Laparoscopic (keyhole) Gastric (Stomach) 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 feeling full. The procedure is usually completed in under an hour and most patients are discharged home within 24 hours of surgery. Recovery after the gastric band is quicker than with other surgical procedures for weight loss.
The procedure involves placing an adjustable band around the upper part of the stomach to create a small pouch (15 -20 mls size).
The part of the stomach just below the band is fixed to the part of the stomach just above the band to make sure that the band remains around the upper stomach not the lower oesophagus.
The new upper stomach (the pouch) can only hold about 4 ounces (1/2 cup) of food. The pouch fills up quickly with smaller size meals making you feel full sooner. The lower stomach does not need to fill for you to feel full.
The place where the band is wrapped around the stomach creates a junction between the stomach compartments. This junction or pouch outlet (gate) is called a stoma.
How does it work?
The stoma (pouch outlet) controls the passage of food from the upper to the lower part of the stomach. Satiety (fullness) sensation is achieved upon filling of the small stomach pouch above the band. The food passes through the outlet slower than normal, prolonging the sensation of satiety. This leads to reduction in food intake and the attainment of the desirable weight-loss. The food then passes normally through the rest of the digestive system.
The band is designed to be adjusted in accordance with the needs. Adjustability of the band is its main attribute. The size of the gastric stoma is adjusted by adding or removing (inflating or deflating) saline (a salty solution similar to fluids found in the body) in the balloon on inner surface of the band.
How can it be adjusted?
The band is lined with an inflatable balloon.
Inflation of the balloon tightens the band, increasing the restriction (tightness) at the stoma and thereby increases weight loss, while deflation of the balloon loosens the band, reducing the restriction and the degree of weight loss.
This balloon is connected to a small reservoir (Injection Port) that is placed under the skin of the abdomen through which the diameter of the band can be adjusted.
Mr Rasheed can control the amount of saline in the balloon by piercing the reservoir (Injection Port) with a fine needle through the skin.
If the band is too loose and weight loss is insufficient, the stoma size can be made tighter by adding more saline. If the band is too tight, the doctor can remove some saline. This can be done in a clinic without further surgery.
The ability to change the restriction is why the Band is called an adjustable gastric band.
When and how often is the band adjusted?
At WLLW Gastric bands may be adjusted from 4 to 6 weeks post-operatively. The adjustments are performed gradually enabling adequate restriction, whilst maintaining healthy eating. Weight loss is monitored and further band adjustments (from 3 to as many as 12 in some cases in the first year) are carried out.
What to expect?
Patients are expected to lose up to 60% of their excess body weight in the first 24 months.
What is the key for success?
The success of this type of surgery depends on the surgeon's expertise, appropriate positioning of the band and on the patient's motivation and commitment to achieving a long-lasting weight loss.