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Gastric Banding

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Gastric Banding

Overview

Obesity is characterized with highest increase in prevalence around the world. Even though there are tens of medical etiologies of obesity, the most important ones are abnormal weight gain and sedentary lifestyle. Life time of obese patients is approximately 15 years shorter than other people due to diseases caused by obesity, including but not limited to hypertension, type 2 diabetes, hyperlipidemia, ischemic heart disease etc. Obesity is a risk factor for cancers such as colorectal cancers, breast cancer and prostate cancer.

Gastric banding surgery facilitates weight loss. In this surgery, a band is placed that completely surrounds the stomach by your surgeon. This band narrows your gastric inlet and makes you feel full with a small amount of food. After the surgery, your surgeon can adjust the band so that food can pass through your stomach faster or slower.  Contrary to gastric sleeve surgery that utilizes both mechanical and hormonal factors, gastric banding surgery provides a quick feeling of fullness due to narrowing of the gastric passage, resulting in losing the excess weight.  

Why is this procedure done?

This method began to be used in weight loss surgeries 15 years ago when daily use of close surgeries became widespread. This method is colloquially known as ‘stomach stapling’ since it compresses the stomach immediately under the area where the esophagus enters into the stomach. This method functions by restricting food intake into stomach. Since it does not cause loss of appetite, patients try to find a way to take food and they consume liquid foods rich in calorie such as ice cream or honey. Despite tabloid news, rate of complication and death is lower than other surgical therapies when it is performed by experienced physicians. Even if it seems advantageous since it can be removed at any time and it does not cause a permanent change in body, long-term success rates are low. In other words, even though gastric band is placed, patients may start gaining weight again with consuming high calorie foods which "trick" the “gastric banding”. Moreover, it may be necessary to remove it because of long-term problems that are faced in 30-40% of the cases.

Therefore, it will be the most suitable approach for you to ask all your questions to your surgeon before deciding on a gastric banding surgery to manage the postoperative period.

Risks

As the case for all surgeries, gastric banding surgery involves some risks.

Although all possible measures that modern medicine allows are taken to prevent occurrence of risks, it is no means possible to warrant that the risks will be completely eliminated.

Albeit possibility of facing a major complication is very low in gastric banding surgery, potential complications are listed below:

  • Infection
  • Clot formation and migration of the clot to other body parts
  • Anesthesia-related complications
  • Organ injury
  • Gastric erosion
  • Shift or migration of the band
  • Need to remove the band
  • Insufficient nutrition

Your surgeon will explain in detail whether those risks apply to you or if so, the rate of occurrence.

Preparation

The first phase of preoperative preparation is same in all Medicana Hospitals. Decision of gastric banding surgery is made following a series of medical tests and examinations.  Your doctor will make a comprehensive assessment to determine whether this surgery helps your complaints or not.

In the preoperative period, all of your prescription and over-the-counter medications, your comorbidities such as obesity-induced hypertension, diabetes mellitus and cardiovascular diseases, and your overall health will be assessed.  All these assessments will both help you be ready for the surgery and minimize the problems that can be encountered during or after the surgery.

  • Review of health history
  • A detailed physical examination
  • Necessary laboratory tests and radiology studies
  • Assessment by anesthesiologist and other laboratory tests and radiology studies to minimize anesthesia-related complications

After it is verified that the surgery does not pose risk, you will be asked to quit smoking, if you are a smoker, and to stop taking certain medications that increase risk of bleeding. All other prescribed and over-the-counter medications, herbal products and supplements will also be questioned and you will be informed to continue or stop taking them.

A preoperative discussion with your surgeon about gastric banding surgery is very important. All details of the procedure, potential risks and healing period are explained.  

Moreover, it is reasonable to plan discharge, post-discharge accommodation and travel at this phase in order to manage postoperative period better.

Surgery and early postoperative period

Gastric banding surgeries are performed under anesthesia with laparoscopic approach to a great extent.

Your surgeon makes small incisions.  First, your abdominal cavity is inflated by CO2 gas through one of those incisions. Then, a camera is inserted into your abdominal cavity. Other incisions are used for surgical instruments to be inserted into your abdominal cavity.

The band to narrow the inlet of the stomach is placed to the upper part of the stomach and secured. Accordingly, a pouch is formed in the upper part of the stomach.  Next, the reservoir that contains the fluid used to inflate the band is placed beneath the skin. The saline solution in this reservoir is used to inflate the band and thus, your physician can narrow the inlet of your stomach gradually.

This surgery takes 30 minutes to 1 hour in average.

Your surgeon will decide on how long you will stay at the hospital after the surgery.

After you recover from anesthesia and you are ready to walk, you will be mobilized by or under supervision of our healthcare professionals.

You will be given pain killer(s) after the surgery in order to manage the postoperative pain.

Treatments will be started and measures will be taken to eliminate risks arising out of clot formation.

You may also need to use antibiotics to prevent a possible infection.

It is very important that you follow all instructions of your doctor after the surgery to protect and support the outcome of the surgery.

You should see your surgeon for follow-up visits that are scheduled before you are discharged.

If you experience warmth and redness in your incision line, or if you have a fever or any symptoms that you think are due to surgery after you are discharged, contact your surgeon immediately.

Results

This method functions by restricting food intake into stomach. Since it does not cause loss of appetite, patients try to find a way to take food and they consume liquid foods rich in calorie such as ice cream or honey.

Therefore, for the people who are placed a gastric band, compliance to diet and lifestyle changes is of great importance.  Otherwise, losing weight as a result of this procedure may not be possible.

Albeit it is advantageous regarding future removal of the band, the requirement of patient’s compliance and complication risks in the long run are the disadvantageous aspects of this procedure.