Adjustable Gastric Banding
Adjustable gastric banding, or Lap Band surgery, is a form of restrictive bariatric weight loss surgery designed for obese patients with a body mass index (BMI) of 40 or greater – or 35 – 40 with those who have co-morbidities that are known to improve with weight loss. The gastric band is an inflatable silicone prosthetic device which is placed around the top portion of the stomach via keyhole laparoscopic surgery.
The gastric band surgery creates a small pouch at the top of the stomach which holds approximately 50 ml (2-3 tablespoons). This pouch fills with food quickly and the passage of food from the top to the bottom of the stomach is slowed. As the upper part of the stomach believes it is “full,” the message to the brain is that the stomach is full and this sensation helps to eat smaller portions and lose weight over time.
The band is inflated or adjusted via a small access port placed just under the skin subcutaneously. Radiopaque isotonic solution or saline is introduced into the band via the port. A specialized needle is used to avoid damage to the port membrane. There are many port designs and they may be placed in varying positions based on the preference of your bariatric surgeon. The port may be sutured in place. When fluid is introduced the band expands, placing pressure around the outside of the stomach. This decreases the size of the passage in the stomach and restricts the movement of food.
Over a period of time, restriction is increased until patients feel they have reached a “sweet spot” where optimal weight loss can be reached with the minimal fluid required. This is an individual experience and timing cannot be predicted. There are different adjustable bands on the market, which means the amount of fluid required and total content varies.