Weight Loss Procedures
LAPAROSCOPIC ADJUSTABLE GASTRIC BANDING
Animation of the Lap Band Procedure
WHAT IS LAPAROSCOPIC ADJUSTABLE GASTRIC BANDING?
GASTRIC BANDING is a type of weight loss procedure originally developed in the 1980's. It has been the most commonly performed weight loss procedure in Australia in the last decade. Approximately greater than 10,000 GASTRIC BANDING procedures are performed in Australia each year. Worldwide, it has been used in over 650,000 patients and has a long and proven track record for safety.
It is particularly effective in people who need big portions to feel satisfied and or people who have excessive hunger. It works well in people who can lose weight with diet and exercise but struggle to keep it off.
It is highly effective, and patients can expect to lose 60% of their excess weight within 12-18 months. It has a significant effect on the medical problems associated with obesity such as Diabetes, Hypertension, Sleep apnoea, Hyperlipidaemia, Back pain and Osteoarthritis, Asthma, Gastroesophageal Reflux, Infertility, Depression, and significantly improves patients quality of life.
Perhaps the two main reasons why GASTRIC BANDING has been so popular for such a long time is that is relatively safe compared to some of the other weight loss procedures, and it can be reversed. GASTRIC BANDING is considered the least traumatic of all weight loss procedures, as it does not involve permanently cutting and stapling the stomach. The gastric band may be removed at any time.
GASTRIC BANDING involves the use of laparoscopic techniques (using small incisions and long-shafted instruments), to place an inflatable silicone band around the top of the stomach. Like a wristwatch, the band is fastened around the upper stomach to create a new, tiny stomach pouch, about the size of a golf ball, that limits and controls the amount of food you eat. It also creates a small outlet that slows the emptying process into the stomach and the intestines. As a result, patients experience an earlier sensation of fullness and are satisfied with smaller amounts of food. In turn, this results in weight loss.
The operation takes about one hour, and is performed under a General Anaesthetic. Four very small (5mm) incisions are made on the upper abdomen, the Gastric Band is placed around the stomach, and a few holding stitches are placed around the band to keep it in the correct position (this reduces the chance of band slippage). Next, an adjustable access-port is placed deep under the skin through one of the incisions and connected to the Gastric Band by special tubing. The skin incisions are closed by absorbable sutures which are invisible and do not need to be removed.
HOW DOES THE GASTRIC BAND WORK?
New Gastric Band Research
The Gastric Band allows you to eat much less but still enjoy your food and feel satisfied. It works by:
1. Reducing background hunger (satiety)
2. Allowing you to feel full with smaller meals (early satiation)
3. Preventing overeating (restriction).
For LAPAROSCOPIC ADJUSTABLE GASTRIC BANDING the Selection Criteria are as follows:
- BMI of 35, or
- BMI greater than 30 with at least 1 major obesity related disease eg. Diabetes, Hypertension, Sleep Apnoea , osteo arthritis.
- Acceptable operative risk
- Reasonable attempts at other weight loss techniques in the past
- A capacity to understand the risks and commitment associated with the surgery
- Dedicated to life-style change and follow up
WHAT ARE THE RISKS OF GASTRIC BANDING?
No surgery is completely free from any risks - however Gastric Banding is very safe. It is significantly safer than the other types of weight loss surgery.
The short term risks involved with a gastric banding procedure are similar to any other laparoscopic abdominal operation such as removal of a gallbladder or repair of a hernia. Such risks include bleeding, accidental injury to internal organs, infection, anaesthetic problems, and blood clots. The risk of a complication such as these during surgery is approximately 1%.
The long term problems that may occur after Gastric banding include infection of the band or port, Access-port rotation, disconnection of the tubing between the band and port, Band slippage, enlargement of the pouch above the band, Oesophageal dilatation, Erosion into the stomach.
Fortunately most problems are quite straight forward to fix, allowing your Gastric Band to continue to provide ongoing hunger and portion control. It Is important that you maintain an ongoing relationship with the clinic, with band check-ups at least once a year long term, so that we can identify and correct any problems.
GASTRIC BAND ADJUSTMENTS
The adjustability of the Gastric Band is a significant advantage over other weight loss procedures, as it allows its effect to be customised for each patient to properly control hunger.
During your procedure, a small access port is placed deep underneath one of your abdominal scars. This port is connected to the Gastric Band by thin tubing. This port allows the size of your band to be adjusted with a high degree of precision using a salty sterile solution called saline. The sterile saline inflates the inner surface of the band. This is a little bit like inflating a floatie on a child's arm to keep them afloat when swimming. Instead we use saline, rather than air. The surgeon can control the amount of saline in the band by entering the port with a fine needle through the skin.
Adjustments are performed by Dr Hatzifotis and only take a few minutes. You will be reviewed on a monthly basis in the first year to check on hunger levels, the amount of food needed to feel full, and your weight. The need for a gastric band adjustment will be based accordingly.
Once your goal weight has been reached, further adjustments are needed much less often, and clinic appointments can usually be reduced to once a year.
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DIET FOLLOWING GASTRIC BANDING SURGERY
KEYS TO SUCCESS
Knowing that you qualify medically for a Gastric Banding Procedure can be exciting – however, emotional preparation is critical to your success. Whilst a Gastric Banding Procedure is a powerful weight loss tool, you also must be ready to make lifestyle changes that support long-term weight loss, including:
1. STICKING TO DIETARY REQUIREMENTS
- Only eat when you’re hungry. Never eat just because of the time, because others are eating, or to prevent hunger later.
- Stop when you start to feel full. Generally a cup of food, or an entrée sized meal will be enough to fill you up.
- Avoid liquid calories. As solid food passes through the Gastric Band area, you will notice a sense of fullness building up. Liquids do not give the same sense of fullness as solids. It’s as if solids rotate a little turnstile as they pass through the band area, whereas liquids simply slide through without paying. You should try and keep alcoholic drinks, juices, cordials, milkshakes, ice cream and chocolate to a minimum for this reason. Calorie-free drinks such as water, tea, and coffee are fine. It’s important to keep well hydrated.
- Avoid drinking while eating.
- Eat slowly and chew thoroughly. Meals should take 20-30 minutes to complete. Each mouthful of food should be chewed very well before swallowing. You should try and leave one minute between each mouthful of food.
- Take a suitable multivitamin supplement indefinitely. A greater intake of folate and vitamin B12 is required to maintain low favourable homocysteine levels in the blood. Patients who take a multivitamin supplement have a lower level of homocysteine than those that do not. High levels of homocysteine place you at higher risk of heart attack, stroke and Alzheimer's disease.
Helen Bauzon: Eating Tips #1
Helen Bauzon: Foods to help you lose weight
2. ADDING EXERCISE TO YOUR ROUTINE
As patients begin to experience weight loss there is also a reduction in the obstacles to physical activity. Incorporating physical activity into their daily routine is very important. Diet and exercise work together for successful weight management. Physical activity helps in the treatment of obesity in many ways;
- Burns calories
- Maintains muscle tone
- Increases metabolic rate
- Improves circulation
- Improves heart and lung function
- Increases a sense of self-control
- Reduces stress levels
- Increases the ability to concentrate
- Improves appearance
- Reduces depression
- Suppresses appetite
- Provides better sleep quality
3. MEETING WITH YOUR SURGEON FOR ADJUSTMENTS AND ONGOING SUPPORT
Research has shown that patients who attend post-operative clinic appointments more regularly lose more weight following gastric banding surgery.