In the Adjustable Gastric Band, popularly known as the stomach clamp method, a band made of silicone is placed around the stomach, approximately 20 mm below the junction of the esophagus and the stomach. The inner wall of the band is like an elongated balloon or bicycle tire. This balloon is connected to a port placed under the skin via a thin tube. The Adjustable Gastric Band is left deflated during the surgery but is gradually inflated approximately one month later with serum injections from the subcutaneous port. In this way, the size of the gastric passage can change with a simple intervention after the surgery.
How Does It Work?
The adjustable gastric band, made of silicone and does not have any allergic effect, divides the stomach into two parts, almost like an hourglass. When the upper small stomach pouch is filled with food, an early feeling of satiety occurs, and thus food intake is reduced. In the Adjustable Gastric Band method, as in other surgical procedures, the basic principle is to change the patient’s behavioral habits and to eat style. If the band is removed, it may be possible to return to pre-operative weight quickly. Therefore, this operation is not a permanent solution for morbid obesity unless the patient’s eating habits change. However, it can provide significant weight loss and offer a healthier life by reducing the risks associated with obesity-related secondary diseases.
How Is The Adjustable Gastric Band Placed?
The laparoscopic method is now the gold standard for the band, which was placed in most cases by open surgery in its first years. In Sweden, doctors used the laparoscopic method in 100 of the 1000 cases. The first surgery took place in 1985, and the technique is improving. With this surgery, it is possible to predict that 75% of patients will lose 75% or more of their excess weight within 18 months. Again, in most patients, the importance remains close to the level of the 2nd year in the 4th year after the surgery.
The tube portion of the adjustable gastric band, usually 10 mm, from the outer trocar, is placed in the abdomen. This end is held by the endgrasp roticulator and passes behind the stomach at the level of the dissecting area.
Then, the tube of the band passes through the locking mechanism, and the silicone band is tightened by placing it around the stomach.
The first filling process takes place after 1.5-2 months to the follow-up of weight loss. While some physicians grope in the office environment, others prefer to do it under radiological control. Filling rates may vary depending on the type of band used (some bars can be filled with max. seven ccs, some 10, some 12 ccs), weight loss curve, and appearance on X-ray.
Adjustable Gastric Band Problems
The Adjustable Gastric Band can be punctured early. With the technological development of bands, such problems have been minimized. With the puncture of the band, patients suddenly begin to gain weight. In this case, the patient needs to be re-operated, and the band should replace with a new one. Although such problems are minimized thanks to advanced band technology, it is never guaranteed that such technical issues will not occur.
Adjustable Gastric Band Migration
The migration band gradually erodes the stomach wall and passes into the stomach lumen. These patients also quickly gain their pre-operative weight. Patients whose Adjustable Gastric Bands fill quickly and reach total volume fast are at greater risk for migration. The filling should be slow and gradual.