Under general anaesthetic and using laparoscopic keyhole surgery, an inflatable band is inserted, placed to sit around the top of the stomach and is locked into place. The stomach is then restricted by inflating the band through a tube that controls the amount of food that enters the stomach, encouraging weight loss.
Although it is a permanent weight loss procedure, it can usually be removed using keyhole surgery and without any long-term consequences to your stomach.
The surgery is a minimally invasive lapascopic procedure that helps to reduce recovery time. Weight loss varies from patient to patient, but in general patients who comply with the advice given following surgery would expect to lose between 50-80% of their excess weight within two years, much of it within the first few months. Surgery helps to control weight but it also requires a commitment to a lifelong diet and regular exercise plan to maintain a healthy weight.
It is important that you are fully aware of the implications before committing to gastric band surgery as it requires a change to the way you think about food, eating and drinking, and exercise. Losing weight before surgery will help with your recovery, increase your rate of weight loss and help with the transition to a post-operative diet.
Once surgery is agreed, you will need to follow a strict diet in the two weeks prior to the operation in order to prepare your body for the surgery. A pre-operative diet will help shrink your liver and also reduce fat in your abdomen, allowing the surgeon to operate more easily and safely.
You will also be advised to stop smoking as this will increase your risk of getting an infection after surgery, which can slow down your recovery. It can also make your surgery less effective and can lead to complications.
Under general anaesthetic, an inflatable band is inserted using laparoscopic keyhole surgery, and placed to sit around the top of the stomach, just below the gullet, and locked into place.
The stomach can then be restricted, by inflating the band through a tube. The tubing travels internally to a port, just beneath the skin on top of the muscle of the tummy wall. This can be felt through the skin to allow injection of solution into the port that tightens the ring when adjustments are required, thus creating an hour-glass effect on the stomach.
The much smaller pouch above the ring quickly fills with food, limiting the stomach's ability to take food and restricting the ability to eat any more, whilst giving a sensation of fullness.
The band's effectiveness will be reviewed as part of your regular 8-12 week follow-up cycle and topped up if needed. It's a simple procedure to inject further saline solution through the port, which then flows into the ring, tightening it. The follow-up team will then ask you to sip some water to check that the ring is not too tight.
It may take you a week or two to recover from gastric band surgery however, this can vary from person to person, so it is important to follow your surgeon's advice.
You may be asked to wear compression stockings to help prevent blood clots forming in the veins in your legs.
In most cases patients can leave hospital after two days and would be advised to be off work for two weeks. You will have access to a dietician for nutritional advice, including diet sheets if you wish and you will have face to face follow up appointments for several months afterwards to monitor your progress.
In the two week post-operative period you will be permitted to only take liquids, before easing yourself into more solid foods. Whilst you are off you will be advised to avoid sleeping or sitting for long periods, and to push yourself to be generally mobile, as this will help you avoid blood clots forming. You should also avoid lifting heavy objects and you should not drive.
Following surgery you will need to change your eating patterns and your diet, cutting out certain foods that may cause you problems in your changed gastro-intestinal situation. Eating smaller amounts and choosing carefully which foods you eat should help to reduce any nausea as well as helping with weight loss.
Your dietician may suggest dietary supplements to ensure you get the nutrients you need for energy and good health. You will need to eat smaller portions and will also have to chew your food thoroughly or you may experience discomfort.
All surgery, even minimally invasive laparoscopic surgery, has risks such as bleeding, infections, or clots forming in the legs and travelling to the lungs. With gastric band surgery there is a small chance of complications such as infection resulting from leakage of the band tubing, or slippage or erosion of the band ring, but this has now been minimised by the use of new stapling technology.
It is likely that you may have some bruising, pain and swelling on your skin around your wounds. If you should require pain relief after your surgery, or if you experience any side-effects, it is important to discuss this with your surgeon.
Once your gastric band is fitted, you may feel sick or vomit after you eat, especially if you try to eat too much. It is important to chew your food well and avoid foods that are difficult to digest.
Other weight loss options include lifestyle changes, weight-loss programs, psychological treatments and medication. The effectiveness of each of these options will depend on the problem and the individual concerned:
Lifestyle changes involve making changes to diet, undertaking exercise and altering other lifestyle habits, either on their own or with the aid of a self-help support group.
Weight-loss programmes set out an eating pattern and give dietary advice, as well as an exercise programme.
Psychological treatments can support the patient's thoughts, feelings and actions towards themselves and their relationship with food, eating and exercise.
Medications; There are new medicines on the market which may help you lose weight, which can be prescribed by your GP.
In our experience, most candidates for weight loss surgery have already undergone some or all of the other treatment options. The specialist team at Benenden Hospital, led by your consultant, will discuss how effective these weight loss methods have been for you to establish if surgery is an option and how they can support you in the future.