Today’s blog is going to look a little deeper into gastric band surgery. When most people think of weight loss surgery they typically think of gastric band surgery, as it has been so widely reported in the media over recent years. It is also very popular amongst patients who first enquire about weight loss surgery, not only because they have heard of this surgery, but because it is the least invasive form of weight loss surgery.

Despite it’s popularity over the years gastric banding is now not as common as you may think, as other forms of weight loss surgery have prevailed to be much more popular for weight loss.

Why is gastric band surgery so popular amongst patients?

Well there are several reasons why gastric banding has become increasingly popular since people starting opting for weight loss surgery, let’s explore some of the reasons below:

Adjustable – the gastric band (often referred to as a lap band) is adjustable once it is in place, which means that your doctor can easily adjust the restriction on your stomach depending on your needs.

Reversible – a gastric band can be removed by your doctor at anytime, unlike other surgeries which make permanent changes to your digestive system.

No malnutrition – as the gastric band doesn’t actually adjust the way your body processes food, it simply reduces the amount that a person can consume, their nutrition isn’t affected by the band.

Considered safer – as the operation is minimally invasive it is considered safer than other forms of surgery.

Given the above it is easy to understand why we get so many calls from patients who are considering weight loss surgery and ask for gastric banding. However at Upper GI Surgery, along with our peers, gastric band surgery is less commonly recommended than it was in the past.

Drawbacks of gastric band surgery

Whilst gastric banding paved the way for weight loss surgery in Australia, showing the world that it can assist with a person’s weight loss over many years, the drawbacks to this surgical option have led to its decreasing popularity.

The main reason that it is falling out of favour is that long-term studies have shown that significant follow up and patient compliance are required for long term weight maintenance and many patients struggle to eat a normal diet even many years after surgery. If patients “fight” the band when they eat they run into problems with regurgitation, reflux and stretching of their stomach or oesophagus usually 4-6 years after surgery. This leads to weight regain and re-operations to either fix a band complication or remove the band. The risks of re-operation are probably 1-2% per year in patients who have an organised and disciplined approach to eating but are up to 20% per year for patients who struggle to manage to stick to an eating plan.

The types of band complications seen are:

Pouch dilation – If the band is adjusted too tightly and the patient experiences regular “resistance” to food passage, food getting stuck or regurgitation, the stomach stretches and then the oesophagus stretches. As this happens the oesophagus becomes progressively weaker and less able to push food into the stomach itself. A late stage of this leads to progressive reflux and while these symptoms can be corrected by deflating or repositioning the band, symptoms will recur if the band is tightened beyond a minimum level.

Band slippage – If the band pouch stretches suddenly the band can slip position. This leads to rather sudden and significant symptoms that may require emergency surgery to correct, as the stomach can be at risk of strangulation if the “slip” is large enough.

Risk of infection – the risk of the device becoming infected at the time of surgery is about 1 in 200. Any band infection can easily be fixed by device removal if antibiotics don’t fix the problem quickly. Late infections introduced when fluid is injected into the device are uncommon, but can make the access port “flip” and unable to be accessed. The most difficult type of infectious complication after band placement is that of band erosion. This complication occurs in less than 0.5% of patients per year, and occurs when the band cuts into the stomach, ending up partially inside it. While many patients have minimal symptoms other than return of their hunger, it’s possible to end up with an abscess around the stomach.

If you’re considering gastric band surgery to lose weight then you’re not alone, and this surgery is still safely performed in Australia and across the world. We recommend it mainly for younger or more motivated patients due to the compliance requirements. Our view is that it has much in common with dieting, so it is a good option for patients who are happy with the dieting process. If you would like to discuss weight loss surgery options with one of our doctors then please contact our team who will be able to arrange this for you.


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