Gastric banding

Gastric banding involves placing a band around the stomach, with the aim of reducing the amount of food ingested — a system that allows patients’ eating to be adjusted. The operation involves no stomach resection and is suitable for anyone who wants to get rid of excess weight and is ready for a change of lifestyle and eating habits. The method can reduce excess weight by about 50% in the first 3 years, and the weight can then be maintained for life.

Adjustable gastric banding at a glance

• Type of procedure: restrictive, laparoscopic, without stomach resection
• Incisions: 4, sized between 0.5 and 1 cm
• Upper reservoir created: about 15 ml
• Reversible and adjustable: yes — the diameter is regulated from outside, without a new operation
• Return to work: about 1 week (sedentary activities) or 2 weeks
• Reported results: reduction of excess weight by about 50% in the first 3 years

What is the gastric band?

Laparoscopic gastric banding is based on an inflatable balloon placed around the stomach through a minimally invasive surgical intervention. The balloon is connected to an injection port through a long, resistant silicone tube. The ideal location for placing the band is the lower portion of the junction between the oesophagus and the stomach.

The diameter of the laparoscopically placed gastric band can be modified and adjusted, dividing the stomach into a small upper reservoir of about 15 ml, with the rest of the stomach remaining below.

Who is it recommended for?

The procedure is suitable for anyone who wants to get rid of excess weight and is ready for a change of lifestyle and eating habits. It is easy to perform both with classic methods and laparoscopically; compared with the traditional surgical technique, the laparoscopic technique carries much lower risks, and the aesthetic aspect of the results is greatly appreciated by patients. If the patient wishes to give up this weight-loss method, the operation is reversible.

How does the operation work, step by step?

1. The incisions — the intervention involves making 4 incisions sized between 0.5 and 1 cm.
2. Positioning the band — the band is placed around the upper pole of the stomach, at the oesophago-gastric junction.
3. The adjustment — the passage channel between the upper and lower reservoir is regulated from outside by injecting liquid into the port of the inflatable band.
4. The effect — a state of quick satiety sets in: the amount of food per meal is reduced to just a few mouthfuls (15–30 ml). Food first reaches the upper reservoir, then passes slowly into the lower one.

The quantitative restriction of the diet creates a negative energy balance: the body has to draw on its fat reserves.

What are the advantages of the gastric band?

• the procedure causes minimal pain, helping the patient recover in a short time
• reduces the risks of obesity-related diseases: cardiovascular conditions, changes in respiratory function, diabetes, chronic venous insufficiency, musculoskeletal conditions, hormonal imbalances
• no mineral or vitamin supplements are needed
• the scars are minimal and fade gradually
• the rate of possible post-operative complications is extremely low
• it is adjustable from outside and fully reversible

What is the recovery like, day by day?

• Hospitalisation: reduced, thanks to the minimally invasive surgical method.
• First 2–3 days: driving is strictly forbidden; it may remain less comfortable for about 10 days after the intervention.
• First week: returning to work is possible after about one week for sedentary activities — otherwise, after about 2 weeks.
• Physical activity: regular physical activity is extremely important — walks at first, continued with progressively more complex exercises.

The diet of the first 2 weeks

In the first 2 weeks after the operation, the diet is quite strict, in order to help the stomach adapt to normal eating and to avoid vomiting or stomach blockages:

• a meal should last about 20–30 minutes
• 6 daily meals, less substantial, are recommended, replacing the 3 main, larger meals
• no food should be eaten in the absence of hunger
• when the feeling of satiety appears, the meal should be stopped

Following the post-operative dietary regimen is essential, and the details of the diet are discussed with the surgeon. For optimal monitoring of the weight-loss process, good collaboration with the doctor is needed: the goal is a gradual loss of the kilograms, because rapid weight loss can create major health risks.

Frequently asked questions

How much weight will I lose with the gastric band?

The method can reduce excess weight by about 50% in the first 3 years after the operation, and the weight can then be maintained for life, by following the regimen and the check-ups.

Does the band stay for life?

Not necessarily — the intervention is reversible, and the band can be removed if the patient gives up the method. It does, however, require periodic visits to adjust the diameter.

How is the band adjusted?

By injecting or withdrawing liquid at the port placed under the skin — a simple manoeuvre, without a new operation, which tightens or loosens the band according to the patient’s progress.

Gastric band or gastric sleeve?

The band is reversible and adjustable but involves a permanent implant and regular check-ups; the sleeve needs no adjustments and introduces no foreign body, but is permanent. See all bariatric procedures.