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Gastric Banding, Obesity Surgery, Weight Loss Surgery

Obesity is a major health problem worldwide and has reached an epidemic proportion in the Western society. Evidence continues to accumulate that obesity is a major risk factor for many diseases and is associated with significant morbidity and mortality.

Laparscopic Bariatric surgery is currently the only modality that provides a significant, sustained weight loss for morbidly obese patients, with resultant improvement in obesity-related comorbidities.

Gastric banding as it is otherwise known, is an operation performed under general anaesthetic. A surgeon will place an adjustable band around the top of the stomach to create a small pouch to hold food. The band is attached via a thin tube to a small "port" or reservoir, which is placed under the abdominal skin at the time of surgery. This port allows the surgeon to increase the tightness of the band (by injecting fluid into the reservoir) at a later stage. In Australia, laparoscopic (key-hole surgery) is the most common method used to perform gastric banding. This procedure is considered simple and safe for people who are very overweight and experience complications because of their weight.

Surgical Implications for Gastric Banding

Gastric Banding or Bariatric Surgery is indicated for people with:

  • Body Mass Index above 40  kg/m2

  • Between 35 to 40  kg/m2 with co-morbidities that may improve with weight loss

    • Type 2 diabetes

    • Hypertension,

    • High cholesterol

    • Non-alcoholic fatty liver disease

    • Obstructive sleep apnea

  • Failure of medically supervised dietary therapy.

  • Comprehension of the risks and benefits of the procedure and willingness to comply with the substantial lifelong dietary restrictions required for long term success.

Dr Clement Tsang is a specialilst in the field of Bariatric Surgery, open to hearing your individual case. To discuss your surgical options please contact us or Ask us a question.

 

What to expect after Surgery

You will usually be in the hospital 1 to 3 days after a laparoscopic procedure. You may have a tube through your nose and not be permitted to eat or drink anything until it is removed. You should be out of bed, sitting in a chair the night of surgery and walking by the following day. You will need to participate in breathing exercises. You will receive pain medication when you need it.

On the first or second day after surgery you will be permitted to have liquid drinks which will be gradually increased during the day. Some surgeons allow you to eat baby food or a “puree” type of food. You will remain on a liquid or puree diet until your doctor evaluates you approximately 1-2 weeks after you return home.

Patients are encouraged to walk and engage in light activity. It is important to continue the breathing exercises while at home after surgery. Pain after laparoscopic surgery is generally mild although some patients may require pain medication. At the first follow-up visit the surgeon will discuss with you any dietary changes.

After the operation, it is important to follow your doctor’s instructions. Although many people feel better in just a few days, remember that your body needs time to heal. You will probably be able to get back to most of your normal activities in one to two weeks time. These activities include showering, driving, walking up stairs, and work and light exercise.

You should call and schedule a follow-up appointment within 2 weeks after your operation.

Expected Outcomes of Gastric Banding Surgery

The success rate for gastric banding weight loss surgery is reported as being slightly higher than gastric bypass surgery. All weight loss surgical techniques however demonstrate excellent results for weight loss.

Gastric Banding is reported to have a 40-50% loss of excess weight after the first year alone! Gastic bypass is reported as a 65-70% loss of excess body weight after the first year but is a much more complicated surgery with a longer recovery time. For most people it is recommended to have gastric banding surgery first, and if later required, to have gastric bypass surgery.

The expected outcomes for gastric banding are:

  • Shorter recovery time than other weight loss surgeries
  • Rapid wieght loss of 40-50% of excess body weight after the first year
  • Excellent success rates in achieving weight loss
  • Continual wieghtloss for 18-24 months after surgery
  • Minimal weight gain in the first 2 years
  • Easy adjustment of the LapBand if weight gain is noticed

While some weight gain is common about two to five years after surgery, for the majority of patients, proceeding with gastric banding surgery leads to a happier, healthier and more active life!

If you would like to discuss the expected outcomes of gastric banding, please contact Dr Clement Tsang for your personalised assessment and outcomes.

The Day of Surgery

  • You will arrive at the hospital the morning of the operation.
  • Preparation before surgery often includes changing into a hospital gown.
  • A qualified medical staff member will place a small needle/catheter (IV) in your vein to dispense medication during your surgery.
  • Often pre-operative medications are necessary.
  • You will meet the anesthesiologist and discuss the anesthesia.
  • You will be under general anesthesia (asleep) during the operation, which may last for several hours.
  • Following the operation you will be sent to the recovery room until you are fully awake. Then you will be sent to your hospital room.
  • Most patients stay in the hospital the night of surgery and may require additional hospital days to recover from the surgery.

Preparation for Surgery

  • A thorough medical evaluation to determine if you are a candidate for laparoscopic obesity surgery by your physician.
  • Supplemental diagnostic tests may be necessary, including a nutritional evaluation.
  • A psychiatric or psychological evaluation may be required to determine the patient’s ability to adjust to changes after the operation.
  • Consultation from specialists, such as cardiologist, pulmonologist or endocrinologist may be needed depending on your own specific medical condition.
  • Continued participation in Obesity Support Group is encouraged
  • A written consent for surgery will be needed after the surgeon reviews the potential risks and benefits of the operation.
  • The day prior to surgery, you will begin a clear liquid diet.
  • Blood transfusion and/or blood products such as platelets may be needed depending on your condition.
  • Your surgeon may request that you completely empty your colon and cleanse your intestines prior to surgery.
  • It is recommended that you shower the night before or morning of the operation.
  • After midnight the night before the operation, you should not eat or drink anything except medications that your surgeon has told you are permissible to take with a sip of water the morning of surgery.
  • Drugs such as aspirin, blood thinners, anti-inflammatory medications (arthritis medications) and Vitamin E will need to be stopped temporarily for several days to a week prior to surgery.
  • Diet medication or St. John’s Wort should not be used for the two weeks prior to surgery.
  • Quit smoking and arrange for any help you may need at home.

