Is Gastric Banding Safe?

Gastric banding is a bariatric surgery that involves placement of a silicone band in the top portion of the stomach. The silicone band squeezes the stomach into a pouch that can hold only about an ounce of food. 

Gastric banding is a surgery to reduce the size of the stomach and help patients lose weight.

It is a restrictive surgery, as it reduces the size of the stomach. Gastric banding reduces hunger and prevents overeating, as the patient feels full faster and starts to lose weight.

Gastric banding is indicated in the patients:

• Who have a body mass index (BMI) greater than 40 kg/m2
• Who have a BMI between 30 and 40 kg/m2 and have one medical condition associated with obesity

However, gastric banding should be avoided in the patients:

• Who have inflammatory diseases of the gastrointestinal system (e.g., Crohn’s disease, severe inflammation of the esophagus)
• Who have liver diseases
• Who have severe heart and lung disease
• Who have a birth defect in the digestive tract
• Who are using steroids or other immunosuppressant medications
• Who have autoimmune diseases
• Chronic pancreatitis (inflammation of the pancreas)
• Unwilling to follow dietary restrictions post-surgery
• With a history of substance abuse
• With a history of active major psychiatric disorder

Gastric banding includes several steps. The following information can prepare you for a gastric banding procedure.

Before the surgery

• The physician will enlist your medical and medication history, especially any medical condition associated with obesity.
• The physician provides nutritional counseling
• You need to undergo blood tests and complete physical examination
• You need to stop taking aspirin, ibuprofen, vitamin E, Coumadin (warfarin), and other blood thinner medicines or any herbal supplement for some time before the surgery.
• You should be on a liquid diet 24 hours before surgery.
• You have to fast for a minimum of 12 hours before surgery.
• You’ll be given antibiotics and unfractionated heparin 30 to 120 minutes before the surgery.

During the procedure

• A gastric band is fitted under general anesthesia. It is a minimally invasive procedure and is performed through a keyhole incision. 
• The patient is made to lie flat on the operating table and is secured to the operating table to prevent sliding. 
• The patient’s abdomen is sterilized and draped. 
• The surgeon makes three to five small surgical cuts in the abdomen. 
• The surgeon inserts a long narrow tube with a camera (laparoscope) through one of the incisions. 
• Through the other incision, the surgeon uses surgical instruments to place the band. 
• The gastric band is placed around the upper part of the stomach and secured with stitches.
• The port attached to the band is secured to the wall of the abdomen. 
• The procedure takes about 30 to 60 minutes to complete.

After the procedure

After the surgery, food intake must be restricted. For the first few days, a liquid diet should be taken. 

• The patients can resume a normal diet after six weeks. 
• The patients can resume a normal routine within two days. 
• The physician educates the patient about how much to eat, what to eat and exercise routine to achieve adequate weight loss.

Normally patients survive this surgery. But, the risks increase after surgery. The risk of death due to gastric banding is less than one in 3,000. The most common complications of this procedure include:

• Band erosion
• Band slippage
• Gastric band erosion
• Nausea and vomiting
• Wound infections
• Minor bleeding
• Perforations in the gastrointestinal tract
• Gastritis (inflammation of lining in the stomach)
• Poor nutrition
• Scarring inside the abdomen

Gastric bands do not last forever. A gastric band can deteriorate over time and may need to be removed or replaced to prevent complications.