Gastric band surgery

This is a very good alternative for those patients who do not want the more extensive gastric bypass surgery. It is classed as a ‘restrictive’ procedure which means that food intake is reduced but food absorption is not affected.

It is a highly successful procedure which is also one of the safest and carries the least amount of risks as compared to the more technically demanding gastric bypass, biliopancreatic diversion or sleeve gastrectomy.

What is gastric banding?

This is a surgical procedure which involves placing a silicone band around the stomach to reduce the amount of food eaten. Smaller meals mean a reduced calorie intake which results in weight loss.

You will not have to take a daily nutritional supplement as food is absorbed as normal; however, you will have to follow a sensible eating regime and take exercise as well. This may seem like an easier option but, it is the same as the other procedures in that it is a long term approach to the problem of excessive weight gain.

It is often referred to as ‘LAGB’: this stands for Laparoscopic Adjustable Gastric Banding’ as this procedure is carried out using laparoscopic or keyhole surgery. Keyhole surgery means a series of small incisions are made rather than one long incision which results in less scarring and a quicker recovery for the patient.

However, the selling point of this device is that it can be adjusted by your surgeon according to your calorie intake and weight loss.

How does gastric band surgery work?

The gastric band is a hollow tube in the shape of a ring. Your surgeon can inject a saline solution into the band which then causes it to expand and so tighten around the stomach. If this band needs tightening then more solution is added. If it needs loosening then he/she will remove some of the solution. This is often referred to as adjustments and fills.

There are two types of gastric band systems currently in use although a new, revolutionary type of band – the ‘Easyband’ has entered the market.
The two most commonly used bands are the ‘Realize’ band system and the ‘LAP-BAND AP’ system.

Realize band system

This is a newer type of gastric band: It works in the same way as the LAP-BAND system in that it is designed to be fitted around the stomach so that food intake is restricted.

It takes the form of a small hollow ring (which contains a narrow tube) and is attached to one end of a slim tubing. At the other end of this tubing is an ‘access port’. This port allows the surgeon to inject saline solution into the tube which then enters the band.

The band expands to accommodate this fill. As more solution is injected then the band expands even further. The band can hold up to a maximum of two teaspoons of solution.

LAP-BAND system

This is the more commonly used type of gastric band. LAP-BAND is the brand name of this device which works in much the same way as the Realize band.

There are two types of LAP-BAND: APL (large) and APS (small) which have differing types of capacity. As you can imagine the APL type has a larger capacity than the APS. The smaller version is more commonly used although the APL type can be used in bigger, heavier patients.

Easy band system

This is a new player in the field of gastric banding. This highly innovative system uses electronics rather than saline solution for adjustments and fills. Its proper title is the Telemetric Adjustable Gastric Band.

How does it work?

It still looks very similar to the other two systems in that it uses a silicone ring and tubing. However, the radical difference is that it uses microchip technology.

Inside the ring is a small metal loop which contains a tiny motor and a microchip. The band is fitted in exactly the same way as the other two but instead of an access port there is a tiny receiver instead. This receiver is attached to a thin wire which is also attached to the band.

The wire is then fed up through the body into the chest area (underneath the skin). The receiver is attached to this end and rests just under the skin.

How is the gastric band adjusted?

The surgeon will have a small handheld device, similar to a remote control. He/she will also place a small transmitter onto the patient’s chest – where the receiver is located. He/she will press a button on the handheld device which causes a signal to be sent to the transmitter and the receiver. The receiver then sends that signal to the tiny microchip inside the ring. This tells the ring to expand or contract.

What is especially useful is that the surgeon can receive feedback about the current state of the ring and can make any necessary changes.

This is seen as a less uncomfortable procedure than the other two conventional systems.

It is still at an experimental stage though and there is no long term evidence to prove or disprove its effectiveness.

Gastric Band Surgery Guide sections

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