An adjustable laparoscopic gastric band is also called a lap band. It is an inflatable device that is made out of silicone and is put in place via a surgical procedure around the topmost part of the stomach. This is done in extreme cases of obesity and it helps to reduce excess bodily fat. Known as bariatric surgery, it is done for any obese patient who has a BMI (or body mass index) of 40 or higher. Sometimes, patients with a BMI of 35 to 40 have this surgery performed due to experiencing certain comorbidities. A comorbidity is the simultaneous manifestation of at least two physical or psychiatric illnesses, such as depression, alcohol dependence, hypertension, osteoarthritis, diabetes or sleep apnoea; illnesses that are known to get better with weight loss.
A gastric band is not the answer for everyone. Together with their BMI, a patient will have to meet these criteria:
- They are severely overweight
- They have experienced obesity for longer than five years
- Serious attempts at losing weight have resulted in short term successes
- There are no underlying diseases causing the obesity
- The patient is prepared to make substantial changes within their lifestyle and eating habits
- The patient is prepared to undergo a pre-surgery nutritional programme in preparation for the surgical procedure
- The patient is prepared to undergo continuous post-surgery monitoring by the specialist that is treating them
- The patient does not drink an excessive amount of alcohol
How does the Gastric Band Work?
The inflatable silicone band is positioned around the topmost section of the stomach. This makes the stomach pouch smaller in size, and will result in restricting the amounts of food being eaten at any one time. It will then take longer to empty the stomach of its contents. Constant weight loss is achieved by limiting the amount of food taken in, reducing the appetite, as well as slowing digestion.
Gastric band surgery is definitely not an easy way out for those who suffer from obesity. Bariatric surgery is a radical step, and will carry the usual risks and pain of any serious gastrointestinal surgery. In saying this though, gastric banding itself is not as invasive as other surgeries of similar procedures. Gastric banding surgery is performed by utilising laparoscopic surgery. A patient will experience less pain, smaller scars, a faster recovery and shorter stay in hospital than other open surgical operations.
No parts of the patient’s stomach are removed or stapled. The intestines are also not re-routed, which means the patient can continue absorbing nutrients from their food in a normal way. A gastric band is also entirely made out of biocompatible materials. This means that they cause no harm while staying inside the patient’s body. Not all patients are suitable candidates for the laparoscopy procedure, though. A patient who is extremely obese or who has had abdominal surgery before, or who suffers with complicated medical problems might need the open surgery approach.
What is the Laparoscopic Surgery Procedure?
A tiny incision of less than half an inch will be made near the patient’s belly button. Then, carbon dioxide will be introduced into the patient’s stomach. Carbon dioxide is a gas which is found naturally within the body, and by introducing it into the stomach it helps in creating a working area for the surgeon. A tiny laparoscopic camera is then fed through the belly button incision into the stomach.
A video monitor is then able to capture images of the abdominal cavity and stomach that are taken by the camera. The surgeon is then able to see and ascertain key structures within the abdominal cavity. More small incisions are then made within the abdomen. By watching the video monitor all the time, the surgeon works through the small incisions and uses long handled instruments to carry out the procedure. A tiny, circular tunnel is made behind the patient’s stomach by the surgeon, who then puts the band through this tunnel. The gastric band is then locked around the patient’s stomach.
The gastric band creates a tiny pocket at the top end of the patient’s stomach. This pocket or pouch will hold about half a cup of food. A typical stomach will hold approximately six cups of food. The pocket will quickly fill up with food, and the gastric band will slow the passage of the food from the pocket to the lower parts of the patient’s stomach. Because of the slow passage of food and the upper stomach registering as full, the whole stomach feels full. This will result in the patient always feeling less hungry, feeling fuller for longer, eating smaller portions, and ultimately losing weight.
As a patient starts to lose their weight, their gastric band will need certain adjustments to ensure effectiveness and comfort. This is done by introducing saline into a tiny access port that is placed just underneath the skin and inflating the band, further restricting the movements of food but still allowing the food to move through the patient’s digestive system.
As a rule, gastric banding will not be recommended for anyone who experiences the following:
- Any untreated endocrine disease, for example hyperthyroidism
- Inflammatory gastrointestinal diseases such as Crohn’s disease, esophagitis or ulcers
- Cardiopulmonary diseases
- Dependency on drugs or alcohol
- People who are emotionally unstable