The main advantage of the gastric band obesity surgery is that it is the safest of all the available surgical procedures. Most modern published studies have between 0 and 0.1% (1:1000) mortality rates for the gastric band and serious complications such as haemorrhage (bleeding) are exceedingly rare. Of course the main reason why it is such a safe procedure is because unlike other procedures – e.g. gastric bypass – implantation of the band does
not involve cutting the stomach or the bowel. Another important benefit is that the gastric band is adjustable – by adding or removing saline from the band the degree of restriction can be varied and, thereby, individualised.
No other procedure offers any form of adjustment.
Some studies suggest that although early weight loss after gastric bypass obesity surgery tends to be greater at the end of 5 years there is almost nothing to choose between gastric bypass and gastric banding. On the other hand, the gastric band does require regular adjustment and generally has a higher re-operation rate that the gastric bypass.
The advantages and disadvantages of gastric banding versus gastric bypass surgery are illustrated below:
|
| |
|
| % Excess weight loss | 50-60%
| 0-75% |
| Mechanism of weight loss | Mainly restrictive
| Works by a combination of restriction, together with major changes in gut hormones (especially ghrelin). The net effect is a marked loss of appetite and a change in food preferences
|
| Mortality (death) rate | 0-0.1% (0 to 1:1000) | 0.3% (3:1000) |
| Early complication rate | Less than 2% (2:100) | 3-4% (3:100 -4:100) |
| Average length of procedure | 45 mins | 1 to 1½ hours |
| Type of procedure | Laparoscopic (keyhole) | Laparoscopic (keyhole) |
| Average length of stay in hospital | 1 night | 2 nights |
| Recovery time | 7-10 days | 2-3 weeks |
| Long-term re-operation rate | 5-10% | 5% |
| Follow-up requirements | Band adjustments are required | Lifelong daily vitamin and mineral supplementation and regular blood tests |
| Adjustability | Fully adjustable | No adjustment possible |
| Reversibility | Fully reversible | Effectively irreversible |
