Adjustable Gastric Bands
For Certain Level BMI Patients, Adjustable Gastric Band Can Help
Like all the other surgeries described on this site, the adjustable gastric band is appropriate in certain patients and can provide a satisfactory degree of success under the right circumstances, said David Greenbaum, M.D., medical director of the bariatric surgery program at Lourdes Medical Center of Burlington County.
(Lap-Band is the trademarked name for one product used by surgeons, while adjustable gastric band is the generic name for that type of product.)
The gastric band procedure is the simplest, the safest, and usually is done by the laparoscopic technique, said Dr. Greenbaum. That means a recovery time of just days and less pain and discomfort.
"With the band, unfortunately, it is easy to cheat, so there is a moderately high failure rate, especially if your BMI is on the high side," said the surgeon. "People who have a BMI in the low 40s can do well with the gastric band but it is a poor choice in patients with BMIs over 50." (The BMI is a popular index, using height and weight calculations, to estimate health risk related to weight. The upper limit normal BMI is 25. See a BMI calculator here.)
The gastric band is placed around the upper portion of the stomach, creating a much-reduced upper chamber with far less capacity. It works by restricting the amount patients can eat and those who like to eat sweets may often override its effectiveness. Its major advantage is that the gastrointestinal tract is not altered and there is minimal chance that the patient could develop a vitamin deficiency.
The band also controls the stoma (stomach outlet) between the two parts of the stomach. The size of the stoma regulates the flow of the food from the upper to the lower part of the stomach. When the stoma is smaller, you feel full sooner and have a feeling of satiety so you are not hungry between meals.
The inner wall of the band contains a chamber that can be filled with saline to make the band tighter. The band is connected by tubing to an access port that is placed beneath the skin during surgery. Later, the surgeon can change the stoma size by adding or subtracting saline inside the inner balloon through the access port. This adjustment process helps drive the rate of weight loss.
Although the procedure is reversible, there are still changes to the stomach and esophagus that occur as a result of the surgery Less time may be spent in the operating room under anesthesia. Because of certain pre-existing conditions, some patients may be better surgical candidates for the band than the Roux-en-Y gastric bypass
Other potential problems with the band to consider:
- Slower weight loss initially and less weight loss overall.
- Less tolerance to solid food, especially meat.
- More patient compliance necessary due to band adjustments and lifestyle education required.
- Involves placement of a foreign object inside the body, and may require removal and/or replacement.
- Band slippage may require having another surgery.
- Erosion of the band may mean removal of the band or repair of the stomach with the possibility of Roux-en-Y gastric bypass.
- Infection of the port site.
To locate a Lourdes Health System bariatric surgeon by phone, call 1-888-LOURDES.
