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Adjustable gastric banding surgery is now one of the most popular methods of restrictive weight loss surgery in the UK and Europe. gastricv banding or bariatric surgery is a surgical procedure specifically designed to assist in wieght loss for obese or morbidly obese patients who generally have a body mass index (BMI) of between 35 to 40 or sometimes a little higher.
The Gastric banding appliance itself is an inflatable prosthetic medical device which is placed around the opening and top section of the patients stomach . A tube is connected to this banding devices via a tiny keyhole laparoscopic surgical procedure. Once the gastric banding device is in situ around the top of the stomach the gastric banding device is then filled, or inflated with fluid which then creates a small area at the upper end of the stomach. The gastric banding device is usually inflated and adjusted through a small access port which is normally located just under the surface of the skin in the abdominal area of the patient. A solution of saline or other non toxic solution is introduced into the banded area via this port to fill the pouch. A specialized surgical needle is used to avoid any damage to the portal membrane and any adjustments must subsequently be undertaken by a qualified gastric banding Surgeon or one of His assistants who have been specially trained in this procedure. There are several port designs in common use today, which may be placed in varying positions, according to the surgeons own personal preference and experiences in managing these types of procedures. The port is generally stitched into place to maintain the stability of the portal access point, and also to avoid any accidental damage by the Patient in their normal every day life.
This pouch normally ‘fills’ with food quickly as the patient eats and thereby restricts further passage of food from the top to the bottom area of the patients stomach. Once the gastric Banding is applied to the patients stomach, that part of the stomach sends a subconscious message to the brain receptors that the stomach is full. This sensation is interpreted by the brain as a message that the stomach is now full. This in turn helps the patient to eat smaller portions of food and fluids, with the resultant effect of providing the required weight loss over time.
When fluid is introduced into the band, the band itself inflated further, and as it expands it places additional pressure around the outside of the banded stomach area. This then decreases the size of the passage between the two areas of the stomach thereby restricting the movement of food into the lower part of the stomach. Over a period of time this restriction is often increased until the patient feels that they have reached a point where optimal weight loss can be reached for them, with the minimum amount of fluid required. This is an individual preference, and several visits and consultations are generally required to fine tune the tightening of the band and the amount of fluid content required for each individual patients overall comfort and weight loss targets
The Main benefits provided by Gastric Banding Surgery is that it does not require any major surgery cuts, nor is it necessary to remove any part of the digestive system of the patients. Furthermore Subsequent Removal of the Band is possible, but this does require a further keyhole surgery procedure to be performed to remove the device. Once the Gastric Banding has been removed from the patient the stomach usually returns to its normal pre-banded state over time without any known problems to date.
COMMON GASTRIC BANDING PROBLEMS
It is unusual for gastric banding patients to experience any nutritional deficiencies following gastric band surgery. “Gastric dumping syndrome” issues also do not normally occur with gastric banding surgery, since no parts of the intestines or indeed of the stomach need to be removed or re-routed.
However weight regain is possible as with ANY weight loss procedures including gastric banding. Some of the more radical procedures can initially result in rapid weight loss but this is normally controlled and managed well in Gastric Banding situations. World Health Organization recommend that monthly weight loss of ½ to 1 kilograms per week should be a general target weight loss for the average Gastric banding patient generally, and then the (Patient) should have no problems to lose this amount of weight, however this can be very variable, and in accordance with the individual patient, their personal life circumstances, their personal attitude and mobility.
A commonly reported occurrence for gastric banding patients is regurgitation of non-acidic food from the upper pouched area. This is commonly known as Productive Burping. If the gastric banding Patient experiences this regularly, then they should consider eating less, eating much slower, and chewing their food much more thoroughly. If this does not eventually solve the problem then further medical advice must be obtained from your Practitioner or gastric banding surgeon.
Occasionally, the narrow passage at the Banded are of the stomach can become blocked by a larger portions of un chewed or unsuitable food. If this occurs on a regular basis then further adjustments to your diet should be considered, and once again you are strongly advised to consult your gastric banding Reactionary or dietician.
I some cases Ulceration or Gastritis Erosion can occur as the band can wear and aggravate a small area on the outside of the stomach wall which can then, in very rare and extreme cases, lead to a migration of the band itself into the inside the stomach. This however is a very very rare occurrence and usually there are many warning signs well in advance of this ever happening.
Slippage of the gastric Band is also an unusual occurrence. This when the lower part of the stomach may prolapsed over the band devices and cause an obstruction. Once again however this a very rare occurrence and warning signs are usually noticed well beforehand.
Psychological effects of any weight loss procedure may also be considered. Many Patients who have been Obese for extended periods of time prior to the gastric banding surgery procedure, have been habitually overeating for a greater part of their lives, therefore any sudden changes to their diet and lifestyle can have some adverse affects on the Patient.