Adjustable Gastric Band
Surgeon Explains Facts to Patients On Adjustable Gastric "Band-Wagon"
The adjustable gastric band is the simplest bariatric surgery available from Yves Manigat, M.D., who performs bariatric surgery program at Our Lady of Lourdes Medical Center. Because the primary mechanism is a ring (band) placed around the stomach, patients can grasp the surgery details quickly.
"The gastric band is purely restrictive, unlike gastric bypass which reduces the stomach size and also alters the absorption by the intestines," said Dr. Manigat.
"Using the band, the surgeon creates a little pocket or pouch from the upper portion of the stomach and there is a locking mechanism to keep it in place. The pouch becomes the initial reservoir and is quickly filled."
Before further explaining the process, Dr. Manigat injected a few other facts about the adjustable gastric band. One is that this purely-restrictive surgery usually is not recommended for patients with huge amounts of excess weight. It is unlikely that a person can lose, for example, 200 pounds, as a result of this surgery, he said.
And while patients often enter his office seeking the gastric band surgery, he always distributes the facts about the average success rates with the band. Most times the gastric band surgery patients will lose about 60 percent of their excess weight while gastric bypass patients may lose 85-95 percent of excess weight, he said.
Although the gastric band surgery is reversible, Dr. Manigat said he does not emphasize that to prospective patients. "Because if people want and get it reversed, before you know it they are back to their initial unhealthy obesity," he said.
The key to a successful gastric band is to constrict the new pouch sufficiently to allow just enough food to get through, limiting food consumption while still creating a sense of "fullness."
That takes several sessions to gradually adjust the ring, which is done via a flexible, saline-filled lining attached to the inside of the ring. The adjustable container is connected via a tube connected to a port which is implanted near the skin of the abdomen. The amount of saline in the circular container can loosen or narrow the constriction around the stomach to regulate the amount of consumed food released into the intestine.
To loosen the band, a needle inserted into the port extracts saline; to narrow the band more saline is inserted. Initially, there is a gradual narrowing of the band after surgery so the patient feels a sensation of fullness and does not indulge in destructive eating habits, the surgeon said.
"The gastric band needs adjustments for various reasons," said Dr. Manigat. "When you lose fat around the stomach, this creates more space, loosens the band and you lose the sensation of fullness. So then we need to inject more solution to narrow the constriction."
Gastric band patients certainly can lose 100 pounds if they comply with the diet he provides. But cheating with the gastric band is an issue for some patients, "which is why they do not come back for adjustment and you never see them after that," he said. "They can lose initial weight, but you need to come back for adjustments to keep losing weight."
Because the laparoscopic technique uses only five small incisions and causes little distress to nearby internal organs, the patient benefits in a number of ways, which he outlined below:
- Foremost, it is better tolerated, even on less healthy patients, with no significant alteration of their vital functions.
- The fluid shift usually associated with open surgery does not occur, eliminating the need for excessive fluid replacement.
- Very little pain and discomfort is reported and the need for post-operative narcotics is significantly reduced.
- The recovery is hastened, allowing for a short hospital stay and a quick resumption of normal activities, including work.
- Because surrounding organs are less likely affected, the risk of complications is markedly reduced.
To locate a Lourdes Health System bariatric surgeon by phone, call 1-888-LOURDES.
