Gastric Banding and Lapband Surgery
Gastric Banding (better known as the LapBand) has been performed in Australia since 1992, and more than one million patients have had a Lapband inserted worldwide.
One of the key advantages of the gastric band is that it can be removed at a later date if ever required or desired. Another advantage is potentially serious complications such as leakage and internal bleeding are largely avoided as the procedure does not involve cutting the gastrointestinal organs or blood vessels.
Furthermore, as the gastrointestinal tract is not altered, the risk of deficiencies in vitamins and minerals is also largely avoided.
The gastric band may be better suited to people who have big meals rather than a habit of snacking or grazing. Patients with mild obesity (typically BMI between 30-35) with a history of successful short term weight control with dieting also tend to do better with the gastric band. In these patients, the gastric band may help sustain better long term weight control over dieting alone.
Proper clinic support is essential after gastric band surgery. At OClinic you will feel fully supported by an experienced and well-trained team to help you get the results you deserve. As you lose weight you will need your band size adjusted to maintain your hunger and portion control. You will need regular support from experienced dietitians so that blockages and other food problems can be avoided. Regular check-ups with your surgeon will allow any band issues to be picked up early and avoid corrective surgery.
How does the gastric banding work?
The gastric band allows you to eat much less but still enjoy your food and feel satisfied. It works in three broad ways:
- Reducing background hunger (satiety)
- Allowing you to feel full with smaller meals (early satiation)
- Preventing overeating (restriction)
The band is made from high-grade medical silicone, a safe and inert material. It is placed around the top of the stomach by laparoscopic (keyhole) surgery. The operation takes less than one hour, performed under a general anaesthetic. Four small keyhole incisions are made on the upper abdomen, and the Band is placed around the top of the stomach. Holding stitches are placed around the band to keep it in the correct position.
Next, an adjustable access-port is placed under the skin and connected to the band by tubing. This allows our clinicians to adjust the tightness of the band quickly and simply in the office. The skin incisions are closed by absorbable sutures which do not need to be removed.
Recovery is quick. Patients are able to walk around the ward and drink liquids within a couple of hours of waking. The procedure is often performed as day surgery, allowing patients to return to their home the same afternoon.
We recommend taking one week off work to recover, but most patients usually feel well enough to do gentle day to day activities such as driving within a couple of days.
Data from our own experience shows that whilst individual results vary, the average patient loses about half their excess weight within 6-12 months, and multiple published studies show durable weight loss can be enjoyed long term (10 years and beyond) by committed patients. Motivated patients who are committed to dietary and lifestyle improvement, and regularly attend aftercare appointments, tend to do better than those who don’t. Regular participation in our aftercare program is the key.
Am I eligible?
Gastric Banding may be suitable if:
- Your BMI is between 30 and 35. CHECK YOUR BMI
- You have genuinely tried to first control your weight through diet and exercise without success
- Your weight problem is not caused by an underlying endocrinological disorder (such as Cushings Syndrome) or medication (eg long term prednisone use)
- You are at least 16 years of age
- You are committed to dietary improvement and participation in regular medical follow-up, particularly in the first 2 years
If your weight is also contributing to other medical issues such as insulin resistance, polycystic ovaries, high blood pressure, or poor sleep quality, then weight loss surgery may be especially beneficial in improving your health and longevity.
Are there any risks with the Gastric Banding Procedure?
Gastric Banding is considered one of the safest surgical weight loss procedures available. It is generally safer, at least in the short term, than the other types of weight loss surgery that involve stapling or suturing the gastrointestinal tract. However some patients may experience long term problems such as dislodgement of the band (slippage and erosion), reflux, or damage to the oesophagus if the band is not maintained properly.
Short term risks
The short term risks involved with a gastric banding procedure are similar to other day-only laparoscopic abdominal operation such as removal of a gallbladder or repair of a hernia - such risks include unexpected reactions to the anaesthetic, and wound bleeding or infection. In our experience, these and other problems occur in fewer than 1% of patients.
Long term problems
Problems that may occur long term after Gastric banding include:
- Difficulties digesting doughy bread, tough meats, or fibrous vegetables.
- Enlargement of the stomach pouch above the band from either band dislodgement or stretching
- Difficulties accessing the subcutaneous port for adjustments
- Disconnection of the tubing between the band and port
- Reflux or heartburn
- Migration of the band into the inside of the stomach
- Oesophageal dilatation
Fortunately most problems are quite straightforward to fix, either by repositioning or replacing the band, or having the band removed entirely. Proper care of your band is essential, with regular check-ups recommended in the first year or two, and then annually thereafter. This allows us to keep your band at the appropriate setting for optimal weight control, as well as identify and correct any problems. Because it can be difficult to address gastric band problems in the public hospital system, we require that all our gastric band patients maintain Gold-level health insurance cover- this allows us to deal with any problems that might arise quickly and efficiently.
If you feel gastric banding surgery might be a suitable choice for you, or you would like to find out more, then we suggest you schedule an appointment with Dr Taylor. All our initial consultations are completely obligation free, and are the best way to find out all the facts and get a professional opinion on your own individual circumstances. Note that a referral from either your GP or another doctor is needed.