Laparoscopic Adjustable Gastric Banding
This relatively new technique reduces the amount of food the stomach can hold. With this bariatric surgical procedure we are placing an adjustable band around the upper part of the stomach. The band is held in place by stitches and later on, by fibrous tissue formed during the healing process. The band makes a pouch that can hold only small amount of food.
At the end of the procedure we place an access port beneath the skin on the right side of the abdomen. The access port is connected to the band on the stomach by tubing. The access port allows us to change the diameter of the band during office visits.
Surgery is usually done laparoscopically and is 100% reversible.
Topics Covered:
• How much weight will you loose?
• Pros/Cons of gastric banding
• What you will experience the day of surgery at St. Vincent’s Medical Center
• Discharge and follow-up
• Medications
• Diet
• When to Notify Physician
How much weight will you loose?
Adjustable band works as a restriction mechanism. There is no risk of malabsorption and nutrient deficiency directly related to gastric banding. Excess weight loss with the adjustable gastric band is slightly lower that with gastric bypass and you will be loosing less dramatically. Official numbers for amount of excess weight loss are anywhere between 25-70%. Twenty five percent weight loss was concluded in early studies and our current results, as well as in centers of excellence for bariatric surgery country wide, reach at least 70% excess weight loss.
Please remember, the gastric band is not filled during your surgery, you may say it is loose, and usually is not restrictive immediately after placement. It is OK if you lose some or no weight within first six weeks after surgery. Your first adjustment is scheduled a couple weeks after surgery.
Pros/Cons of gastric banding
Pros
• No dumping syndrome
• No anemia
• No malabsorption
• Shorter stay in the hospital
• Low complication rate
• Low mortality rate (around 0.1%)
Cons
• Gastric or esophageal perforation
• Band slippage
• Band erosion into stomach
• Incisional hernia
• Not satisfactory weight loss
• Infection
• Diet
What you will experience the day of surgery at St. Vincent’s Medical Center
On the day of your procedure you will go to the surgery center. You are prepared for surgery and an IV will be put in place at this time. You will be transferred to the holding area to meet your surgeon, your anesthesiologist and OR staff taking care of you. In the OR you will be put asleep after inhaling oxygen enriched air via face mask by intravenously fast acting medication.
After surgery you will be transferred to the recovery room. If you have a history of sleep apnea you will receive extra monitoring at this time.
Discharge and follow-up
• Activity as tolerated. Exercise in encouraged, however, no heavy lifting or strenuous activity for four weeks.
• You may take a bath or shower.
• Abdominal binder for comfort as desired.
• You may remove the Steri-strips after 5 or 6 days.
• You may drive when you are no longer taking pain medication.
• The second visit in our clinic is usually 6 weeks after surgery, when we fill the gastric band for the first time.
• Adjustment is done under sterile precautions. It is very well tolerated and one can compare it to the any injection shot.
• You may need several adjustments to help you to control the rate of the weight loss.
Medications
• Resume pre-surgery home medications as instructed by physician.
• Multivitamin twice a day (chewable or liquid).
• Nexium (prescription) or Prevacid (over the counter) for heartburn.
• Roxicet every four hours as needed (prescription) for pain.
Diet
• Drink a lot of water – at least 2 quarts (64 ounces) each day.
• Do not gulp. Take frequent (every 5 to 10 minutes) small sips.
• Clear liquids: Beef, chicken or vegetable broth.
• Diet drinks, such as Crystal Light.
• Sugar-free frozen fruit flavored ice pops, such as Popsicles.
• Sugar-free gelatin, such as Jell-O.
• Flavored waters.
• You may have caffeinated diet drinks sparingly (limit to two 8 ounce servings per day).
• Avoid carbonated beverages.
When to Notify Physician
• Notify your physician if your temperature exceeds 101۫ F.
• Notify your physician if you experience signs of infection which include redness or drainage from incision site, chills or pain not controlled by pain medications.
• Notify your physician if you have pain and swelling in your leg or calf, if you have chest pain, palpitations or shortness of breath.
• Notify your physician if you are constantly nauseated and/or you vomit for prolong period of time; if you cannot keep down your medications including vitamins.
Additional Instructions may be given based on individual circumstances.
Call 904-389-8871 to schedule follow-up appointment.
If you are Diabetic and seen by Endocrinology associates, please call their office.
This information is selective and does not include all possible side effects and complications resulting from this medical condition, diagnostic procedure or treatment. Potential complications should be discussed in more detail with your physician.
If weight loss is not satisfactory or if complication of the adjustable band occurs, another bariatric procedure may be needed.
Conversion of a failed LAGB to another bariatric procedure may be technically more difficult and associated with more complications than with a first time RYGB.