Cosmetic Surgeries - Obesity Surgeries

According to the American Society For Metabolic Bariatric Surgery, gastric reduction surgery is not an easy option for obesity sufferers. It is a drastic step, and carries the usual pain and risks of any major gastrointestinal surgical operation. Some patients who undergo adjustable gastric band surgery lose more than 60% of excess body weight. Typically, patients who undergo adjustable gastric banding procedures, such as Lap-Band or RealizeBand lose less weight over the first 3.5 years than those who have gastric bypass, or other surgeries such as Biliopancreatic Diversion (BPD) or Duodenal Switch (BPD-DS). However, over 7 to 8 years weight loss from gastric banding and bypass are essentially equal according to the American College of Surgeons. Most patients reach 65 to 90% of their ideal weight. However, in order to maintain this type of weight reduction, patients must follow carefully the post-operative guidelines relating to diet, exercise, and band maintenance.

The placement of the band creates a stoma, or small pouch at the top of the stomach holds approximately 110 to 220 grams of food each meal. This pouch fills with food quickly and the band slows the passage of food from the pouch to the lower part of the stomach. As the upper part of the stomach registers as full, the message to the brain is that the entire stomach is full and this sensation helps the person to be hungry less often, to feel full more quickly and for a longer period of time, to eat smaller portions, and lose weight over time.

The band is inflated/adjusted via a small access port placed just under the skin. Saline is introduced into the band via the port. A specialized non-coring needle is used to avoid damage to the port membrane. There are many port designs and they may be placed in varying positions based on the surgeon’s preference. The port is sutured or stapled, in case of the RealizeBand into place. When saline is introduced into the band it expands, placing pressure around the outside of the stomach. Gastric Bands usually can hold 8 to 10 cc of saline. This decreases the size of the passage between the pouch and the lower stomach, and further restricts the movement of food.

Over the course of several visits to the doctor, the band is filled such that the patient feels s/he has found what is colloquially known as the “sweet spot” or "green zone", where optimal restriction has been achieved, neither so loose that hunger is not controlled, nor so tight that food cannot be consumed. This is an individual experience and cannot be predicted. There are approximately 7–8 adjustable bands on the market. The amount of fluid required and total content varies.