How does gastric bands work?

The gastric band, aka the Lap-band is a restrictive only procedure. This surgery works in only one (1) way and that is to basically control portion size, thereby reducing the amount of food you take in and that results in less calories consumed. The gastric band received FDA approval in the United States in June of 2001; but had been used successfully in Europe for many years prior. Almost every gastric band that is placed is done using the laparoscopic approach (tiny incisions). This surgery is the least invasive weight loss treatment currently available today. It is important to note that there is no cure for obesity, bariatric surgery, including the gastric band, is only a tool to help you lose weight and sustain the weight loss.

Since it's introduction in 1983, there have been more than 350,000 gastric bands placed world-wide and studies have shown that the placement of this band has been proven to help patients feel full with the intake of small meals and weight loss occurs when following proper nutrition guidelines and incorporating exercise into your daily routine. Like all bariatric surgeries, this procedure does not work alone, you will need to modify your behavior and adopt new habits, including exercise, to have a successful outcome.

The gastric band does not involve the cutting, stapling or re-routing of the stomach or the intestines in any way. Food travels from the smaller banded pouch on the top of the stomach to the larger lower part of the stomach where it is completely digested. Unlike the gastric bypass, the digestion process for the gastric band is not affected at all. Gastric band patients do not experience the dumping syndrome, so you will need to watch your intake of sugar and fat and make nutrient-rich food choices.

The gastric band works by physically restricting the size of the stomach to about the size of a ping-pong ball or an egg using an adjustable silicone band that is placed around the top portion of the stomach. When you eat, the smaller top pouch created can only hold a small portion of food (usually 1/4 to 1/2 cup per meal) and when that pouch is full, it tricks your body into thinking the entire stomach is full so you are not hungry. The channel or opening that is created with the gastric band that separates the top portion of the stomach from the bottom is narrow and allows food to pass very slowly out of the top pouch to the bottom portion of the stomach where it mixes with gastric and digestive juices normally. No mal-absorption takes place so you need to be wise with your food choices, especially with high fat and sugar content. The band physically restricts the amount of food your stomach can hold; as stated above, a change in eating habits is essential in order to make the surgery work, as is daily exercise.

One of the best features about the gastric band is that it is adjustable, so if a patient starts to feel hungry and is able to eat greater portions without being satisfied, the band itself can be adjusted by the injection of saline into the silicone bands inner ring which greater narrows the channel or the opening between the upper pouch and the lower stomach so the food will pass more slowly, and in turn, keeps the top pouch full longer. Like the gastric bypass, the key is to keep your smaller stomach pouch full so you do not feel hungry, this is accomplished by not drinking with your meals. Fluid intake is done a half hour or so before and after meals. If you drink fluids with meals, your solid foods will liquify, causing what you have eaten to pass quickly through the stomach pouch and you will experience hunger rapidly. With this procedure, you will eat four (4) to six(6) small meals per day.

As stated, the gastric band is made out of silicone and is easily accepted by the body. The inside portion of the band is like the inner tube of a bicycle tire and can be inflated or deflated to make the opening between the upper pouch and the lower stomach larger or smaller as needed. A small thin tube leading to what is called a port, connects to the inner tube of the band. The port is small and will be surgically placed under the skin of the abdominal wall when the band is placed and cannot be seen from the outside. It is through this port that band adjustments are made when needed with the filling or removing of saline.

When the band is first placed, it is empty. Most patients will have their first fill or adjustment at about six (6) weeks after surgery. Regular and routine visits with your surgeon after surgery are expected to keep your band filled at an optimum level for you. Weight loss with the gastric band is gradual and much slower than that of the gastric bypass patient; expect about a one (1) to two (2) pound weight reduction per week. The more weight you have to lose, the quicker the weight loss. All patients should receive nutrition counseling prior to this surgery. The intake of protein, fruits and vegetables is essential to avoid malnutrition following any bariatric surgery.

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