Laparoscopic (Lap) Adjustable Gastric Band – Parham Doctors’ Hospital

Laparoscopic (Lap) Adjustable Gastric Band – Parham Doctors’ Hospital


– Another option for weight loss surgery is the laparoscopic
adjustable gastric band. The gastric band is a device. We’re not going to remove or
rearrange any part of you. We’re gonna put a silicone device in around the top of your stomach, and put a small port underneath the skin on the abdominal wall. The port will be connected to the band, and the band will wrap around
the top of the stomach. The band has a balloon secured to the inside
of the rigid portion. So when we put fluid in the band, the balloon gets larger, and the opening on the inside
of the band gets smaller. When we remove fluid,
the opposite is true. The fluid comes out of the balloon, and the opening gets larger. This opening acts as a regulatory device for how quickly your food is gonna move from you esophagus, or your food tube, into your stomach. The position of the
band is very important. The band is placed on an area of the stomach called the cardia. The cardia is different than
the rest of your stomach. There are multiple nerve
endings at that location that monitor and send
signals to your brain that you’ve eaten food. With a gastric band, we want
the opening at that level to be just wide enough that when you eat a four ounce portion of solid food, it takes about 20 minutes for that food to move across the area. That’s just enough time for those nerves to send a signal to your
brain that you’re full. Unlike gastric bypass
or sleeve gastrectomy, there’s no secondary hormonal component. The intestines are not rearranged and a portion of the stomach
has not been removed. So people will get hungry during the day after they’ve had gastric band. Now there are studies that
show that level of hunger is decreased from before
surgery, but it’s not zero. So it’s very important
with the gastric band that you eat three times per day, evenly spaced throughout the day. Breakfast, lunch, and dinner. The meals need to be solid foods, not soft foods like mashed potatoes, or smoothies, or ice creams, or even protein shakes. Because those foods are not gonna deliver the level of hunger control that you will need to
effectively lose weight. When people are eating the correct foods, in the right portions, at the
right times during the day, and their gastric band
is adjusted properly, they tend to lose between
a pound and a half and two pounds per week. That may seem like slow weight loss, but when you add that out
to six months or a year, you’re talking about 50 to
100 pounds of weight loss. On average, people with a
gastric band are gonna lose about 50% of their excess
weight over 12 to 18 months. That’s not as high as other operations, but it’s still significant weight loss, and likely to result in
significant improvement of medical comorbidities, like
sleep apnea or hypertension. The gastric band has been
documented to work best in patients with a body
mass index under 42. In that group, the weight
loss result is a bit higher, and that group is uniformly
a bit more successful. And so we typically aim
gastric banding at that group. In addition, as I’ve said,
there’s a significant behavioral component
to the operation work. You have to eat three times per day, certain foods that largely,
you need to prepare yourself. People with daytime jobs,
that work in offices, are much more likely to be
able to do that kind of work that say, a nurse who works at night, or a long-term truck
driver that has odd hours. And so we typically will try
to match the band therapy to the patients whose lifestyle is gonna be compatible with it.

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