Bariatric surgery is a viable alternative for people looking to lose 50-100 pounds or more. Placement of a Gastric-Band is a fairly straightforward procedure that is accomplished by placing the Band, which is a belt-like section of plastic, around the upper stomach.
This converts the stomach, in essence, into an hourglass. However unlike an hourglass, the upper portion and the lower portion of the stomach are not the same size. The upper portion is much smaller and is called the pouch. Part of the stomach is then used to form a tunnel or “Belt Loops” around the Band to help prevent the band from slipping down to the middle of the stomach.
The Band creates a calibrated narrowing at the bottom of this tiny pouch, so that it fills up with small amounts of food and empties slowly like an hourglass.
The band is connected to the port, which is placed outside the abdominal muscles but under the skin and fat so that it is not visible. The band is adjusted and restricts the amount of SOLID food that can be consumed before one feels full.
The adjustment is accomplished by placing a special needle into the port (which is buried under the skin) to increase or decrease the amount of saline fluid contained in the balloon. The Band is pictured in its normal position on the upper stomach at right.
There are several key features that make Gastric Banding an attractive surgical technique for weight loss:
- Laparoscopic placement
- No division or anastomosis of stomach or bowel
- It is removable
The first two of the features above probably reduce the risk of surgery, which is especially important when operating on patients who suffer from morbid obesity. The fact that there is no cutting or repositioning of any intestine brings the risk of leak or obstruction to very low levels (not impossible, as outlined in the risks section below). The fact that the procedure is almost always done laparoscopically may allow decreased stress on the vital organs (heart, lungs, etc.) and may allow quicker recovery in comparison to open procedures.
Risks specific to Gastric Band surgery include:
- Band Slippage
- Band Erosion
- Band and/or PortSite Infection/Flipping