Gastric band surgery is proven to be an extremely safe procedure, with mortality rates reported to be around 0.5%. It’s a minimally invasive laparoscopic procedure and patients can almost always return home on the same day.
Gastric bands often get a bad reputation, with the media portraying horror stories at every opportunity. More often than not, these stories contain incorrect or misleading information. In fact, due to a common misunderstanding of what a gastric band is, they are often stories about gastric bypass or sleeve patients instead.
So, how safe is gastric band surgery? We look at the stats, the complications and comparisons to other procedures as well as the risks of not losing weight and of going abroad for surgery.
Complication rates
When looking at surgery complication rates it’s important that patients consider the potential severity of complications when they do arise. In the case of the gastric band, most complications can be managed and treated successfully through a simple, day case corrective procedure, perhaps a port replacement or, rarely, a band removal.
These are recognised complications that are easily treated by an experienced band surgeon. The short AND long terms complications with sleeve and bypass are usually far more severe and the outcomes are unknown.
We like to be transparent with our effectiveness in the operating theatre. That’s why we proudly publish our stats. Here’s a breakdown of Healthier Weight complication rates, based on a study of 2,246 gastric band patients over 9 years.
- Operative mortality – 0% (this means no-one died)
- In-hospital returns to theatre – 0 (no-one returned to theatre whilst in hospital)
- Rate of all complications requiring re-operation – 4.2% (over 9 years)
- Slippage or pouch dilatation re-operation rate – 1.5% (over 9 years)
- Band removal rate – 0.5% (over 9 years)
Safety compared to other procedures
Compared to the low risk complications of the gastric band, the short term risks of bypass and sleeve are rare but more serious: haematoma (bleeding), staple line leakage, stricture (sleeve) and internal hernia (Roux bypass but not Mini bypass).
The major concern with these complications is that although incidence rates are low, when they do occur they are so unpredictable. Often a post-operative haematoma can be linked to or lead to a staple line leak, especially if the bleed was along the staple line. Staple line leakage is a terrible complication when the presentation is later (8 days after surgery or later) as it is rarely possible to return to theatre and simply close the leak.
This is an option when the leak is ‘early’ and the tissue around the leak is relatively undamaged. Those 1 in 80 patients experiencing a leak can expect several weeks in the hospital and there is always the risk of further complications arising from the treatment. In the case of the bypass, long-term complications can arise from vitamin and mineral deficiency, in extreme cases leading to malnutrition. This is avoidable however with vitamin and mineral supplementation and regular blood tests with your GP. These are very important. The later risk we are concerned about in bypass patients is an internal hernia.
This is rare but can be life-threatening. Indeed the internal hernia, staple line leakage and haematoma are all life-threatening.
The risks of not losing weight
When you consider the following life-threatening conditions, the risks of not losing weight far outweigh the potential short and long term problems patients can experience after gastric band surgery.
- Coronary heart disease
- Some types of cancer
- Stroke
- Type 2 Diabetes
Ref: Obesity – NHS – https://www.nhs.uk/conditions/obesity/
Losing weight can also have a huge impact on a patient’s mood and help improve depression, it can help women who are struggling to get pregnant due to PCOS (polycystic ovarian syndrome), it reduces reliance on blood pressure and asthma medication and many see improvements or resolution of liver disease and dyslipidaemia (abnormal blood fats).
Perhaps the question shouldn’t be “how safe are gastric bands?” but “how safe is not having a gastric band?”
The effectiveness of gastric band surgery
As well as being safe, the gastric band is also very effective when used as it should. How successful you are with the band depends on how well you are able to adapt to the diet and eating regime required for success, but in general our patients can expect to lose between 50-60% of their excess weight in the first 2 years.
The 3 golden rules are to eat slowly, to eat foods of the right texture and to reduce consumption of food and drink that is high in calories, e.g. ice cream and alcohol. Eating slowly is important because you need to allow time both for food to clear from the pouch, through the band and into the bigger stomach, and to allow time for the messages from your stomach to reach your brain.
If you follow these rules and get a little more exercise, you will be giving yourself and your band a greater chance of success.
Going abroad for gastric band surgery
If you go abroad for your gastric band surgery, yes, you will save money. But if complications are to arise after you have flown back to the UK, you won’t have anywhere to go apart from onto the NHS waiting list.
As we talk about so often, aftercare is the most important factor in any weight loss procedure. And all too often, overseas surgery packages have no aftercare whatsoever. Furthermore, some countries do not operate to same high standards as we do.
In the UK, all of our surgeons have to be registered with the General Medical Council and are usually members of the British Obesity and Metabolic Surgery Society (BOMSS). However, in some centres outside the UK, these accreditations may not exist.
Rishi’s final thoughts
It’s true, the gastric band is not as powerful a procedure as the sleeve or bypass (where you can expect to lose 60-70% of your excess weight), and you’ll have to work harder to get the weight loss results you are striving for, but the safety profile makes it well worth considering. In my opinion, too many people have dismissed the band and promote the sleeve instead.
Both have their place and the sleeve and bypass are excellent procedures. Let’s not forget the value of a safer procedure, however, especially so for younger, generally healthier patients with lower BMI. Let’s not forget also, that the gastric band operation is completely reversible with no changes to your anatomy required.
At a Healthier Weight consultation, your surgeon will talk to you about the pros and cons of all the procedures. Make sure you fully understand them.