Gastric Band Removal
Laparoscopic Weightloss Surgeries
An overview of gastric band surgery
Gastric band surgery, also called laparoscopic adjustable gastric banding (LAGB) or lap band surgery, is a weight loss procedure that restricts food intake without permanently altering the stomach’s anatomy.
This minimally invasive keyhole surgery involves placing a silicone band around the upper part of the stomach, creating a small pouch into which food passes. This helps limit food intake and promotes a feeling of fullness early after eating. This procedure helps patients to achieve weight loss by reducing calorie intake and promoting prolonged satiety (fullness).
How the gastric band works
The concept behind gastric band surgery is to help individuals lose significant weight by reducing their food intake. The gastric band is adjustable, which means it can be tightened or loosened over time to control the amount of food that the stomach can hold.
This adjustability makes it a flexible option for long-term weight management. By creating a smaller stomach pouch, patients feel full after eating smaller portions of food, which aids in reducing overall calorie consumption and promoting weight loss.
Criteria for surgery
Candidates for gastric band surgery typically include individuals who:
- Have a Body Mass Index (BMI) of 35+ and favour a lower-risk reversible operation.
- Have a BMI of 30+ with obesity-related health conditions such as diabetes, hypertension, or sleep aponea.
- Have not been able to achieve and sustain significant weight loss through diet and exercise alone.
- Are committed to making permanent, long-term lifestyle changes and participating in follow-up care.
It is important for candidates to undergo a thorough medical evaluation and consultation with a bariatric surgeon to determine if gastric band surgery is the appropriate option for them. Psychological assessments and nutritional counselling are often part of the pre-surgical process to ensure patients are fully prepared for the lifestyle changes required after surgery.
What happens during the procedure
The gastric band procedure is performed via keyhole surgery and involves making five small incisions. Here’s what to expect:
- Preparation: The patient is positioned safely on the operating table, and small incisions are made in the tummy.
- Insertion of Instruments: A camera (laparoscope) and surgical instruments are inserted through the ports to guide the surgeon during the procedure.
- Band Placement: A tunnel is created behind the stomach, and the band is secured around the top of the stomach, forming a small pouch that limits food intake.
- Connection: A tube connects the band to an access port placed just under the skin on the front of the tummy, which allows for adjustments post-surgery by adding or removing saline solution.
- Closure: The ports are removed, and the incisions are neatly closed with dissolvable sutures and surgical glue.
The procedure typically takes about 45 minutes, and patients are usually able to go home the same day.
Results Expected
Following surgery, patients can expect gradual weight loss – in the order of 1-2 pounds per week. The total amount of weight lost varies between patients depending on adherence to dietary instructions and the amount of activity undertaken. Studies suggest that most patients can expect to lose between 15-20% of their total body weight within one year.
Weight loss results depend on the patient’s adherence to dietary and lifestyle recommendations including undertaking reagular exercise. Regular follow-ups are crucial to adjust the band for optimal results and to monitor progress.
Aftercare
Post-surgery care is essential for the success of gastric band surgery:
- Dietary Changes: Patients will start with two week liquid diet, progressing to pureed foods for two weeks, then soft easy to chew foods for two weeks, and eventually textured solid foods. It is important to eat slowly, chew thoroughly, and avoid drinking fluids during meals.
- Regular Adjustments: The band will need periodic adjustments (adding or removing saline) to control the size of the stomach pouch and optimise weight loss. These adjustments are done through the access port under the skin. Patients will need to attend clinic monthly for the first few months to allow band adjustments. Some patients may need 6-8 band adjustments in the first year to reach the optimal amount of fluid in the band.
- Follow-up Appointments: Regular visits with the surgeon are necessary to monitor progress, make band adjustments, and address any concerns or complications.
- Lifestyle Changes: Long-term success requires commitment to healthy eating habits, regular physical activity, and ongoing medical support. Patients should also attend support groups or counselling sessions to help them stay motivated and address any emotional challenges related to weight loss.
Complications
Patients need to be aware that gastric bands can be associated with high long term failure and complication rates (in up to 40% of patients). Examples of commonly encountered problems include:
- Failure to lose adequate weight or weight regain in future.
- Band slippage which could be acute (and need emergency surgery to remove the band) or chronic (leading to pouch dilatation and reduced effectiveness of the band).
- Acid heartburn, indigestion and reflux symptoms.
- Capsule formation (dense scarring around the upper stomach where the band sits) which can lead to difficulty eating (food sticking after swallowing, pain on eating, regurgitation, vomiting)
- Oesophageal dilatation and dysmotility (leading to difficulties in eating).
- Band erosion (when the band ulcerates into the stomach reducing the efficiency of the band and resulting in band infection)
- Power-related complications such as the access port becoming flipped or dislodged, tubing breaks or leaks – all these require reoperation to correct.
As the band is a foreign body, the vast majority of patients will need the band removing in future due to development of one or more of these complications. For this reason Dr Sherif has stopped offering the gastric band as a weight loss surgery option.
Start your Weight Loss Journey! If you seek Gastric Band Surgery - Consult with Dr Sherif Awad
It is important to choose the right surgeon for your weight loss journey. Dr Sherif Awad is a leading bariatric surgeon with over 10 years experience. If you are considering gastric band surgery, schedule a consultation with Dr Sherif Awad and discuss your weight loss surgery options.
If you are considering gastric band surgery, Dr Sherif’s comprehensive approach includes pre-surgical assessments, personalised surgical plans, and post-operative support to ensure the best possible outcomes for his patients.
Start your weight loss journey with confidence under the expert care of Dr Sherif Awad.
