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Gastric Banding

Laparoscopic adjustable gastric banding (LAGB) or Laparascopic Gastric banding is one of the least invasive weight loss treatments available for obesity. It's done with a few tiny abdominal cuts, instead of with one large cut. The surgeon puts instruments through the cuts. One of those instruments is a laparoscope, a tool with a tiny camera. Using this, a silastic band is placed around the stomach just below the junction of esophagus (food pipe). This forms a small pouch thus creating an hour-glass effect. The silicon ring passes around the stomach, thus giving a small outlet, that allows only as much food as the size of an eraser, to enter the distal stomach. The reservoir is placed under the skin in the midline just below the chest such that it can easily be felt while lying down. A needle can be injected through the skin into the reservoir and to add or remove fluid to adjust the size of the stomach outlet.

Gastric Banding

The hour glass configuration only constricts the upper stomach thus acting as a pure restrictive operation. Since the outlet is small, food stays in the pouch longer and one also feels satiated for a longer time. The small pouch ensures that the patient feels full after eating only small amounts of food. This causes weight loss. As its name suggests, this is an adjustable gastric band Scheduled follow-up visits will be at 6 weeks, monthly for the first six months and yearly thereafter or as and when medically required.

Why might I need a laparoscopic adjustable gastric banding?

LAGB is used to treat severe obesity, which is linked to high blood pressure, high cholesterol, type 2 diabetes, sleep apnea, and arthritis. It is recommended for people who have tried other weight loss plans without long-term success. Once you lose a significant amount of weight, your risk falls for these weight-related health problems. Adjustable gastric banding may help you live longer if you can't lose weight in other ways.

Indications

  • Presence of serious sequelae of morbid obesity
  • 30 kg overweight or BMI > 32 with co-morbidities
  • BMI> 35 with or without co-morbidities
  • Large volume eaters

Merits

  • Faster recovery < 48 hours
  • Reversible procedure and does not cause disturbance in normal anatomy
  • Band is inflatable and can be adjusted over time
  • 40 - 50% excess weight loss in 1 year
  • Improvement in associated co-morbidities & quality of life

More to know

Preparing for Laparoscopic Adjustable Gastric Banding

  • Pre surgery work up may involve blood tests and ECG as well as routine pre surgical and pre anesthetic clearance tests
  • Surgery isn't recommended for people who are abusing drugs or alcohol, who may have other serious medical problems, or who are not willing to make a commitment to life-long diet and exercise programs.
  • If you're a smoker, you must quit before surgery and should not start again.

What happens after laparoscopic adjustable gastric banding?

Your diet will be mostly liquids and pureed food for 2 to 3 weeks. You will then slowly begin adding soft foods, then regular foods. You can return to a regular (but smaller) diet after about 6 weeks.

As part of necessary lifestyle changes, you'll need to eat smaller meals. You'll need to chew your food slowly and repeatedly into a liquid slurry before swallowing. You also need to eat a healthy diet high in protein, vitamins, and minerals, and low in sugar.

LAGB does not make you lose weight suddenly. But it is a safer, less invasive procedure than other weight-loss surgery, including traditional gastric bypass. You'll have to be prepared to eat appropriately and exercise. But you can expect long-term weight loss equaling one fourth to one third of your original weight.

Because you'll be at high risk for nutritional deficiencies for the rest of your life, you'll need to take daily supplements as prescribed. You'll also need to have life-long medical care to watch for any nutritional problems.

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