FAQs - Laproscopic Adjustable Gastric Banding Surgery

Gastric banding is a surgical procedure that involves fitting a band around the upper part of your stomach. Gastric banding is usually only recommended as a last resort for people who are extremely obese (those with a BMI over 40), and whose weight poses a serious health risk, for example from diabetes or heart disease. Gastric banding helps you lose weight by controlling the amount of food that you eat.

Once the gastric band is in place it can be adjusted externally (outside the body) at any time by a surgeon.This means the band can be made either tighter or looser, depending on the amount of food your surgeon wants to restrict you from eating.

Your surgeon can make the band tighter by adding salt water (saline) into the band. This slows down the amount of food that can pass through your stomach - meaning your stay feeling full for longer. To loosen the band, some of the salt water fluid is removed, meaning food passes through quicker to your digestive system. Generally, a gastric band is loose to start and then tightened when you are used to eating less food.

A gastric band is designed to remain permanently within your stomach. However, it can be removed, and in the majority of cases leaves you with no permanent changes to your stomach. The procedure to fit a gastric band can involve a certain degree of complication, for example there is a risk of infection, and in rare cases, leaking into your stomach may occur .

• Any surgery has a degree of risk and should not be taken lightly. However Laparoscopic Adjustable Gastric Banding is the safest of all weight loss surgery with lowest complications because no cutting, stapling or rerouting of intestine is involved. When you weigh the risks involved with surgery against the risks of the co-morbidities that accompany being over weight, the surgery is usually far less risky.

• This is not predictable; most of the patients will never be skinny people. But the majority can and do achieve a normal, healthy weight for their height and bone structure. Success after bariatric surgery is defined as losing 50 percentage of excess body weight. After a Laparoscopic Adjustable Gastric Banding, one loses an average 60 percentage of excess body weight at 18 months.

You may be eligible for the lap band surgery if :

• Your BMI is =40, or you weigh twice your ideal weight or are at least 100 pounds (45Kgs.) more than your ideal weight.
• You have been overweight for more than 5 years .
• Your serious weight loss attempts have had only short-term success.
• You are not suffering from any other diseases that may have caused your obesity.

• No, most of the patients plateau with weight loss when they get close to a normal weight and stop losing. If you continue to lose beyond your ideal weight, some of the fluid may be removed from your band to stabilize your weight. Most banded people regain most if not all of their excess weight if the band is removed.

• One of the major advantages of the Adjustable Gastric Band is that it can be adjusted. If your illness requires you to eat more, the band can be loosened. This can be done by removing fluid from it. When you have recovered from your illness and want to lose weight again, the band can be tightened. This can be done by increasing the amount of fluid

First, the tiny size of the upper pouch limits the quantity of food that the patient can physically eat. Second, the narrow exit slows down emptying, thus maintaining a feeling of satiety for longer. In simple terms, you feel full after eating much less food. The combination of these effects forces patients to eat less food and consume fewer calories.

No. One key drawback of restrictive procedures, like Lap-Band, is that the gastric volume restrictions may be circumvented by patients who consume high-calorie liquid foods such as sports drinks or milk shakes, since these calorie-dense liquids pass easily through the exit channel from the upper stomach. Consuming these foods reduces weight loss and may even lead to weight gain.

Lap-Band is always performed laparoscopically, a "keyhole" surgical method, which reduces pain, reduced surgical trauma, reduced hospitalization and recovery period. Lap-Band placement requires no cutting or stapling of the stomach or bypass of the intestines. If the band needs to be removed, the patient's stomach usually reverts to its original form.

For higher risk patients, whose health or comorbidities warrant it, Lap-Band procedures are typically performed in a hospital with an intensive care unit. Other patients may be operated on in a bariatric surgery center.

Some patients are discharged within 24 hours, others within 2-3 days. Outpatient follow-up is typically scheduled for 5-7 days after the procedure. Bariatric surgeons recommend most patients to avoid vigorous activity for about 6 weeks after surgery, although most patients may return to work or 'most' normal activities within about 7-10 days. Post-op check-ups are a normal part of the Lap-Band process. Typically, surgeons see their patients once a week during the first month post-op, and every 4-12 weeks during year 1. Adjustments to the band may be performed during these consultations. In years 2 and 3, follow-up visits are normally scheduled every 3-6 months. These timetables vary from patient to patient.

An average weight reduction of 2-3 pounds a week during the first 12 months after the operation is possible, but an average of one pound a week is more likely. During the period 12-18 months after Lap-Band, weekly weight loss is less. In general, since June 2001, preliminary indications from America suggest that patients can lose about 40-50 percent of their initial excess body weight by having Lap-Band surgery. By comparison, patients who undergo gastric bypass, such as Biliopancreatic Diversion, Duodenal Switch or Roux-en-Y, typically lose 50-80 percent of their initial excess weight.

It is essential for all patients to adhere to their post-op eating and drinking instructions. These diet guidelines permit the new stomach structure to heal completely and the band to remain in the right position. For instance, eating too much after surgery can cause vomiting which can lead to stretching of the small stomach pouch. In time, patients move gradually to solid food. Note that during the first few weeks, patients may be able to eat to eat certain types of food that will be off-limits later because these foods are too high in calories. Point is, it is more important immediately after the operation to let the stomach adjust to the gastric band than it is to reduce weight. Here are some general diet guidelines after Lap-Band surgery.

Immediately After Lap. Gastric Banding (First few days)

Immediately following surgery, patients may have an occasional sip of water or suck on an ice cube. Do not drink more than this. The day after the operation, you may take a little more fluid, but only a small amount at any one time, otherwise you risk nausea and vomiting. Try to choose liquids with an adequate amount of calories.

1-4 Weeks After Lap. Gastric Banding

During this period you may enjoy the following liquids and very soft foods:

• Clear broth or soup (without vegetables or meat or cream)
• Low-fat yogurt
• Skimmed milk
• Jello
• Fruit juice or pureed soft fruit.

4-6 Weeks After Lap. Gastric Banding

During this period, you may start introducing thicker, or creamier soups. This helps you transition to more solid food. It is safer to consume softer foods that are easier to digest. At the end of this period you might include foods such as fish or moist white meat like chicken and pork. If you have any problems with solid foods and suffer from nausea or vomiting, return to the liquid diet immediately. Then slowly add soft foods to help you move on to solid foods later. Always ask for advice from your doctor or dietician.