Adjustable gastric banding helps you lose weight by making you feel full sooner. In this laparoscopic procedure, an inflatable silicone band is placed around the uppermost part of the stomach, dividing it into two parts: a small upper pouch and a lower stomach.
The upper pouch can hold only about 2 ounces of food, limiting the amount of food you are able to eat at one time, and as a result, making you feel full sooner and satisfied longer. As you lose weight, the band can be adjusted by injecting more saline into a port placed underneath the skin on your abdomen. This helps to maintain the band’s effectiveness. Adjustable gastric banding is a reversible procedure.
Your weight loss during the first year after surgery can range from 30 to 40 percent of excess body weight; that amount can increase to 50% in the second year.
Adjustable gastric banding may offer a number of benefits, including:
- It’s one of the least invasive surgical options.
- The degree of restriction can be customized for an ideal rate of weight loss.
- The band can be adjusted without additional surgery.
- There’s no intestinal rerouting, cutting or stapling of the stomach wall or bowel.
- Small incisions may lead to less pain, minimal scarring and a quicker recovery.
- There’s a low risk of nutritional deficiencies that can occur with other surgical options.
- In the case of pregnancy, your stomach size can be increased to accommodate additional nutrition needs.
- Adjustable banding can help maintain long-term weight loss.
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Adjustable Gastric Banding Adjustments
Placement of fluid in the band is purposely delayed until four to six weeks after surgery in order to allow the band to “settle in” and the patient to get used to the sensation of having the band in place. Despite the fact that no restriction is added to the band initially, patients may lose weight during the first three weeks. Most patients need a “fill” or band adjustment by the fourth to sixth week after surgery. In most cases, adjustments are made in the office and take just a few minutes. On a rare occasion, the adjustment port is too deep to feel in the office and the patients will need to be adjusted in the radiology department at the hospital under fluoroscopy for the first one or two adjustments.
Band adjustments are made by having the patient lie down on the exam table in the office and “do a sit up” to enable the practitioner to feel the port under the skin and fat of the abdomen. Some patients will have their adjustments while seated in a chair. The port is located and marked, and the skin is prepared with alcohol. Then, a special non-coring needle attached to a syringe filled with a small amount of sterile saline (salt water) is passed through the skin into the port. Patients tell us that adjustments are nearly painless.
Patients must take liquids only for four hours immediately prior to a band adjustment. After band adjustments are made, patients drink liquids for the remainder of the day, pureed food for a day and then back to a soft/regular diet. The average patient loses one to two pounds per week. The first year after surgery, the average patient will get seven band adjustments to maintain weight loss. The second year, an average of one or two adjustments can be expected, and the third year, probably no adjustments will be necessary. Lifelong, patients will need small adjustments to the band from time to time because there is a small amount of saline that will diffuse out of the band system over time.
As a patient, you will be given clear instructions about what constitutes readiness for the next adjustment including diminishing weight loss, ability to eat more at meals, increased hunger, and difficulty following the eating guidelines. You will also be given instructions on what would occur should the band be too tight. Some symptoms include salivation, inability to eat solid food, coughing, and regurgitation of food. Patients who wait too long before their next adjustment have slower weight loss over time because the band is too loose. Patients who have a Band that is overfilled will begin to engage in dysfunctional eating. Dysfunctional eating occurs because patients are unable to eat solid foods therefore eat softer, easier to digest foods that are often high in fat and high in sugar.