Gastric Banding

What is Gastric Banding?

Gastric Banding is a type of restrictive weight loss surgery aimed at reducing the food and calorie intake by reducing the size of the stomach. The stomach size is reduced by placing a band that divides it into 2 small pouches. These pouches can hold very small amounts of food thus, a feeling of fullness is attained very quickly.

Where can I get Gastric Banding?

Country	Cost with MedSolution
India	$16,542 (inquire)

Cost of procedure performed in the US: $30,000.

All prices are in US dollars and include the cost of the procedure and minimum hospital stay. Estimates and minimum hospital stay will vary depending upon individual needs and requirements.

What are the variants of Gastric Banding surgery?

The type of Gastric Banding procedure can be performed either by using a band, a ring, staples or a combination of all.

1. Open Gastric Banding - The band is placed around the upper part of the stomach, forming a small gastric pouch to limit food intake and slow the food passing from the stomach into the intestines.
2. Laparoscopic Gastric Banding - This procedure is popularly known as Lap. Band or Adjustable Gastric Banding. Laparoscopic Gastric Banding is performed with the help of a Laparoscope. In this surgery a small pouch is created by placing a band around a portion of the stomach, thus reducing it's size considerably. The band can be adjusted to accomodate the increased need for food e.g. during pregnancy.
3. Vertical Banded Gastroplasty (VBG) - This procedure of Gastric Banding uses a combination of staples and band. In this procedure, staples are used to create a small pouch which limits the amount of food that can be eaten at one time. The band then prevents the food from leaving the pouch too quickly thus giving you a full feeling that lasts longer.
4. Silastic Ring Gastroplasty (SRG) - In this procedure, a silastic ring is placed at the stoma to control it's size and prevent it from over stretching.

Who is an ideal candidate for Gastric Banding?

If you have obesity-related health problems that significantly interfere with employment, physical mobility or family function, if your Body Mass Index (BMI) is above 40 or above 35 and you suffer from diabetes, or any other serious obesity-related condition such as heart disease or severe sleep apnea and if you have a mind-set to make long term, positive lifestyle and behavioral changes to your diet and exercise routine and are also committed to life long medical follow up, then you are an ideal candidate for Gastric Banding.

What does the procedure for Gastric Banding involve?

Gastric Banding is usually performed under general anesthesia. Gastric Banding can either be performed as an open surgical procedure or it can be performed laparoscopically. Open Gastric Banding procedure typically takes about an hour whereas Laparoscopic Gastric Banding may take a little longer i.e. 11/2 - 2 hours. In Adjustable Gastric Banding (AGB) surgery, an adjustable band is placed about 20 mm below the point where the esophagus joins the stomach (gastro-esophageal junction). Due to creating a stomach pouch that has much reduced capacity, you will experience a sense of fullness after eating just a few bites. In the inner lining of the band, there is a balloon which is connected to a small tube attached to a subcutaneous port which would be placed under the skin on the lower chest or abdomen. At the time of Gastric Banding surgery, the balloon is empty. It is filled up with saline later on, which is injected through the subcutaneous port. The opening in the stomach can be widened or narrowed by increasing or decreasing the amount of fluid in the balloon. Depending on the type of surgery, the incision will either be long or short. The incision will be sutured, you will spend the next couple of hours in the recovery room under observation for immediate post-operative complications.

What is the pre-operative preparation like for Gastric Banding?

Like all major surgeries, pre-oparative preparation for Gastric Banding consists of screening studies like gastroscopy, routine blood examination, a thorough consultation with physical examination by your physician. Make sure that you inform your surgeon about your other health condition, all the prescription and non-prescription medications including vitamin, mineral and herbal supplements that you take. You will be instructed to stop smoking at least 2 weeks before your Gastric Banding surgery and not smoke until your stitches are completely healed. Try to reduce your calorie intake and lose as much weight as possible before the Gastric Banding surgery. You will be instructed not to eat or drink any thing for at least 12 hours before the Gastric Banding operation. You may be required to get hospitalized day before or morning of Gastric Banding surgery.

