Gastric banding

Gastric band surgery is a surgical technique where a band is placed at the top of the stomach, reducing its size and the patient's appetite. This technique is carried out laparoscopically requiring at most one night in hospital.

How gastric banding works

It's a procedure for the very overweight (morbidly obese). Extreme cases of obesity may be suitable for gastric banding. The "band" looks like one of the plastic clips you may use in the kitchen to reseal bags. It is placed around the upper part of your stomach decreasing it's size and restricting the amount of food you can eat.  In the immediate post-operative period your weight may decrease quite quickly, but after a few weeks (approximately 6 or so) you may find your weight begins to plateau and you will then be advised to have the band inflated by a Consultant Radiologist who works closely with Mr Boyle.

It doesn't "close off" your stomach - rather, it makes the upper stomach (where food arrives first) much smaller in capacity. This means you'll feel full much faster. The food then passes slowly through the small gap in the band to be digested in the normal way. Providing a healthy well-balanced diet is followed after insertion of a band you should not suffer nutritional deficiencies.  Ideally you should aim to lose between 1/2-1kg per week.  It is an effective tool that helps achieve substantial and long term weight loss.  On average 60-70% of patients with a gastric band in situ can be expected to lose 60-70% of their excess weight.  In this procedure the stomach is not cut, stapled or re-routed in any way, and although the band can remain in permanently, it is possible to have it removed if necessary.

While a low-risk procedure, Mr Boyle will only perform gastric banding if other methods of weight loss have failed. In general, it won't be offered to you unless you're very overweight with a body mass index (BMI) of more than 35, or if there are sound medical reasons (such as diabetes) that weight-loss would be advised.

Gastric banding is not covered by private medical insurance, and, although in some cases is available on the NHS it is not currently available in the Tunbridge Wells area and the wait can be lengthy with very strict criteria needing to be met. See our Self Payers page for more information.

Multi-disciplinary Team

Once you have had an initial consultation with Mr Boyle and decide you would like to proceed with a view to surgery he will advise that you consult with the other members of the Obesity Multi-disciplinary Team.  Dr Dennis Barnes is a Consultant Endocrinologist; Mrs Claudia Williamson a Nutritional Therapist and Mr Nathan Faulkner a psychotherapist with a special interst in bariatric surgery.  Once they have given their agreement that surgery is the right course of treatment for you, your surgery can be booked.

Procedure

Mr Boyle uses the Swedish adjustable gastric band.  This is inserted laparoscopically (keyhole) under a general anaesthetic.  The operation normally takes 45-60 minutes.

The band is secured in place around the top of the stomach creating a small pouch and limiting the amount of food you can eat at any one time.  This is connected via a length of tubing to a small port fixed under the skin just below the breast in your upper abdomen.  This device is used to "fill" the band with fluid to maintain optimal restriction.  It will not set off the metal detectors at airports, so there is no need to worry about that!

Following your operation you will normally remain in hospital overnight, although in some cases it may be possible to return home the same day.  It is impossible to be exact on recovery time but many patients find they are able to return to work within a couple of days, whilst others may find it takes approximately two weeks to return to normal activities or work dependent upon the nature of your work.  Mr Boyle will advise regular follow-up consultations to monitor your progress.

Diet

For the first few weeks following your operation you need to eat a liquid or pureed diet, this will enable your body to heal and for the band to settle firmly in place.  You should then progress to a soft diet before returning to solid foods.  Having a band in situ will not alter the way you digest food and so if you follow a healthy diet you should not experience any nutritional deficiencies. 

Following insertion of a Swedish adjustable gastric band your portion sizes should greatly reduce.  You should find a starter-sized portion will be sufficient and you should not find you want to pick between meals.  You must remember that the band is a tool that restricts the quantity of food you can eat, but to achieve your goal you will need to ensure you follow a healthy diet and you should follow a few simple rules:

 Following your surgery you should also aim to increase the amount you exercise to three or four times per week.  This will greatly increase the overall success of your procedure.

Risks

Laparoscopic insertion of a Swedish adjustable band is a very safe procedure.  However all operations carry an element of risk, especially when you are morbidly obese.  These risks include:

 

Life After Weight-loss Surgery

Your operation is the first step in your treatment which will continue for the rest of your life.  It is likely to take time to adjust to the changes in your body but you will gain the rewards of improved health, looking and feeling better and being able to participate in increased activities, without the additional benefits to your health. 

Following your surgery you should also aim to increase the amount you exercise to three or four times per week.  This will greatly increase the overall success of your procedure.

It is important to remember that it will take time to get out of some of the bad habits that have contributed to your excessive eating in the first place.  The continued support of the Obesity Multi-disciplinary Team may help you to overcome any problems you may experience.

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Julie Wood
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