According to the American Society for Metabolic Bariatric Surgery, bariatric surgery is not an easy option for obesity sufferers. It is a drastic step, and carries the usual pain and risks of any major gastrointestinal surgical operation.
However, gastric banding is the least invasive surgery of its kind. Gastric banding is performed using laparoscopic surgery and usually results in a shorter hospital stay, faster recovery, smaller scars, and less pain than open surgical procedures. Because no part of the stomach is stapled or removed, and the patient’s intestines are not re-routed, he or she can continue to absorb nutrients from food normally. Gastric bands are made entirely of biocompatible materials, so they are able to stay in the patient’s body without causing harm. However, not all patients are suitable for laparoscopy.
Gastric banding is indicated for people for whom all of the following apply:
- Body Mass Index above forty, or those who are one hundred pounds (seven stone/forty-five kilograms) or more over their estimated ideal weight, according to the National Institutes of Health, or those between thirty-five to forty with co-morbidities that may improve with weight loss (type two diabetes, hypertension, high cholesterol, non-alcoholic fatty liver disease and obstructive sleep apnea.)
- Age between eighteen and fifty-five years (although there are doctors who will work outside these ages, some as young as twelve).
- Failure of medically supervised dietary therapy (for about six months).
- History of obesity (up to five years—depending on the Insurance pre-approval requirements).
- Comprehension of the risks and benefits of the procedure and willingness to comply with the substantial lifelong dietary restrictions required for long term success.
Gastric banding is usually not recommended for people with any of the following:
- If the surgery or treatment represents an unreasonable risk to the patient.
- Untreated endocrine diseases such as hypothyroidism.
- Inflammatory diseases of the gastrointestinal tract such as ulcers, esophagitis, or Crohn’s disease.
- Severe cardiopulmonary diseases or other conditions that may make them poor surgical candidates in general.
- An allergic reaction to materials contained in the band or who have exhibited pain intolerance to implanted devices.
- Dependency on alcohol or drugs
- People with severe learning or cognitive disabilities or emotionally unstable people
A commonly reported occurrence for banded patients is regurgitation of non-acidic swallowed food from the upper pouch, commonly known as Productive Burping. Productive Burping is not to be considered normal. The patient should consider eating less, eating more slowly and chewing their food more thoroughly. Occasionally, the narrow passage into the larger, lower part of the stomach might also become blocked by a large portion of unchewed or unsuitable food.
Other complications include:
- Gastritis (irritated stomach tissue)
- Erosion -The band may slowly migrate through the stomach wall. This will result in the band moving from the outside of the stomach to the inside. This may occur silently but can cause severe problems. Urgent treatment may be required if there is any internal leak of gastric contents or bleeding.
- Slippage – An unusual occurrence in which the lower part of the stomach may prolapse through the band causing an enlarged upper pouch. In severe instances, this can cause an obstruction and require an urgent operation to fix.
- Malposition of the band – This can cause a kink in the stomach, or (rarely) the band may not encircle the stomach at all, giving no restriction to the passage of food.
Band was not placed on the stomach – (very rare—especially with an experienced bariatric surgeon.) However, in two asymptomatic patients, the band had not enclosed the stomach but only perigastric fat.
- Problems with the port and/or the tube connecting port and band – The port can “flip over” so that the membrane can no longer be accessed with a needle from the outside (this often goes hand in hand with a tube kink, and may require repositioning as a minor surgical procedure under local anaesthesia); the port may get disconnected from the tube or the tube may be perforated in the course of a port access attempt (both would result in loss of fill fluid and restriction, and likewise require a minor operation).
- Internal bleeding
Before going ahead with gastric band surgery for weight loss, you might want to review all of the adverse effects of gastric banding as documented by the FDA.