Surgery Overview

Laparoscopic adjustable gastric banding is surgery to make the stomach smaller. It is done to help people lose weight. The surgery limits the amount of food the stomach can hold. This helps you eat less and feel full sooner.

Adjustable gastric banding is done through several small cuts, called incisions, in the belly. The doctor will place small surgical tools and a camera through the incisions. The doctor will then wrap a device around the upper part of your stomach to form a ring. Attached to the ring is a thin tube leading to an access port that is left under the skin. The access port is the place where the doctor puts in a needle to add or take away saline. Adding saline tightens the band and makes the stomach smaller. The doctor can take away saline if the ring is too tight.

What To Expect After Surgery

Your doctor will give you specific instructions about what to eat after the surgery. For the first 2 weeks, you will need to follow a liquid or soft diet. At first you may feel full after just a few sips of water or other liquid. It is important to try to sip water throughout the day to avoid becoming dehydrated. You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements.

Bit by bit, you will be able to add solid foods back into your diet. You must be careful to chew food well and to stop eating when you feel full. This can take some getting used to, because you will feel full after eating much less food than you are used to eating. If you do not chew your food well or do not stop eating soon enough, you may feel discomfort or nausea and may sometimes vomit.

Your doctor may recommend that you work with a dietitian to plan healthy meals that give you enough protein, vitamins, and minerals while you are losing weight. Even with a healthy diet, you probably will need to take vitamin and mineral supplements for the rest of your life.

Weight loss

After this surgery, weight loss is usually gradual but steady. You will have regular visits with your doctor to check how you are doing. The doctor can adjust the band if you are not losing weight as expected or if you have problems with the band. Some people continue to lose weight for 4 or 5 years after surgery.

Emotions

It is common to have many different emotions after this surgery. You may feel happy or excited as you begin to lose weight. But you may also feel overwhelmed or frustrated by the changes that you have to make in your diet, activity, and lifestyle. Talk with your doctor if you have concerns or questions.

Why It Is Done

Weight loss surgery is suggested for people who are severely overweight and who have not been able to lose weight with diet, exercise, or medicine.

Surgery is generally considered when your body mass index (BMI) is 40 or higher. Surgery may also be an option when your BMI is 35 or higher and you have a life-threatening or disabling problem that is related to your weight.

It is important to think of this surgery as a tool to help you lose weight. It is not an instant fix. You will still need to eat a healthy diet and get regular exercise. This will help you reach your weight goal and avoid regaining the weight you lose.

How Well It Works

Since the adjustable gastric banding procedure does not require cutting or stapling of the stomach, it is less invasive than gastric bypass or vertical banded gastroplasty.

Studies have shown that people lose weight as successfully with adjustable gastric banding as they do with other weight loss methods or surgeries.

In a study that compared a group of people who had adjustable gastric banding for weight loss and a group that used a program of behavioral modification, medicine, diet, and exercise, the gastric banding patients lost more weight in a year's time. The gastric banding group also continued to lose weight for 2 years.¹

Risks

Although adjustable gastric banding is considered the least invasive of the weight loss surgeries, problems can occur. They include:

• Obstruction. The band can cause something (usually food) to block the opening from the upper part of the stomach to the lower part of the stomach. This can cause pain, nausea, and vomiting.
• Band slippage. The band can slip out of place. Symptoms might include belly pain or heartburn (acid reflux). You may need a second operation.
• Access port problems. You could get an infection around the access port, or the access port could disconnect or leak. The tube that leads from the band to the access port could also become blocked.
• GERD. You could develop esophagitis or gastroesophageal reflux disease (GERD).
• Esophageal dilation. If the band is too tight, or if you eat too much, your esophagus could expand. This can make it hard for you to swallow, which could cause food to get stuck in your throat. If it is not fixed, you could get pneumonia.
• Malnutrition. Eating less may mean that you are not getting enough nutrients. You will probably have to take vitamin supplements for the rest of your life.

What To Think About

You will probably continue to lose weight for up to 2 years. Even with the surgery, you will need to eat right, exercise, and work with your doctor to keep track of your progress.

If you have other health problems that are caused by being overweight, such as diabetes or high blood pressure, they may go away as you lose weight. Your doctor may change the type and amount of medicines you take for those health problems. It's important to work with your doctor to keep track of health problems while you're losing weight.

Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.

References

Citations

1. O'Brien PE, et al. (2006). Randomised trial of medical versus surgical weight loss. Annals of Internal Medicine, 144: 625–633.