Gastric banding is one of the best-known, bariatric surgery procedures and is designed to help patients with extreme obesity lose weight when all conventional methods have failed. The goal of the minimally invasive, laparoscopic procedure is to narrow the diameter of the stomach at the entrance to the stomach, allowing the patient to eat less food from then on, thereby reducing their weight and the risk of secondary diseases. Although the complication rate of gastric banding surgery is less than one percent, long-term complications are relatively common after surgery, such as those that can result from a slipped band, port infection or increased vomiting.
What is gastric banding?
Gastric banding is what bariatric surgery refers to as a minimally invasive and restrictive procedure designed to help patients with severe obesity reduce their weight. By gastric banding, bariatric surgery means a minimally invasive and restrictive procedure designed to help patients with severe obesity reduce weight. In principle, the procedure can be expected to reduce about 16 percent of the original weight, making it one of the most promising methods of bariatric surgery. The operation can be used to treat morbid obesity in particular, where dietary and other conventional methods of weight reduction have already failed in advance. Gastric banding is one of four standardized bariatric surgery procedures that is often combined with one of three other standard procedures. To be distinguished from the gastric band is the tubular stomach, which, like the gastric band, aims to minimize the size of the stomach but, unlike the band, requires the surgical removal of entire pieces of the stomach. Gastric bands are usually removed after a considerable period of time because of the high long-term complication rate, although explantation in particular is often combined with a second procedure such as tubular gastroplasty.
Function, effect, and goals
Gastric banding aims to narrow the entrance and diameter of the stomach. Such narrowed stomach diameter prevents excessive intake of food and thus helps the patient to lose weight. The procedure does not necessarily require the patient to be hospitalized, but can be performed in most cases on an outpatient basis as long as there are no contraindications. After a consultation and marking of the necessary incisions, the doctor usually puts the patient under anesthesia. During the operation, he performs a procedure on the entrance area of the stomach with the help of an optical instrument. This procedure is also called laparoscopy and belongs to the minimally invasive surgical procedures. During gastric band laparoscopy, the physician places a silicone band around the stomach fundus. The opening of this silicone band is adjusted by adding fluid to the band. In the wall of the abdomen or in front of the sternum, the doctor creates a so-called port chamber, i.e. an access. Gastric bands can be completely removed again. In about half of all cases, an explantation becomes necessary within ten years because the band slips or the associated tube system leaks. Often, gastric band explantation is accompanied by creation of a tubular stomach, in which the physician removes between 80 and 90 percent of the patient’s stomach under general anesthesia and uses laparoscopic sutures to convert the tubular remainder into a closed system.
Risks, side effects and dangers
Because gastric bands are placed using a minimally invasive procedure, the procedure carries far fewer risks to the patient than invasive surgical procedures. Although anesthesia is generally expected to increase the risk of complications for overweight individuals, the complication rate for gastric banding is less than one percent, especially under the guidance of experienced surgeons. In this case, an experienced surgeon is one who has performed more than 50 equivalent operations on the stomach. Although the operation itself is hardly risky, various complications may arise after the procedure. For example, larger chunks of food can block the passage of the gastric band. Expert nutritional counseling is therefore a crucial point for the continued success of the surgical procedure. After the operation, an infection of the port can also develop as a long-term complication.Under certain circumstances, the gastric band also cuts into the stomach or the band slips and has to be readjusted in an additional operation. One of the frequent complications is increased vomiting, which can cause dental damage and other health consequences for the patient. Due to these risks alone, a professional consultation in specially equipped consultation centers is irreplaceable before the procedure. Like all other bariatric surgery procedures, gastric bands are not suitable for everyone. The basic requirement is a BMI over 40 or over 35 if overweight-related illnesses are present. People with psychoses or addictions are generally not considered candidates for gastric banding. Generally, the procedure is performed only on individuals with a biological age between 18 and 65, and the patient must have already exhausted all conventional weight loss methods without success. Potential gastric banding patients must have been fully motivated to lose weight and fully informed of all available methods and risks. The risk of surgery must not exceed the risk of other available interventions for the individual patient. Compared to bariatric surgical procedures such as the sleeve stomach, the gastric band primarily offers the advantage of complete revisability. On the other hand, in the long run, a procedure such as the tubular stomach is associated with fewer long-term complications.
