By far the most common procedure in Australia with over 5000 bands being inserted in the last 12 months alone. The operation involves placing a band around the top most part of the stomach to effectively create a small pouch.
Outflow from the pouch is controlled by the internal diameter of the band, which can be adjusted by adding fluid to a reservoir, which sits under the skin. Adding fluid effectively tightens the band and this needs to be done in small increments so as not to cause obstruction to food. The band works by restricting the amount of food that can be eaten and also by creating a sense of fullness when only a small amount of food is eaten.
The biggest advantage of the procedure is that it doesn't require any adjustments to the normal anatomy of the gastro-intestinal tract and it doesn't require any part of the stomach or bowel to be removed. Because of this immediate post operative complications are greatly reduced and hence it is the safest of all the obesity procedures. The reduction in short-term complications needs to be weighed up against medium term complications such as the band slipping or eroding through the stomach.
The type of foods that can be eaten is also greatly reduced compared to other procedures and some patients may even vomit if they eat the wrong foods. Because of this some patients eventually do not tolerate the band and request that it be removed. Between patients who do not tolerate there bands plus band related complications such as slippage, almost 10% of bands that are placed are eventually removed. If a band is removed patients should consider conversion to another procedure as reversal of surgery in most patients ultimately leads to weight regain.
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