What is the recovery period like after Gastric Banding surgery?

You will be called in to remove your stitches after about 4 - 6 days after Gastric Banding operation. You will be expected to rest at home for the next few days, after that you can resume your daily activities gradually and carefully. Make sure not to lift any weight or participate in any strenuous activities like playing sports etc for about 6 weeks following Gastric Banding surgery. It is extremely important that you follow your surgeons instructions on your diet plan. Your diet will consist of clear liquids for several days, followed by a liquid diet of low fat, low sugar, low calorie liquids and soups for 4-5 weeks. After this liquid diet plan, soft high-protein foods may be added, and thereafter you can proceed to eating soft meats, fruits, vegetables and grains. Make sure you chew your food thoroughly and do not drink any liquids after eating as it might cause vomiting.

What is the outcome of Gastric Banding?

Morbid obesity poses an increased risk to health problems like diabetes, heart disease and is an increasing problem worldwide. The results achieved by weight loss surgical procedures especially Gastric Banding (open or laparoscopic method) has long lasting success. You can lose about 75% of your weight in five years and keep it off provided you closely follow the diet and exercise plan as outlined by your surgeon. Like all other weight loss surgeries, the outcome of Gastric Banding largely depends on your commitment to follow exercise and diet regime.

B . R . A . N . D . of Gastric Banding

Benefits of Gastric Banding

• There is rapid loss of weight soon after the Gastric Banding operation
• Laparoscopically performed Gastric Banding is a relatively safe procedure and requires short hospital stay.
• There are smaller scars
• There is no cutting of the stomach
• Gastric Banding is reversible and adjustable if need be.

Risks of Gastric Banding

• Leakage or pouch enlargement due to slippage of band or formation of fistulas.
• Infection at incision site
• Leakage of stomach contents in the abdominal cavity resulting in peritonitis
• Nutritional deficiencies
  • Anemia - Vitamin B12 deficiency
  • Osteoporosis - Calcium deficiency
• Gallstones
• Pain and vomiting due to overeating

Alternatives to Gastric Banding

• Gastric Bypass - Gastric Bypass operation is considered to be the 'Gold Standard' for weight loss program in morbidly obese people. This surgery offers a successful combination of weight loss without significant nutritional deficiency. The Gastric Bypass operation restricts food intake and reduces the feeling of hunger. As a result, you experience an early sense of 'fullness' and satisfaction just after eating a few bites of food.
• Laparoscopic Gastric Bypass - Laparoscopic Gastric Bypass is performed to create a small pouch out of a portion of stomach. Laparoscopic Gastric Bypass surgery helps you to fight the problem of obesity. You can lose about 75% of your excess weight and maintain the weight loss for years after Laparoscopic Gastric Bypass surgery.
• Bilio-pancreatic diversion or Bilio-pancreatic diversion with duodenal switch - This operation restricts your food intake and also the amount of calories and nutrients your body can absorb.

Now or Never

• Gastric Banding surgery commonly referred to as Laparoscopic Stomach Stapling is an excellent option for you if you are severely obese and cannot lose weight by traditional means or if you suffer from serious obesity-related health problems. Timely Gastric Banding surgery accompanied by change in eating behavior and regular exercise can decrease your chances of developing serious and life threatening health problems. The procedures of Gastric Banding are quite effective in maintaining the weight loss. Morbidly obese individuals can expect to loose 70 - 80% of their excess body weight. The weight loss is maintained, in most patients, for lifetime.

Decision to have Gastric Banding

• Following Gastric Banding surgery most people start to lose weight immediately. However, there are some long term problems due to malabsorption of nutrients like iron, vitamin B12 and calcium deficiency which can be prevented if you work closely with a dietitian and follow their advice. This is most definitely a sure shot way to lose weight and keep it off.