Gastric Banding Surgery (Adjustable Weight Loss Surgery)
Adjustable gastric banding (AGB) is the only adjustable weight loss surgery. It works by placing an inflatable silicone band around the top part of the stomach, which will create a small pouch and, in effect, make the stomach smaller.
This pouch holds about a half-cup of food, rather than the roughly six cups that a normal stomach holds. It fills with food quickly, which means you won't be able to eat as much, and will feel full faster, yet it also allows you to absorb nutrients from food normally.
The band can be adjusted to meet a patient's needs. For instance, it can be deflated if a woman becomes pregnant, and it can be tightened for patients who are not losing enough weight to make a healthy difference.
Currently there are two Adjustable Gastric Banding Systems on the market in the United States. WakeMed surgeons use the REALIZETM Personal Banding Solution, FDA approved in 2007.
During the procedure, your surgeon uses laparoscopic techniques, making a small incision and using long-shafted instruments to implant an inflatable silicone band into the patient's abdomen. Like a belt, the band is fastened around the upper stomach to create a new, tiny stomach pouch that limits and controls the amount of food you eat. It also creates a small outlet that slows the emptying process into the stomach and the intestines.
The band is connected by tubing to a reservoir, which is placed under the skin during surgery. To change the size of the band, saline solution is injected into or withdrawn from the tubing with a fine needle, which inflates or deflates the band's inner surface.
Results: Gastric banding patients typically lose 47 percent of their excess weight.
Studies found that gastric banding:
- Resolved type 2 diabetes in 47.8 percent of resolved high blood pressure in 38.4 percent of patients.
- Improved high cholesterol in 78.3 percent of patients.
Quality of Life
One meta-analysis stated that for bariatric surgery patients who experienced significant weight loss:
- Overall quality of life improved greatly
- They experienced improved physical functioning and appearance
- They experienced improved social and economic opportunities
Your healthcare team will advise you when to return to work and when you are able to resume normal activities.
Potential Concerns of Gastric Banding
- Gastric banding can help you feel satisfied sooner and with less food, but it won't eliminate the desire to eat. You will need to follow your specific diet and exercise guidelines provided by your bariatric surgeon to achieve success.
- Gastric banding requires intensive follow-up care. This is because the band is adjustable. Keep in mind that even after reaching and maintaining your success weight, you may still need to see your bariatric surgeon for further adjustments.
Adjustable Gastric Banding is not right for you if:
- You have an inflammatory disease or condition of the gastrointestinal tract, such as ulcers, severe esophagitis or Crohn's disease.
- You have a problem that could cause bleeding in the esophagus or stomach, such as esophageal or gastric varices (a dilated vein).
- You have portal hypertension, cirrhosis, or pancreatitis.
- The anatomy of your esophagus, stomach, or intestine is not normal (congenital or acquired). For instance, you might have a narrowed opening.
- You have experienced an intra-operative gastric injury, such as a gastric perforation at or near the location of the intended band placement.
- You have an infection anywhere in your body or one that could contaminate the surgical area.
- You are on chronic, long-term steroid treatment.
- You might be allergic to materials in the device.
- You or someone in your family has an autoimmune connective tissue disease. This would include diseases such as systemic lupus erythematosus or scleroderma. The same is true if you have symptoms of one of these diseases.
WakeMed's dedicated bariatric surgeons perform minimally invasive weight loss surgeries at WakeMed Cary Hospital, a Bariatric Surgery Center of Excellence.