Weight-loss surgery, or bariatric surgery, has only been around for about 60 years, but it has changed the lives of countless patients in that short time. Over the years, innovations in bariatrics have allowed patients to find the right surgical procedure for their unique medical needs. Of these choices, gastric band surgery remains one of the most widely used.
First performed in the 1970s, gastric banding involves the separation of the stomach into a small upper portion and larger lower portion to restrict a patient’s food intake. The first gastric bands—made of mesh—were nonadjustable, which ultimately failed to yield the results that patients were expecting.
The development of the first adjustable band in the 1980s revolutionized gastric band surgery. Its design ultimately evolved into a silicone-based device that surgeons could implant laparoscopically and adjust through the use of an inflatable balloon.
Laparoscopic adjustable gastric banding (LAGB), as it is now known, helps patients lose weight without many of the complications of other procedures. One of the most popular gastric bands is the LAP-BAND System, which received approval from the FDA in 2001 and has been used in bariatric surgery ever since.
Who is gastric band surgery for?
Previously, physicians would only recommend that a patient undergo gastric band surgery if they had a body mass index (BMI) of at least 35. However, guidelines now allow patients with a BMI of 30 to receive a gastric band if they are experiencing complications related to obesity (like sleep apnea or diabetes) and previous non-surgical interventions have not yielded results.
LAGB is designed for patients over the age of 18. All those who are preparing to undergo this procedure must commit to making post-surgical lifestyle changes to improve their odds of success. It is also vital that patients understand the procedure, including its risks and alternatives. In addition, physicians will not recommend a gastric band for those with untreated mental conditions or an alcohol or drug addiction.
How does the procedure work?
LAGB placement is a minimally invasive procedure performed on an outpatient basis, meaning that you will not need to stay in the hospital unless you require extra monitoring before surgery. The procedure is fairly straightforward and quick, taking around an hour to complete.
Once under general anesthesia, your surgeon will make between three and five keyhole incisions in your abdomen. These cuts allow them to place trocars, through which they will insert the laparoscope and other surgical tools needed to carry out the procedure. After examining your abdominal cavity, your surgeon will insert the gastric band through one of the trocars and loop it around your upper stomach to create a smaller pouch. They will then attach a tube to the band, which connects to an injection port that sits just below the abdominal wall. This port allows your surgeon to adjust your gastric band as needed.
What happens after surgery?
Unlike other bariatric procedures, the gastric band doesn’t change anything about your digestive function. Rather, by creating a small pouch at the top of your stomach, it encourages you to eat less at mealtimes by making you feel full more quickly. Food will still pass through your stomach as it did before, but you will simply reduce your food intake because your appetite will be suppressed.
About six weeks after your LAGB, you will visit your surgeon for the first of several gastric band adjustments. Your clinician will insert saline solution into the port that is located under your skin. This liquid inflates the inside of the band, decreasing the size of the opening between the two portions of your stomach.
This non-surgical process takes about 10 minutes, making it easy to adjust your LAGB to your weight loss goals. You can return to your surgeon to have your band adjusted as needed. For instance, if you aren’t experiencing the level of weight loss needed to make progress, your surgeon can tighten your band.
What are the pros and cons of gastric bands?
LAGB is one of the safest bariatric surgeries available. Since it is done laparoscopically, there is very little risk of complications from the procedure itself and little post-operative pain. The recovery time is also much shorter than it is with other weight-loss surgeries. Most patients can return to work within a few days of the procedure.
Perhaps most beneficially, LAGB is a non-permanent weight loss solution. Unlike other procedures like gastric bypass, which involves the removal of portions of the stomach, gastric band surgeries are entirely reversible. If needed, you can have your surgeon remove the band at any time.
There are some risks associated with LAGB surgery, however. In some cases, patients will develop food intolerances that require them to avoid certain foods. In addition, all gastric band recipients must change the way they eat. Eating food too quickly or in large quantities will make you feel nauseous, so unlearning previous eating behaviors will be vital to your success.
Moreover, your LAGB surgery won’t be successful if you aren’t fully committed to the required follow-up. You need to see your clinician regularly in the first year (or longer) following your surgery. In between visits, changing your eating habits and monitoring your weight will be crucial to determine when your band requires adjustment. You’ll only reach your weight loss goals if you’re committed to this follow-up.
More than a million people around the world have chosen the gastric band to help them lose weight. If you’ve tried to lose weight and aren’t seeing success, ask your doctor whether you might be a good candidate for gastric band surgery.