Surgery Overview

Laparoscopic adjustable gastric banding is surgery to help people lose weight. It makes the stomach smaller and limits how much food it can hold. This helps you eat less and feel full sooner.

You will be asleep during the surgery. The doctor will make several small cuts in your belly. Then the doctor puts special tools and a camera through the incisions. Next, the doctor wraps a silicone band around the upper part of your stomach to make a small pouch. Then the incisions are closed with stitches.

The small size of the stomach pouch means you will feel full after you eat a small amount of food. The doctor can adjust the size of the band by inflating or deflating it.

What To Expect

After surgery, you may need pain medicine to help with discomfort and soreness. You'll be encouraged to start moving around to help your body heal. You may have an X-ray the day after surgery to see that everything is working correctly.

Most people need 2 to 4 weeks before they are ready to get back to their usual routine.

Your doctor will give you specific instructions about what to eat after the surgery. You'll start with only small amounts of soft foods and liquids. Bit by bit, you will be able to add solid foods back into your diet. Your doctor may advise you to work with a dietitian. This will help you learn how to get enough protein, vitamins, and minerals while you lose weight. Even with a healthy diet, you probably will need to take vitamin and mineral supplements from now on.

After you can eat solid food again, your doctor will adjust the band around your stomach by inserting saline into your port. This will inflate the band and cause it to tighten. You will probably have many adjustments to the band in the first year to find the right size that helps you lose weight, feel full at the right time, and not vomit. You'll need to see the doctor each time you need the band adjusted.

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 aren't losing weight as expected or if you have problems with the band. Some people lose weight for up to 3 years after surgery.

Emotions

It's common to have many emotions after this surgery. You may feel happy or excited as you start 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.

Think of bariatric surgery as a tool to help you lose weight. It isn't 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.

What you can eat

Your doctor will give you specific instructions about what to eat after the surgery. For the first 2 weeks, your stomach can only handle small amounts of liquids while you are healing. Some people feel full after just a few sips of water or other liquid. Other people won't notice much difference. It's important to try to sip water all day long 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. That's because you will feel full after eating much less food than you are used to eating. If you don't chew your food well or don't 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 from now on.

Why It Is Done

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

Surgery is typically 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.

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How Well It Works

Weight loss is usually slower and less with adjustable gastric banding than with gastric bypass.

Risks

Here are some risks common to all surgeries for weight loss:

• You could get an infection in the incision.
• You could get a blood clot in your legs (deep vein thrombosis, or DVT) or lung (pulmonary embolism).
• You may not get enough of certain vitamins and minerals. This can lead to problems such as anemia and osteoporosis.
• Some people get gallstones.
• Some people get kidney stones.
• You may gain the weight back a few years after surgery if you don't follow your eating and lifestyle plan.

Adjustable gastric banding is the least invasive of the weight-loss surgeries. But some 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). This may be treated by removing the fluid from the band. Or you may need a second surgery.

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 isn't fixed, you could get pneumonia.