Laparoscopic Gastric Banding
This procedure takes about 1.5 hours and is performed as an outpatient operation. The patient will go home 2-3 hours afterward. Results vary but the average weight loss is 60% of the excessive body weight over two years. Follow up office visits are monthly initially and then every 2-3 months to adjust the band until the patient has achieved the satisfactory weight loss.
Who are the typical patients for
adjustable gastric banding?
The requirements for the adjustable gastric banding procedure are:
1.
That you are at least 100lbs (45kg) more than your ideal weight. Your
BMI (body mass index) is greater than 40 or greater than 35 with co-morbidity
such as high blood pressure, type II diabetes or arthritis.
2. That you have been overweight for more than five years
3. That your serious attempts to lose weight have had
only short-term success.
4. That you are not suffering from any other disease
that could have caused you to be overweight.
5. That you are prepared to make substantial changes
in your
eating habits and lifestyles, and to continue being monitored by
the specialist treating you.
What are the short term complications?
Vomiting – most patients will once or twice feel pain or vomit after intake of food. In most cases, it is caused by eating too much and too fast. If eating is slow and calm, patients will learn to listen to the signals from the stomach. Regular and persistent vomiting is a sign of warning. This can either be caused by wrong eating behaviour or be caused by the outflow of the gastric pouch becoming too narrow. This means that the balloon may need to be adjusted. Call your doctor immediately.
Constipation – many patients feel constipation after surgery. This is mainly caused by the fact that the reduced food intake leads to less feces and it is thus normal with fewer bowel movements. If laxatives become necessary, it is advisable to abstain from so called bulking agents and instead use liquid laxatives, such as lactulose.
Hair Loss – some patients will experience temporary hair loss during the first six months after surgery. This is also caused by the relative starvation. This does not lead to baldness. Normal hair growth will eventually return.
Long-term Complications
Adjustable gastric banding is well tolerated by most patients. Complications rates are low but this does not mean that complications are non-existent. The following is a list of the complications that have been seen following this operation:
1. infection: systemic infection or port infection have
been
reported leading to the removal of the port and/or the band.
2. Leakage of the band – very uncommon and will
require
replacement of the band.
3. Band Migration – very uncommon and will require
an operation to re-adjust the band.
4. Port mal-position - occurs sometimes after the patient
has lost a lot of weight or the anchoring stitches came loose. This will
require a simple local procedure to fix.
Post Op Diet
Four weeks post op liquid diet
You will need to be on a liquid diet for the first four weeks after your
surgery. This will allow time for your stomach to heal and the band to
anchor. Eating solid foods too quickly can hurt your stomach and the band.
It may cause band migration later on. Liquids include anything you can
slurp through a straw. They don’t have to be clear liquids. Slim
Fast, Boost, Carnation Instant Breakfast and other protein drinks are
fine. You can also have tomato soup, creamed soups and even the liquid
part of potato soup. A high fiber supplement will help with your bowel
movement.
Two week pureed Diet
After your four weeks on a liquid diet you will be on a pureed food diet
for two weeks. Pureed foods are foods that don’t require hardly
any chewing to turn into baby food consistency. Such foods as mashed potatoes,
cottage cheese, yogurt and bananas are good pureed foods. You can also
puree chicken and pretty much any other food, but it can change the flavour
so not too many people do that?
Regular Foods
After your liquid and pureed phase you can go back to normal foods. The
key in this phase is “chew, chew, chew”. The amount of fill
in your band may vary from 2 to 8 cc’s. Some people need a lot of
fill and some people need only a little.
The biggest challenge to most bandsters is learning to “chew, chew, chew”. If you don’t chew your food extremely well you will have a very difficult time eating non-mushy foods. Most bandsters spit back up food that has not been chewed well enough, or has been eaten too fast. PBing stands for “Productive Burping”. Most bandsters don’t actually throw up their food, they kind of burp it up. There is no stomach acid at this point and pretty much the food tastes the same coming back up. If this happens to you, chew better next time.
Typical Food with Problem:
- thick breads (such as Italian and French)
- pasta and popcorn
- white rice is better tolerated
- dry meats – moist meat slides better
- Steak is hard to chew well but it can be done
- Milk – generally okay
- Soda Pop – the carbonation will cause discomfort
- Vegetables – generally fine
- Oranges and other citrus fruits – fiber hard to chew well
The band will not work if you drink a milk shake and sip on chocolate all day. Remember that the band is a simple restrictive device that your body will learn to work with to help you lose weight on a long-term basis.
