What is Laparoscopic Gastric banding?

Gastric banding is a procedure performed laparoscopically (which involves small cuts in the belly) wherein an adjustable silicone band is placed around the upper part of the stomach creating a small pouch of 15 ml capacity without cutting the stomach.

A plastic tube runs from the silicone band to a device just under the skin. Normal Saline (sterile salt water) can be injected or removed from the skin, flowing into or out of the silicone band. Injecting saline fills the band and makes it tighter. In this way, the band can be tightened or loosened as needed to reduce side effects and improve weight loss.

The Gastric band acts like a belt around the top portion of your stomach resulting in a reduced amount of food intake. This means that you feel full after eating only a small quantity of food.

What are the Advantages of Laparoscopic Gastric Banding?

1. 1. • • Leads to weight loss of about 35% to 45% of excess weight
        • Least invasive weight loss surgery and also the safest
        • Reversible, and in time, the stomach generally returns to its normal size

Is Gastric Banding for me?

You may be a candidate for Laparoscopic Gastric Banding if you have:

1. 1. 1. • • BMI of > 40 kg/m2 with or without comorbidities or weight 42.5 kgs or more in excess of the normal
           • BMI of 35-39.9 kg/m2 with one or more of the below co-morbidities
           • BMI of 30-34.9 kg/m2 with at least two of the below co-morbidities

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1. 2. • The comorbidities may include:
        1. Life-threatening cardiopulmonary problems as coronary artery Disease (CAD), type 2 diabetes mellitus (T2DM), obstructive sleep apnea, obesity hypoventilation syndrome, Pickwickian syndrome, non-alcoholic fatty acid disease or non-alcoholic steatohepatitis, hypertension, dyslipidemia, pseudotumor cerebrum, asthma, venous stasis disease, severe urinary incontinence, debilitating arthritis or obesity-related cardiomyopathy.
        2. Other obesity-induced physical problems that are interfering with lifestyle as musculoskeletal or neurologic or body size problems precluding or severely interfering with employment, family function and ambulation, and infertility in females.
        3. Made significant efforts at weight loss by participating in physician or professionally supervised weight loss programs and failed to achieve sustained weight loss.

Preparation prior to Gastric Banding Surgery

1. 1. • • Set of Blood tests are required to evaluate Patient’s fitness for surgery
        • An Ultrasound Scan of the abdomen is in order to evaluate size of Liver and presence of Gallstones
        • A Gastroscopy may be required to evaluate presence of a Hiatal Hernia for patients getting Acid Reflux
        • A 2-week Fat-free diet plan is advised to be followed strictly.
        • Protein shakes 40grams and Multivitamins are advised to be taken 2 weeks prior to surgery to build up a reserve in anticipation of a relative lack of nutrition in the first two weeks after surgery when only liquids are allowed to be consumed.

How is Laparoscopic Gastric Banding performed?

The patient will be admitted to the hospital at least 3 hours prior to surgery time and is expected to stay Overnight. You will have a general anaesthetic, and the operation will take approximately 1 hour. The surgery is done laparoscopically, (keyhole). Through a serious of small incisions across your upper abdomen the surgeon will use laparoscopic instruments guided by a small camera attached to a telescope. The surgeon will be able to visualise the inside of your abdomen on a TV screen. The surgeon will then be able to secure the band round the upper part of your stomach. The port used to inflate and deflate the gastric band is placed under the skin of the abdomen so that the surgeon is then able to make adjustments easily in the clinic.

What to expect after Laparoscopic Gastric Banding

• Discharge from the Hospital

• 1. 1. • When the patient is able to drink at least 2 litres of warm water in a day, Pain is under control and patients’ clinical condition is stable, It’s time to go home. You are encouraged to be mobile to accelerate recovery process and most patients are back to work 7 days after Laparoscopic Gastric Banding.
        • Some patients may experience nausea or vomiting but medication is given to rectify this promptly. Some discomfort and limited mobility are also to be expected but prescribed medication is available to control this. You can be assured of immediate care and attention at all times.

• Recovery after Laparoscopic Gastric Banding

  1. 1. • Patients are encouraged to walk and mobilise
        • Pain after laparoscopic surgery is generally mild although some patients may require pain medication.
        • Although many people feel better in just a few days, remember that your body needs time to heal. You will probably be able to get back to most of your normal activities in one to two weeks time. These activities include driving, work and light exercise.

When to call your Surgeon

1. 1. • • Persistent fever over 101F (39 C)
        • Bleeding
        • Increased abdominal swelling or pain
        • Persistent nausea or vomiting
        • Chills
        • A persistent cough and shortness of breath
        • Difficulty swallowing that does not go away within a few weeks
        • Drainage from any incision
        • Calf swelling or leg tenderness

Post op dietary plan following Gastric Banding

A well structured dietary guideline is designed to be strictly followed after the Surgery. Patient must stick to a liquid-based diet for 2 weeks after surgery. A soft diet follows for a further 2 weeks and about 4 to 5 weeks after the surgery, patient graduates to a 600 to 800 per day solid diet.