Step 7: Laparoscopic adjustable gastric banding

Return to Index Step 1: Understanding Morbid Obesity Step 2: The Health Risks of Obesity Step 3: Treatment Overview Step 4: How Weight Loss Surgery Might Help Step 5: Gastric Bypass Surgery Step 6: Vertical Banded Gastroplasty Step 7: Laparoscopic Adjustable Banding System Step 8: Post-Surgical Nutrition Step 9: Post-Surgical Exercise Step 10: Post-Surgical Lifestyle Changes Key Points Glossary

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In this surgery, a silicone band that is placed around the upper part of the stomach. It creates a much smaller stomach pouch. The band also slows the passage of food from the stomach into the intestine. This allows you to feel full for a much longer time after eating.

A balloon within the band also wraps around the top of the stomach. This allows adjusting the opening of the band, so that it can be either tightened or loosened. The adjustable gastric band is designed to be left in place permanently.

During surgery, a port or reservoir is permanently positioned in your upper abdomen (under the skin, where it is not visible). The port is attached to the silicone band by tubing. The balloon within the band can be inflated by using a special needle to inject a saline solution into the port. This helps control the size of the opening of your stomach pouch:

Inflating the balloon with the saline solution further restricts the opening through which food passes out of the stomach pouch. This reduces the amount you can eat and slows the passage of food. You feel full longer after eating.
Deflating the balloon by removing some of the saline solution increases the opening through which food passes. This can be helpful if you develop problems, such as heartburn or vomitting of food.

The laparoscopic adjustable band is placed through small incisions in the abdomen. Each opening is usually less than half an inch in length. A miniature video camera is passed through one of these openings, allowing the surgeon to view your stomach on a monitor in the operating room. The rest of the surgical instruments are passed through the other tiny openings.

In rare cases, complications may require the banding system to be placed using a traditional open abdominal incision.

The benefits of the laparoscopic adjustable banding system

The surgery doesn't require a large incision.
The stomach itself is neither cut nor stapled during the procedure, though you will have sutures placed to keep the band from slipping.
The band can be inflated and deflated by the surgeon in response to the patient's needs. This involves minimal discomfort and no need for another operation.
Many of the complications of obesity may resolve or improve after weight loss. These include diabetes, high blood pressure, sleep apnea, joint pain, and urinary incontinence.
The average person loses over 40% of excess weight and experiences a drop in BMI of more than 10 points. It usually takes 2 to 3 years to lose this weight.

The potential complications of laparoscopic adjustable banding system

In addition to the usual risks of any surgery involving general anesthesia, the risks specific to placing a laparoscopic adjustable banding system include:

Erosion of the silicone band (wearing a hole in the stomach)
Slippage of the stomach's position within the band
Perforation of the stomach
Balloon leakage
Heartburn, regurgitation of food
Eventually having the and removed due to problems
Insufficient weight loss, despite a correctly placed and functioning band
Nausea and vomiting, especially if you overeat
Stretching of the stomach pouch: If you continually overeat, you may slowly but surely increase the size of the stomach pouch, thus defeating the purpose of having undergone the surgery in the first place.
Problems with the port not staying in position, which requires a second operation to fix the port in proper position

Review Date: 12/16/2012
Reviewed By: Robert A. Cowles, MD, Associate Professor of Surgery, Yale University School of Medicine, New Haven, CT. Review provided by VeriMed Healthcare Network.

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