Gastric Band Surgery
What Is A Gastric Band?
A gastric band works by restricting or limiting the amount of food that can enter the stomach. When the band is in place, food can only enter the small pouch to the top of the stomach which the band creates. The larger part of the stomach remains unused, just below the band.
Very small amounts of food entering the small pouch are enough to trigger the feeling of being full, and the brain is therefore tricked into believing enough food has been consumed, leading to weight loss. Once the food in the small pouch of the stomach has been digested, it moves through the digestive system as normal.
Will I Qualify For Gastric Band Surgery?
To qualify for getting surgery on the NHS, you must fulfil their specific eligibility criteria; you will be eligible if:
- You have a BMI of at least 40 or;
- You have a BMI of at least 30 and are suffering from a condition that would benefit from weight loss, such as type 2 diabetes.
Eligibility in the private sector varies from practice to practice, however they are often similar to the NHS guidelines, with the extra criteria of simply not being able to lose the weight through conventional methods such as diet and/or exercise.
Private Gastric Band Surgery
Many patients choose to undergo their weight loss surgery privately, whether to shorten the waiting time, or perhaps if they do not qualify for the procedure on the NHS. The cost of surgery varies between private practices, but typically ranges from £4000-7000. It is important to choose a quality private surgery provider, as the promise of cheap gastric band surgery can often lead to mistakes or unnecessary complications.
The gastric band is fitted using laparoscopic keyhole surgery where small incisions are made in the upper part of a patient's abdomen and a telescopic camera is used to help the surgeon place an adjustable band around the higher portion of the stomach.
The band itself is an inflatable circular tube which a surgeon ties round the top of the stomach to create a smaller pouch which can typically hold around 4-8 ounces of food in each meal. The band can be inflated and deflated as necessary using a small access port placed just under the patient's skin.
Essentially, this helps to manage the patient's weight by restricting the amount of food they can physically consume as it takes a long time for the food to move from the pouch to the lower part of the stomach.
Preparing For Gastric Band Surgery
Before surgery can take place, and to ensure post procedure care and support is at hand, the patient will need to be assessed. A team of people known as a multidisciplinary team (MDT) usually consisting of a surgeon, anaesthetist, dietitian, psychologist, gastroenterologist and a specialist weight loss nurse work together to assess suitability.
The assessment can sometimes consist of three stages:
- Physical assessment - To check if any other health problems could hinder surgery; patients may receive blood tests, an ECG, chest x-ray and ultrasound.
- Psychological assessment - To see how obesity is affecting the day-to-day living of the patient and if there are mental or emotional health issues which could cause problems after surgery.
- Nutritional assessment - To obtain contributing factors to the patient's obesity and find patterns in their current diet to aid aftercare. The nutritionist may recommend a calorie controlled diet before surgery to reduce the complications and risks involved.
Recovering From Gastric Band Surgery
When the anaesthetic wears off, the patient is likely to feel some pain at the site of the surgery. This is perfectly normal and will pass within a few days. The patient will feel swollen and sore for around the first 24 hours and a small amount of liquids is advised.
The specialist weight loss nurse advises the patient on integrating small amounts of solid food back into the diet and will be the patient's first point of contact after surgery.
Approximately four to six weeks after surgery, the band can be adjusted by inflating it with sterile salt water (saline) adjusting the constriction of the pouch. This is usually done with a local anaesthetic and using an x-ray to locate the band.
It may be a few weeks or months before a patient can resume normal activities and, as with all procedures, it will take several days to recover from the anaesthetic.
How Long Will It Take For Me To Recover?
Watch Mr Chris Sutton, Consultant Specialist Bariatric Surgeon at Tonic Cosmetic Surgery, describe a typical recovery process for gastric band patients:
"With a gastric band it can be performed as a day case, but again it’s often a one night stay. The patients are going to be sore but they will be up and about very quickly. The important thing to say about band sleeve bypass is that even though the procedures are performed through keyhole surgery, patients won’t be sure to drive for a week, so they must not drive for a week following surgery and they shouldn’t really lift anything heavy for six weeks following surgery. But otherwise, other than being a bit sore they are up and about very quickly."
Mr Chris Sutton, Consultant Specialist Bariatric Surgeon at Tonic Cosmetic Surgery
Initial Diet After Surgery
For the first month post surgery, food should ideally be taken in very small quantities, preferably pureed. This will help your stomach to heal as a result of any soreness you may experience following surgery. After the first month, you may slowly introduce solid foods, but again in very small quantities. The following guidelines are advised:
- Use a blender or food processor to puree your food. Any sauce or gravy added should be low in fat, sugar and calories to aid weight loss.
- As a guide, aim to eat no more than 6-7 tablespoons of food in any one sitting.
- Stop eating as soon as you begin to feel full, to avoid unnecessary discomfort.
- You should not drink any fluids with your meals, but you should still aim to take in the necessary fluids you need throughout the day.
After the first six months you will be able to eat most solid foods although some dry foods may cause discomfort.
Gastric band surgery will have a major impact on the lives of those who wish to make healthier choices. But it will only work in conjunction with other positive choices such as eating healthy foods and taking regular exercise.
There are many success stories attached to gastric band surgery, but the most important aspect is knowing you have investigated the procedure thoroughly and made the right choice for you.
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What Aftercare Will I Receive?
Here, Mr Chris Sutton, Consultant Specialist Bariatric Surgeon at Tonic Cosmetic Surgery, outlines the aftercare that gastric band patients can expect to receive:
"With gastric banding the important thing is the follow up and the support which is why we offer psychology, dietetics, personal trainer, and then limitless number of adjustments. The first adjustment we tend to do by x-ray to try and get people into what’s called the green zone, it’s the optimal level of restriction."
Mr Chris Sutton, Consultant Specialist Bariatric Surgeon at Tonic Cosmetic Surgery
Risks and Complications
The risk factors you have when undergoing surgery, such as high blood pressure or type 2 diabetes, will determine how safe surgery is. Immediate risks and complications of gastric bypass surgery include:
- Internal bleeding.
- Blood clots in the legs (deep vein thromboses).
- Blockages in the lungs (pulmonary embolism).
There are also a number of risks that can occur in the long term following your gastric bypass surgery, including:
- Excess skin.
- The gastric band slipping out of place, which may cause symptoms such as nausea, acid reflux and vomiting.
- Food intolerance.
Removal of a Gastric Band
Gastric bands can be removed at any time if required, however the intention is that they are kept in permanently as removal can result in weight gain. If the band does need to be removed then the operation is generally carried out as a keyhole procedure.
Alternatives To Gastric Band Surgery
- Gastric bypass surgery.
- Gastric balloon insertion.
- Sleeve gastrectomy.
- Primary obesity surgery endolumenal (POSE) surgery.