Adjustable Gastric Banding
At about 1½ inches across, the gastric band is similar in size and shape to a napkin ring. It’s connected by a plastic tube to a “port” or filling station. The band itself is positioned around the top of the stomach, while the port is fixed to the abdominal wall muscles near the belly button. The port is usually invisible to the eye even after weight loss; your provider will typically have to feel around a bit to find it. He (or she) will need to access that port with a small needle to adjust your band.
The gastric band works, in essence, like all restrictive operations do: it seeks to make you feel full with less food, so that you eat less. When the band is positioned right, there will be just a walnut-sized pouch of stomach above it; the rest of the stomach is below.
When a band patient eats, the esophagus, as usual, pushes each swallow of food toward the stomach. When the food gets into that small pouch above the band, however, the food has to stop. The center channel through the band, when it’s adjusted right, is quite narrow – about the width of your pinky finger. Each swallowed ball of food has to slowly wiggle its way through that narrow channel to get through the pouch and move downstream. Once food gets past the band, it goes where it usually goes.
The idea here is that while those bites of food are waiting in the pouch for their turn to squeeze through, they are distending that pouch, and stretching its walls slightly. The stretch is enough, though, to activate those same nerves which are responsible for giving you the fullness that you get from any large meal. With the band’s help, you activate those nerves – and that full feeling – with a much smaller amount of food.
The LAP-BAND™ has been available in the United States for more than a decade. The other band that one can get in the U.S., the Realize™ band, was approved by the F.D.A. in 2007. These two bands look slightly different, but neither has convincingly proven itself superior over the other. Dr. Baranov is qualified to do both types of bands.
The band operation usually takes about 30 minutes, and most patients leave the hospital the following morning. The rate of serious complications is the lowest of all of the popular bariatric operations, which is nice, but reoperations for problems down the road are more common than with other bariatric operations. Weight loss averages 45% of excess weight.
The band needs to be adjusted periodically for life. In the beginning, though, it requires frequent adjustments – maybe every six weeks – so it’s extremely helpful if you don’t live too far from your surgeon.
Filling the band is not something that anybody with a needle can do for you. A good band adjustment “manager” is also your eating coach. The skill level of this individual, whether he/she is a doctor, nurse, or P.A., is much more important to your success with a gastric band than is the skill level of the surgeon who installed it.