty or is filled with a minimum amount of saline. After this period, adjustments are done by the surgeon in an X-ray suite, which helps him to observe the filling. It takes several visits to the doctor to achieve the ideal positioning and perfect fitting of the band, which can yield the optimum results.
Working Mechanism
The small pouch created on the upper part of the stomach can hold only a very small amount of food. Whenever the person consumes food, the pouch fills quickly. The band slows down the movement of food from the small upper pouch to the lower part of the stomach. As the upper part becomes full and empties very slowly, the person does not feel hungry for a very long time. This slows down the process of digestion, and retains a sensation of fullness of the stomach. In the long run, the intake of food reduces, which in turn results in weight loss.
Advantages
As the name rightly suggests, the advantage of adjustable gastric banding procedure is that the band can be adjusted by adding or removing saline through the port. If the band is too tight, passage of food (to the lower part of the stomach) will get affected, and if it is too loose, the person will feel more hungry. In case of vomiting or discomfort, the band can be loosened, and if it is allowing free passage of food or does not restrict the food intake, it can be tightened further. The normal saline holding capacity of the band is 4 to 12 cc, according to the design. The adjustment facility is very much helpful, in case of pregnancy or other diseases, where the band is deflated to bring back the stomach to its original capacity. It can be inflated at a later period.
Weight loss in persons who have undergone this procedure, is around 500 grams to one kilogram per week. Some people lose weight at a faster rate in the first year itself. They may lose around 22 to 45 kilograms. Even though there are some reports of complications, the popularity of adjustable gastric banding procedure is on the rise.
Disclaimer: This article is for informational purposes only and should not be used as a replacement for expert medical advice.