Gastric banding is a surgical technique to aid in weight loss in the severely obese.
Using a laparoscopic technique, an inflatable band (with the trade name Lap-Band) is tightened around the stomach to create a smaller pouch for the reception of food. The band controls the flow of food from the small pouch into the rest of the stomach and intestine. The patient feels comfortably full with a small amount of food, and because of the slow emptying, the patient will continue to feel full for several hours after eating, thus reducing the urge to eat between meals. Appropriate follow-up of the patient after the procedure is essential.
The size of the opening between the two halves of the stomach created by the band can be adjusted after the operation without additional surgery, depending on the patient’s reactions and results. This is done by inserting a needle through the skin into a reservoir of fluid (usually saline) that controls the tension in the inflatable circular band. X-rays such as a barium meal are normally performed before and after any inflation.
In cases with complications such as vomiting, obstruction and oesophageal enlargement, it is possible to completely deflate the system, opening up the stomach. In the following weeks it is possible to gradually inflate the system again.
Weight loss and diet must be carefully monitored indefinitely after the application of a gastric band.
After the procedure, patients can usually eat less than a quarter of a normal sized meal without causing discomfort or nausea. Most patients lose over a third of their excess weight over the next three years.
Surgery to produce weight loss is a serious undertaking, and each patient should clearly understand what the proposed operation involves.