Gastric Band Surgery Facts
The Adjustable Gastric Band is an obesity surgery also known as LAP-BAND and Realize Band. The gastric band is a relatively safe weight-loss surgery that takes about one hour to perform. There are gastric band risks, however. Gastric band complications can be frequent, and as many as 26% of patients experience some kind of difficulty.
The gastric band surgery decreases the size of the stomach by affixing a silicone and Silastic band around the top portion. An attached balloon is filled and unfilled with saline through the recovery period until an appropriate band tightness is had. Gastric banding reduces the size of the stomach and makes the patient feel full on less food.
Gastric band surgery cost can be less than other types of bariatric weight-loss surgery. Gastric band complications are not as severe as those from other bariatric surgery options, although full failure and removal of the band are among these complications.
Gastric Band Risks
There are gastric band risks and the band itself can be a source of trouble. For example, band erosion is when the band grows into the stomach and might eventually wear a hole in the stomach wall. When the surgery was new, erosion was as high as 10%. It is now down to about 1%. Should erosion occur, the band must be removed permanently.
Band intolerance is when the body cannot tolerate the band. Vomiting and excessive discomfort are the result. Once again, relief is had only after the band is removed.
Gastric band leaks are suspected when the patient feels a change in the amount of restriction. Leaks at the balloon are caused by needle punctures or factory weak points in the balloon. Leaks at the tube connection occur when there is a break in the tube next to the metal connector. Leaks at the body of the tube are caused by unintentional needle punctures. Port membrane leaks occur when the patient has received numerous fills or when an improper needle is used for fills or adjustments. Surgery is normally required to repair leaks.
Band slippage is when the lower part of the stomach slips through the band and increases the size of the pouch. Anterior slippage is when the front part of the stomach slides up through the band. Posterior slippage is when the back side of the stomach slides up through the band. Symptoms of band slippage are reflux, nausea, and vomiting. Slippage is remedied either by fluid removal or surgical repositioning.
Blood clots are a concern because overweight people are at higher risk for them when having any kind of surgery.
Constipation is possible and is addressed by increasing water intake and taking fiber supplements.
Esophageal dilation is when the esophagus becomes enlarged because the band is too tight or incorrectly placed. Deflation of the band will resolve this problem.
Food trapping is when food becomes lodged in one of the openings in the digestive system. The problem is addressed by deflating the band entirely and allowing the food to pass.
Gallstones occur is as many as one-third of bariatric surgery patients due to accelerated weight loss. The doctor can remove the gallbladder during surgery or prescribe bile salt supplements afterwards.
Nausea and vomiting are common side effects following weight-loss surgery and occur about 70% of the time. A doctor ordered bariatric diet will address this problem.
Port problems are reported by about one in five of all gastric banding patients.
Port flip is when the band flips over. The problem is not particularly serious and a simple procedure can turn it back over.
Port leak is self-explanatory, and surgery is usually required to repair it.
Port infection can usually be resolved with antibiotics although band removal could be necessary.
Port dislocation is when the port moves from the original placement. A simple operation can fix this problem.
Gastric Band Surgery Results
Average weight loss after gastric band is 40% of the excess weight. Gastric band surgery is considered a failure if the patient loses only 25-30% or less of their excess weight, or if the band needs to be removed due to complications. It is possible to revise a failed gastric band to another bariatric surgery, such as the gastric bypass or gastric sleeve.
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Photo: Dr. Vishal Mehta