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Gastric banding, also known as lap banding, is a type of weight loss surgery where the size of the stomach is reduced using a band so that only small meals can be eaten before feeling full.  The band makes you eat less and feel full in two ways - first by reducing the capacity of your stomach and second by increasing the time it takes food to get through the digestive system.

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The procedure
A band is applied around the top of the stomach forming two portions – a proximal small ‘pouch’ of about 15cc and a larger normal stomach.  Even a small amount of food will fill the ‘pouch’ up quickly and create the feeling of fullness, before passing slowly through the gap into the rest of the stomach to be digested as normal.  The surgery is performed laparoscopically (keyhole) under general anaesthetic.

The band is connected via a narrow tube to a reservoir ‘port’, which is kept underneath the skin usually over the breast bone or the lower ribs.  A fine needle is passed through the skin into the port to add or remove saline fluid which will tighten or loosen the band.  Adjustments are often done under local anaesthestic.

Recovery
Patients typically spend 24 hours in hospital and most return to work after two weeks or earlier. Vigorous exercise should be avoided for a month to six weeks.  You will lose a lot of weight initially. Twelve to eighteen months after the operation, weekly weight loss is usually less.

Aftercare
Regular check-ups are necessary after gastric banding.  You will need to be seen two weeks after surgery and then every two to twelve weeks for the first year.  Adjustments will be performed during some of these visits.  It is typical for follow-up visits to be scheduled every three to six months during the second and third year, depending on the individual case. The band can be removed at any time, usually laparoscopically.  After removal, though, the stomach generally returns to its original shape and you may soon go back up to or beyond your original weight.

You may eat most foods. However, because you can only eat a little it is important to include foods full of vitamins and nutrients.  You may also need to take a vitamin supplement but your specialist will advise you at your regular check-ups. If you eat foods that contain lots of sugar and fat or drink liquids full of "empty" calories, such as milkshakes, the effect of the band may be greatly reduced. 

The risks
Vomiting should be avoided as much as possible as it can cause the small stomach pouch to stretch. It can also lead to part of the stomach slipping through the band or cause erosion of the band into the stomach. In such circumstances you may have to have the band removed.  If you feel nauseated or sick on a regular basis, it may mean that you are not chewing your food well enough or that you are not following the diet rules properly.

You may have to take H2 blockers like Ranitidine or Proton pump inhibitors like Omeprazole, Lansoprazole if you are taking aspirin and other non-steroidal anti-inflammatory pain relievers (Ibuprofen or Diclofenac) because they may irritate the stomach causing erosion of the band.

The benefits
Weight-loss results vary from patient to patient, and the amount of weight you lose depends on several things. The band needs to be tight enough to restrict your food and you need to be committed to your new lifestyle and eating habits. Obesity surgery is not a miracle cure, and the pounds won't come off by themselves. It is very important to set achievable weight-loss goals from the beginning. The main goal is to have weight loss that prevents, improves or resolves health problems connected with severe obesity.

Next steps
To make an enquiry or book a consultation with our Consultant Bariatric Surgeon please call us on 020 8936 1201.