Adjustable Gastric Band

 

The creation of gastric compartments with the adjustable gastric band was indeed a major breakthrough and established obesity surgery as a safe and definitive therapy. In Europe this procedure is the “gold standard” for the management of morbid obesity.

The goal of the operation is to allow the obese patient to have the sense of fullness with smaller amounts of food in comparison to those he is used to. This is achieved by placing a band to the upper part of the stomach, which gives the stomach the form of a sand glass. In a first phase food accumulates at the upper portion of the sand glass, leading thus to distension of the gastric fundus, which provides with the sense of fullness. Next, food gradually passes through to the lower part and digestion evolves normally.

Also, the band contains internally an inflatable balloon, which allows in a completely painless manner its modulation after the operation. This modulation takes place some weeks after the operation, in our clinic and last only a few minutes. In this way, the diameter of the orifice can be controlled from the upper to the lower part of the stomach so that without causing any vomiting, it can slow down the passage of foods.

In conclusion, the gastric band leads the obese patient to feel, with small amounts of food, the same sense of fullness he previously felt with much greater amounts.

Laparoscopic placement of the gastric band usually lasts approximately 20 minutes and can be performed in a few hour hospital stay basis, without overnight stay.

The gastric band consists of inert solid silicon and never leads to tissue rejection. It is designed to stay in place permanently. Compartment creation with gastric band has nevertheless the advantage of being a reversible technique.

The gastric band is the most simple and painless bariatric surgical procedure. For this reason it is so popular. However, it is important to point out that its effectiveness requires the patient to follow three principles:

1. The obese patient, when he feels the sense of fullness with small amounts of food, should possess the minimum discipline not to force himself to vomit so as to continue eating. Because if this does occur on a regular basis, there is a risk that the upper part of the sand glass forms a “pouch” (slippage) and thus the effect of the band is cancelled.
2. The obese patient must eat the largest quantity of food during his meals, in other words he must avoid “nibbling” between meals.
3. Without the need of a diet (which we know that the obese patient will not follow on a long term period) the obese patient must avoid feeding mostly on sweets and soft drinks.

If these requirements can be followed, the adjustable gastric band is the best choice because it combines effectiveness and less hassle. However, in case that these requirements cannot be followed, then is preferable to choose one of the following techniques.