Gastric banding is a surgical procedure that is done for the management of obesity. Gastric banding is one of the many bariatric surgeries that are done for the management of obesity. Obesity is a leading cause of death worldwide, while it can be medically managed, surgical intervention ensures greater weight is lost and a lesser amount of weight is regained. In gastric banding bariatric surgery, the size of the stomach is reduced by placing an inflatable silicone device around the top part of the stomach. The smaller size of the new stomach helps to reduce the amount of food that is eaten and ensures early fullness and satiety, and the slow passage of food through the stomach.
Gastric banding bariatric surgery is an elective procedure.
Gastric banding surgery is mostly done via the laparoscopic route and may use one of the following types of bands:
The indications for gastric banding bariatric surgery include:
Body mass index is the relative weight for height and it also relates to the total amount of body fat that is present. It is calculated as:
Body mass index = weight in Kg/(height in meters)2
The contraindications and risk factors for gastric bypass surgery include:
Some investigations that are done before gastric bypass bariatric surgery include:
Before a weight loss surgery, the following are done:
Duration: Gastric banding bariatric surgery can last between 1 to 3 hours depending on the type of procedure that is being.
Anesthesia: Gastric banding is generally done under general anesthesia with intubation.
With the individual lying on his/her back, iv lines and urinary catheter are put in place, endotracheal intubation is done and after the general anesthetic has taken effect, 4 to 5 small incisions are made in the abdomen through which a fiber-optic scope and other surgical instruments are introduced after abdominal insufflation. The liver is retracted and the dissection of the gastrophrenic ligaments and a window is created near the gastrohepatic ligament. A small tunnel is then created in the retroperitoneal fat behind the stomach. A band is then passed through the tunnel and placed such that the balloon of the band is facing the stomach and the fundus of the stomach is then sutured with absorbable sutures. Exteriorization of the tubing of the band is done by clearing the connective tissue covering the abdominal muscles and the balloon is completely deflated. The surgical instruments are removed, insufflation is done, and the incisions are closed with sutures.
After the gastric banding surgery, the following are done:
Common post-procedure occurrences:
Discharge: Usually on the 1st postoperative day if there are no complications.
Review: Usually done after 4-6 weeks for the adjustment of the gastric band by inflating the balloon with saline solution. The next adjustment is done at the end of 8 weeks after the procedure. Further adjustment s are done as required every 1-2 months until the individual is comfortable.
Some measures that may be taken after gastric banding surgery include:
Some complications that may be seen after a gastric banding surgery may include:
The prognosis of gastric banding is good especially in young individuals with very high BMI and long-term reduction of body weight. It has been observed that the gastric band would eventually need to be removed in a lot of individuals. In comparison, gastric bypass surgery shows better long-term results and control of comorbidities.
Brief hospitalization will be required for gastric banding.
Gastric banding is done by specialists from the Department of Surgical Gastroenterology and Interventional Endoscopic Surgery.