Gastric Band

The gastric band is a surgical procedure that suppresses the natural feeling of hunger in people who are overweight. A silicone band is wrapped around the upper part of the stomach during the procedure. As a result, a very small stomach pocket is created artificially. The stomach signals satiety when this fills up while eating. 

During an operation, a silicone tube is wrapped around the upper part of the stomach and called a gastric band. It divides the stomach artificially into a small "pre-stomach" (pouch) and the large rest of the stomach. The forestomach is only 20 to 30 milliliters in volume. This is roughly the size of a ping pong ball. When the forestomach is stretched by eating, the brain receives a satiety signal. The gastric band is thus a weight-loss aid, primarily by suppressing the feeling of hunger.

The gastric band is hollow on the inside and is linked to a port system by a small tube. During gastric band surgery, a small chamber is implanted beneath the skin. Liquid can be injected into the port chamber and thus into the gastric band using a special needle. The degree of gastric constriction can thus be adjusted as needed: the more liquid injected into the gastric band, the more the stomach constricts. When liquid is removed, the inner diameter of the gastric band increases and the stomach expands.

 

Gastric band surgery takes between 30 and 60 minutes and is done under general anesthesia. The hospital stay typically lasts from one day before the operation to three to five days afterward. The procedure is typically carried out through a keyhole incision (laparoscopy). The keyhole technique involves making five two-centimeter skin incisions through which the camera and instruments are inserted. A slightly larger skin incision at the lower edge of the breastbone is also required for port implantation.

One of the working channels is inserted with the silicone band. The surgeon places the band around the upper part of the stomach (cardia) and pulls it together like a cable tie. To better assess the size of the forestomach, a gastric tube with a small, expandable balloon is inserted through the mouth into the forestomach. When unfolded, this is roughly the size of a table tennis ball (volume approx. 20 – 30 ml) and roughly corresponds to the forestomach's final volume.

After inserting the gastric balloon, the gastric band can be slightly tightened or adjusted up or down. Once the gastric band is in the proper position, it is sutured to the surrounding tissue.

Finally, the tube and port chamber from the gastric band are removed through an incision in the abdominal wall and sutured under the skin at the lower end of the breastbone. The gastric band diameter can be adjusted at any time via the port by removing or adding liquid.

The port is punctured for the first time about a month after the gastric band operation to introduce a few milliliters of liquid. The liquid is usually an X-ray contrast agent, which is visible in the X-ray image (maximum 9 milliliters in total). An X-ray image, for example, can reveal a leak in the gastric band. Depending on your occupation, you should be able to return to work two to three weeks after the operation.

 

The gastric band is appropriate for people with a BMI of 40 kg/m2 (obesity grade III). If a person has a BMI of 35 kg/m2 and suffers from other metabolic diseases such as diabetes, high blood pressure, or sleep apnea as a result of being overweight, a gastric band may make sense.

However, the prerequisite is that all conservative (non-surgical) measures tried for six to twelve months were ineffective. Nutritional counseling, exercise training, and behavioral therapy are examples of such measures (multimodal concept, MMK). Gastric band surgery requires you to be at least 18 years old and no older than 65, though the procedure can be performed on younger or older patients in some cases.

 

Certain physical and mental illnesses argue against obesity surgery like the gastric band: Previous stomach operations or malformations, stomach ulcers, and addictions or untreated eating disorders (e.g. "binge eating" or bulimia) are all significant contraindications to a gastric band. Pregnant women and people on long-term anticoagulant medication are also barred from getting a gastric band.

 

• The gastric band is regarded as the safest weight loss surgery. It is a low-risk, minimally invasive procedure with few complications.

• Gastric band surgery  has smaller scars, and less pain than other gastric surgery procedures.

• A gastric band does not require any permanent changes to your body, such as removing a portion of your stomach or rerouting and stapling your body. It is fully reversible and removable if desired.

• In the two years following surgery, patients lost 50 to 60 percent of their body weight. The majority of the weight is lost in the first twelve months.

• Obesity-related illnesses such as sleep apnea, heart disease, stroke, Type 2 diabetes, high blood pressure, arthritis, fertility issues, and psychological health can all be improved or eliminated. Finally, your confidence and self-esteem will improve, and you will have a more optimistic outlook on life.

 

On the first postoperative day following the operation, the diet consists solely of liquids. These are consumed slowly and in small sips throughout the day. The hospital will send you a nutrition plan that describes the nutritional structure in detail for the next four weeks. Only liquid food will be available for about two weeks. Only soft foods will be available for the next two weeks. You can resume eating normally four weeks after the operation. However, there are a few factors to consider:

• Gastric band wearers must not only eat less, but also eat differently than before. Each bite must be chewed thoroughly in order for the food pulp to pass through the bottleneck. Long-fiber meat (beef, pork) and vegetables are frequently problematic.

• Because liquids, at least temporarily, fill the small forestomach, you should separate eating and drinking.

• Gastric band users should avoid sweets, particularly sweet drinks, as well as alcohol, high-calorie soups, and porridge. They pass unhindered through the constriction between the forestomach and the rest of the stomach, causing you to gain weight and negating the weight loss effect.