Laparoscopic Adjustable Gastric Banding

Laparoscopic surgery, also known as minimal invasive surgery, is the kind of surgery in which small incisions are made on the patient's body. Various surgical tools are inserted through these incisions to view the patient's body internally, and perform the surgery. The laparoscopic gastric banding surgery is carried out on patients who have a body mass index (BMI) of 40 or more. A person whose BMI is 40 or more is overweight by a minimum of 100 pounds or more. In layman's language, people with BMI of 30 or more are termed obese. This surgery helps morbidly obese patients to lose excess weight in a short span of time.

In laparoscopic adjustable gastric surgery, a band is placed around the top of the intestine, just below the esophagus. The materials used for the band are synthetic polypropylene mesh, synthetic polyethylene terephthalate or polytetrafluoroethylene. Silicone gastric bands are also available now. The placement of the band creates a small pouch at the top of the intestine. Due to this the food intake of the patient is reduced considerably. The food is passed from the pouch, downwards to the stomach through the small opening, that connects the pouch to the stomach. The passing of food is at a very slow rate, hence the patient does not feel hungry often. Studies show that patients who have undergone this surgery, the weight loss is upto 50% of their actual weight, after a period of 5 years.

No change of any kind is made to the anatomy of a patient's body. In this surgery no part of the stomach is cut. Hence the period of hospitalization is also reduced and is normally one day. But it also depends on the health of the patient. The patient can start working after 5 to 7 days of rest. Since this surgery is done via incisions, the chances of infection are reduced drastically. The patient does not face any kind of nutrition deficiency, as is the case with other kinds of gastric surgeries like gastric bypass and vertical banded gastroplasty.

There are two kinds of laparoscopic adjustable gastric banding surgeries that are performed. One of them is laparoscopic adjustable gastric banding, the other being vertical banded gastroplasty. In vertical banded gastroplasty, in addition to the band, the stomach above the pouch is stapled. But this procedure has lot of side effects, like nutrition deficiency, hence it is not a preferred surgery.

In laparoscopic adjustable gastric banding surgery, the band is adjustable. The adjusting of the band is done by passing or sucking out saline water from the band via a small tube. Whether the band is to be inflated or deflated depends on the personal needs of the patient, for example, when a woman is planning her pregnancy. During the pregnancy phase, it's natural that the woman requires more nutrients. Due to less intake of food, there is a possibility, the woman might lack nutrition. Hence the band is adjusted. The band can be re-adjusted to the original size, once the woman has stopped breast feeding the child. The re-adjustment of the band helps the woman to lose weight gained during her pregnancy and lactation period. The surgery at times can also have adverse effects on the patient. These effects can be summed up as under:

• There may be cases where the band can slip. Due to this the food may not pass down to the stomach properly.
• Since the band is made up of elastic, there are chances of the band loosing its elasticity. In such cases, the surgery does not have any effect, as the amount of food intake increases to the original amount that was before the surgery.
• At times, around the band there is a tissue build up. This leads to congestion in the outlet from the pouch, therefore less amount of food passes to the stomach.

Inspite of the risks involved, the benefits are many. The laparoscopic adjustable gastric banding has helped patients suffering from various diseases like type 2 diabetes, high blood pressure, etc. The weight loss achieved has gone a long way in improving the quality of life of morbidly obese individuals.