Laparoscopic Gastric Banding
A laparoscopic gastric band is the commonest weight loss procedure performed in Australia. From a surgeon’s point of view it is the simplest and most straightforward of the weight loss procedures.
It involves placing a silicone band around the inlet of the stomach to create a small pouch of about 30ml capacity. The band is connected to a port that is placed underneath the skin just below the breastbone. The port allows the band to be adjusted after surgery to maintain optimal dietary restriction and weight loss.
The band produces a slow but steady weight loss. Typically a patient will lose half a kilogram per week and will take two years to attain their maximum weight loss. The other weight loss procedures have a much more rapid weight loss profile. Most patients having a band remain in hospital overnight and go home the following day, although increasingly in the United States, the operation is performed as a day case. Initially after going home, the patient will feel some restriction and will be on a largely liquid diet but by the time they return in four weeks for their first band adjustment, you will be able to eat freely. The band is then tightened up over a number of months until the appropriate point is reached for each patient.
On average, it takes five adjustments to reach that ideal point or sweet point, as the Americans call it. It is important that the band is not overly tightened as this can lead to maladaptive eating. In this case, the patient finds it uncomfortable to eat normal, healthy food and therefore falls back on eating softer, sloppy foods which tend to be higher in calories and as this is purely a restrictive procedure, the patient does not lose weight. In an attempt to ensure optimal band adjustment, I see my band patients every month for the first 12 months.
There are some potential complications with the band. These vary from band slippage to more minor issues with the port. Overall, patients can expect a 20% re-operation rate in their lifetime although this varies from minor port issues to more significant issues with band removal or replacement. If patients work with our team programme and particularly the dietary advice combined with appropriate band adjustment, the band will achieve excellent weight loss of 55% to 65% of excess weight.
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