Laparoscopic Adjustable Gastric Banding

 

A Laparoscopic Adjustable Gastric Band procedure is a purely restrictive surgical procedure in which a band is placed around the upper most part of the stomach. This band divides the stomach into two portions, one small and one larger portion. Because passage of food through the upper stomach is regulated, most patients feel full faster. Food digestion occurs through the normal digestive process.

Advantages

• Restricts the amount of food that can be consumed at a meal.
• Food consumed passes through the digestive tract in the usual order allowing it to be fully absorbed into the body.
• In multiple studies involving over 3000 patients, excess weight loss ranged from 28-87%, with a minimum of 2 year post-operative follow-up.
• In 2003, the Obesity Surgery journal published a study (Mittermair) showing that the mean excess weight loss after gastric banding was 72% after years.
• Band can be adjusted to increase or decrease restriction.
• Surgery can be reversed.

Risks

(The following are in addition to the general risks of surgery)

• Gastric perforation or tearing in the stomach wall may require additional operation.
• Access port leakage or twisting may require additional operation.
• May not provide the necessary feeling of satisfaction that one has had enough to eat.
• Nausea and vomiting.
• Outlet obstruction.
• Pouch dilatation.
• Band migration/slippage.

How it works

The adjustable band is a surgical device that is implanted around the stomach during a general anasthetic using laparoscopic surgical techniques. It forms a band around the upper part of the stomach. It works by dividing the stomach into a small upper pouch and the rest of the lower stomach. The band keeps a narrow opening that controls how fast food empties into the lower stomach. The small upper pouch will fill with a very small amount of food and make the patient feel full after eating a much smaller amount of food. The band contains a fluid filled ring that can be adjusted to increase or decrease the rate at which food is allowed to pass through. Fluid can be added or removed via a small port which lies under the skin.

Patients must be severely obese the be considered for this procedure. This means that the BMI must be at least 40 or 35 if they suffer from obesity related medical conditions. Patients must also be motivated and able to make a major lifestyle and diet change in order to live safely with the band.

In order to maximize the effectiveness of the adjustable gastric band, patients are required to follow three basic post-operative rules:

• Eat a healthy, well balanced diet. Counselling with registered dietition is strongly recommend. This can be arranged for you.
• Separate liquids and solids. That means that you should not drink and eat at the same time. This will allow the small stomach pouch that sits above the band to fill with solid food without being washed down with liquids. This will maximize the amount of the time that the small pouch is distended which will increase the sense of fullness. This will then lead to improved weight loss.
• Consume as few liquid calories as possible. The calories in liquids will go right past the band without any restriction and will compromise the amount of weight you can lose. Therefore, we recommend that you only consume zero-calorie liquids such as water, Crystal Light, unsweetened tea, etc.

Wait Time and Cost

Gastric banding is not considered an insurable procedure by the Ministry of Health. Therefore, this procedure can only be offered to patients who are willing to pay the entire costs of the operation and associated care. The total cost for this procedure is $17 000.

Because of the expence, the waiting time for this procedure is many times shorter than for gastric bypass and we can usually schedule your operation within 3 months of your initial consultation.

If you feel that gastric banding is the right procedure for you, please call our office directly at 416 782-2616 and we will schedule an early appointment.