Steps for Gastric Banding Surgery

Gastric banding surgery is one of two FDA-approved procedures for reducing stomach volume--the other being gastric bypass. Gastric banding has been performed for decades in the United States by inserting a silicone band around the upper portion of the stomach in the patient, which then cuts off the amount of food their stomach can process.

Surgery

• Before the surgery, the patient will have an extensive check-up (involving blood work, a gastroscopy, and imaging studies) and multiple visits with their doctor, along with other specialists, before deciding on this procedure. It must be deemed safe, and necessary in order to commence.

  Once the patient is approved for the operation, they will be put under general anesthesia for half an hour to an hour. The surgeons will cut a small incision (about 1cm) into the abdomen, where a simple stoma (a band) is wrapped around the upper part of the stomach, creating a small pouch (roughly 15cc) which dramatically reduces the capacity of the organ to digest food. Currently, the most common stoma is a remotely controlled, adjustable one in which the opening can be manipulated from outside the body, to either allow more or less food into the stomach-effectively turning the stoma into a valve through which food has to go to get to the intestines. What food doesn't pass through the stoma immediately is housed in the upper pouch until the band lets it through to the rest of the stomach. This process makes the patient feel full while the food is housed in the upper stomach pouch, and because the food stays there for much longer, it makes them also feel full for longer.

  The remote controlled opening and closing of the stoma is actually the process of inflating and deflating a tiny balloon located within the device-much like is used in heart attack patients to keep their arteries open and still allow blood to flow through. It is designed so that it can be inflated and deflated at any time after the surgery, allowing more or less food to pass into the stomach proper depending on the weight-loss results of the patient. The inflating/deflating of the stoma is usually done in 15 minutes in a small room, and is completely painless.

Advantages over Gastric Bypass

• The main advantage that banding has over bypass is that it is much less invasive. There is no cutting or stapling of the stomach-there is nothing concerning the manipulation of the organ at all outside of fitting a simple stoma over it. The stoma is an advantage as well, because it is adjustable to the patient/doctor's needs. It can be adjusted accordingly, as opposed to a gastric bypass, which cannot be altered afterward. The hospital stay for a banding is also much less time--only 48 hours compared to the much lengthier Bypass operation. All of these make banding a fairly safe and intelligent choice, but no decision should be made without talking extensively with a doctor beforehand.