Risks and Side Effects of Gastric Banding

There are few side effects with Gastric Banding however the most common side effects are listed below. Please discuss with your doctor before proceeding with any surgical procedures.

Infection and migration

An infection may develop either in the port area or in the abdomen, and in some instances this may cause the band to migrate into the stomach. In such a case, reoperation normally is necessary. Most of the complications linked to migrations have occurred as a result of too much fluid being injected into the SAGB. The balloon must therefore be filled with no more than 9 ml of fluid, as recommended by the manufacturer. In nearly all of the reported cases of migration the balloon had a fluid content above 11ml. This is 2ml more than the recommended maximum volume. The rate of migration will be kept low by avoiding overfilling of the system. Migration can also be caused by a subclinical infection. Even if this is very rare, it is important that you do not let anyone inject liquid into your port without previously applying a swab soaked in 5% chlorhexidine spirit onto the skin for approximately ten minutes before the injection. Omitting skin preparation may result in an infection.

Leakage

Leakage from the gastric band or from the connecting tube between the balloon and the port may require reoperation. The balloon is made of fragile material, and leakage can occur either shortly after surgery or many years later. In the event of leakage, the gastric band can normally be easily replaced with a new one. Nowadays this is a rare complication, but you must be aware that there is a possible risk that in the long term the band may need to be replaced with a new one.

Slippage of the band and pouch dilatation

The band may slip, and the pouch (the part of the stomach above the band) may become too enlarged, and a reoperation may be necessary.

Punctures in the silicone band and port dislocation

The injection port may dislocate.
When injecting into the port, there is always the risk of puncturing the silicone tube.
However, should either of the above occur, both can easily be corrected with a small operation under local anaesthesia.

Other complications

Other complications have occurred. You should ask your doctor for more detailed information.

There is no guarantee that the gastric banding will work without fault for the rest of your life; however, the gastric banding system has been in clinical use since 1987.

The risk of reoperation will always exist, even if none of the above-mentioned complications occur. You must understand that the possibility of reoperation is an integral part of the overall management of morbid obesity. Reoperations are considered a technical measure that is sometimes necessary.

As with any surgical procedure using general anaesthesia, there is, of course, a risk of complications with even the possibility of death. Please ask your doctor for more detailed information.

LapBand TM System

The LAP-BAND System is the only adjustable system for weight loss surgery. The diameter of the band is adjustable for a customized weight-loss rate. Your individual needs can change as you lose weight. For example, pregnant patients can expand their band to accommodate a growing fetus, while patients who aren't experiencing significant weight loss can have their bands tightened.

The LapBand system has revolutionised weight loss for patients, offering a flexible and adaptable system, tailored to each individuals needs.

View the video below to see how easy the LapBand system is to adjust to give you your weight-loss freedom.

To modify the size of the band, its inner surface can be inflated or deflated with a saline solution. The band is connected by tubing to an access port, which is placed well below the skin during surgery. After the operation, the surgeon can control the amount of saline in the band by entering the port with a fine needle through the skin.

 

The Benefits of Laproscopic Bariatric/Gastric Banding Surgery

There are many benefits associated with the LapBand TM system (Gastric Banding). Using LapBand TM is considered the least traumatic surgery of all weight loss surgeries.

Using the laparoscopic approach to the gastric banding weight loss surgery offers the following benefits:

  1. No cutting or stapling of the stomach
  2. No re-routing of the stomach
  3. Reduction in post-operative pain
  4. Reduced hospital stay
  5. Quicker recovery
  6. Easy removal of the LapBand TM system
  7. Significant wieght loss can be achieved

To discuss your options for wieght loss surgery, please contact Dr Clement Tsang now for your individual assessment. Take the first steps to your wieght loss journey today!

Have you used our Body Mass Index Calculator (BMI) yet? Simply put in your weight and height and see if you are appropriate for life changing weight loss surgery.

The LapBand TM Procedure

During the procedure, surgeons usually use laparoscopic techniques (using small incisions and long-shafted instruments), to implant an inflatable silicone band into the patient's abdomen. Like a wristwatch, the band is fastened around the upper stomach to create a new, tiny stomach pouch 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.

Using the LapBand TM System, there is no cutting or altering of a patients internal anatomy. The procedure carries few risks and is well tolerated by patients.

As a result of the implantation of the LapBand TM system, patients experience an earlier sensation of fullness and are satisfied with smaller amounts of food. This in turn, results in weight loss to the patient. Most patients can lose significant amounts of weight, bringing them a happier and healthier lifestyle.

See our demonstration video of the LapBand TM system below.

When to call your Doctor after Gastic Banding Surgery

Be sure to call your doctor if you develop any of the following:

  • Persistent fever over 101F (39 C)
  • Bleeding
  • Increased abdominal swelling or pain
  • Persistent nausea or vomiting
  • Chills
  • Persistent cough and shortness of breath
  • Difficulty swallowing that does not go away within a few weeks
  • Drainage from any incision
  • Calf swelling or leg tenderness

02 92213919

0414676611

  Call now for all Enquires


Dr Clement Tsang
Consultant Surgeon

Waratah Private Hospital clinic
Level 2, 31 Dora st Hurstville 2220

Keyhole surgery Centre

 Level 8, 187 Macquarie st, sydney
Mon-Friday 8 to 4.30pm 

Campbelltown Private Hospital Clinic
Suite 12, level 1

42 Parkside Crescent, Campbelltown 2560