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What is Gastric Banding and Lapband Surgery?

gastric-banding

Gastric Banding is a type of weight loss surgery developed in the 1980s. Gastric Band Surgery has been performed in Australia since 1992, and more than 80,000 Australian patients have benefited from it. Worldwide, it has been used in over 650,000 patients and has a long and proven track record for safety.

One of the key advantages of the gastric band is that it can be removed. Unlike other weight loss procedures, which involve cutting and stapling the stomach, the gastric band can be taken out if ever required or desired. Another advantage of this is that complications such as leakage and internal bleeding are avoided, making the insertion of the gastric band one of the safest surgeries performed. Furthermore, as the gastrointestinal tract is not altered, the risk of deficiencies in vitamins and minerals is also avoided.

The gastric band may be better suited to people who have trouble sticking to small portions, rather than a habit of snacking or grazing. Patients who can lose weight quite easily with diets and exercise but struggle to keep it off tend to do well with the gastric band, which helps end the yo-yo cycles and is more powerful than diet and exercise alone. In our experience, the gastric band works best for patients at the lower end of the obesity spectrum- typically BMI between 30-40, where only 20-25kg of weight loss is required.

Proper clinic support is essential after gastric band surgery. At OClinic you will feel fully supported by an experienced and well-trained team to help you get the results you deserve. As you lose weight you will need your band size adjusted to maintain your hunger and portion control. You will need regular support from experienced dietitians so that blockages and other food problems can be avoided. Regular check-ups with your surgeon will allow any band issues to be picked up early and avoid corrective surgery.

How does the gastric banding work?

The gastric band allows you to eat much less but still enjoy your food and feel satisfied. It works by:

  • Reducing background hunger (satiety)
  • Allowing you to feel full with smaller meals (early satiation)
  • Preventing overeating (restriction)

The band is made from high-grade medical silicone, a safe and inert material. It is placed around the top of the stomach by laparoscopic (keyhole) surgery. The operation takes about one hour, and is performed under a general anaesthetic. Four very small keyhole incisions are made on the upper abdomen, the Band is placed around the stomach, and a few holding stitches are placed around the band to keep it in the correct position.

Next, an adjustable access-port is placed deep under the skin through one of the incisions and connected to the band by special tubing. This allows our clinicians to quickly and simply adjust the tightness of the band in the office. The skin incisions are closed by absorbable sutures which are invisible and do not need to be removed.

Patients usually recover very quickly and are able to walk around the ward and drink liquids within a couple of hours of waking up. The procedure can sometimes be performed as day lapband surgery, although we generally like to keep our patients in hospital overnight.

We recommend taking one week off work to recover, but most patients usually feel well enough to do gentle day to day activities such as driving within a couple of days.

Data from our own experience shows that whilst individual results may vary, on average patients lose about half their excess weight within 6-12 months, and multiple published studies show durable weight loss can be enjoyed long term (10 years and beyond) by committed patients. Motivated patients who are committed to dietary and lifestyle improvement, and regularly attend aftercare appointments, tend to do better than those who don’t. Regular participation in our aftercare program is the key. It really is a partnership.

Am I eligible?

Gastric Banding may be suitable if:

  • Your BMI is over 30 CHECK YOUR BMI and;
  • You have genuinely tried to control your weight through diet and exercise
  • Your weight problem is not caused by an underlying endocrinological disorder (such as Cushings Syndrome) or medication (eg ongoing prednisone use)
  • You are at least 16 years of age (no upper age limit)
  • You are prepared to participate in ongoing medical follow-up

If you also have Type 2 Diabetes, high blood pressure, sleep apnoea, or other obesity related medical disorders, or have a family history of these problems, weight loss surgery may be especially beneficial in improving your health and longevity.

Are there any risks with the Gastric Banding Procedure?

No surgery is completely free from any risks, however Gastric Banding is considered one of the lowest risk procedures available. It is generally safer, at least in the short term, than the other types of weight loss surgery that involve stapling or suturing the gastrointestinal tract. Remember also that chronic, untreated obesity poses many serious risks to a person’s health and indeed their lifespan, and that once a person’s BMI reaches 30 or more, these obesity risks generally become greater than the risks involved with Gastric banding.

Short term risks

The short term risks involved with a gastric banding procedure are similar to any other laparoscopic abdominal operation such as removal of a gallbladder or repair of a hernia - such risks include bleeding, accidental injury to internal organs, infection, anaesthetic problems, and blood clots. In our experience, the risk of a complication such as these during surgery is less than 1 in 500.

Long term problems

Problems that may occur long term after Gastric banding include:

  • Band slippage or enlargement of the pouch above the band
  • Access-port rotation
  • Disconnection of the tubing between the band and port
  • Reflux or heartburn
  • Erosion into the stomach
  • Oesophageal dilatation

Fortunately most problems are quite straightforward to fix, allowing your Gastric Band to continue to provide ongoing hunger and portion control. It’s important that you maintain an ongoing relationship with the clinic, with band check-ups at least once a year long term, so that we can identify and correct any problems. We strongly recommend that you maintain an appropriate level of health insurance so that any problems that may arise can be corrected with minimal/no out of pocket cost to you (apart from your hospital excess).

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