Gastric banding is a form of bariatric surgery used for weight loss. The procedure is typically recommended for patients with a body mass index (BMI) of 40 or greater, but can be recommended for lower BMIs when other weight-related medical conditions, such as diabetes, are present. There are several adjustable gastric band designs, including the LAP-BAND®, the Realize® Band, the MIDband™, the Soft Band, and the Bioring. The brands each have different benefits, some with greater range of inflation, others involve less invasive surgery.
The procedure is considered a low risk surgery and death is extremely rare. Recovery after the surgery can take as little as three to five weeks. The surgery usually is reversible, and the stomach typically will return to normal after removal of the device. Even so, any kind of bariatric surgery is a serious decision and commitment, and typically should be combined with diet and exercise.
Gastric banding works by separating a small pouch at the top of the stomach from the rest of the organ. This limits the quantity of food that a patient can ingest at one time, and also increases feelings of fullness. The procedure does not interfere with digestion or prevent nutrients from being absorbed — it simply decreases the amount of food that can be eaten. Tightness of the band controls how much food can pass into the larger stomach at one time and is adjusted for optimum weight loss.
The phrase gastric banding is short for "laparoscopic adjustable gastric banding." It is a minimally invasive surgery performed laparoscopically, which means it is performed through small incisions leaving little scarring. The procedure also is adjustable, which allows a patient to find the right fit for the device, as well as allows for temporary deflation without removal of the device. This may be required if a patient becomes pregnant, or if other complications arise.
A gastric band is inflated using saline solution that is injected through a port under the skin, which is sutured or stapled into position during the original surgery. Most surgeons do not inflate the band during the initial surgery, because the stomach tends to swell during the procedure. The exact amount of fluid necessary to inflate the band is a delicate measurement and will vary depending on the patient. It may take several adjustments before the band reaches an appropriate fit.
Patients often feel frustrated when they see the dramatic weight loss associated with gastric bypass surgery and feel that their banding was a failure. On average, patients who undergo gastric banding lose 40 to 60 percent of their excess weight. Patients who continue to consume high-calorie liquids may not see any improvement in weight because liquids pass easily through the smaller stomach created by the band.
In addition to rapid weight loss — up to 2 pounds per week — gastric banding can improve symptoms of diabetes, sleep apnea, and high blood pressure. Like any weight loss surgery, the success of gastric banding depends on a lifelong commitment to weight management. Gastric banding may make losing weight easier, but success still depends on the patient.