The gastric band is implanted laparoscopically (“keyhole” surgery) and usually takes around 30-45 minutes. Very briefly, this obesity surgery procedure can be divided into a number of distinct phases.
- After cleaning the skin, the surgeon places a small needle into the abdominal wall through which gas is introduced into the abdominal cavity. This lifts the abdominal wall away from the structures in the abdominal cavity, thus creating space for the surgeon to work.
- The surgeon then makes a few small incisions through which the trocars (hollow tubes) are introduced into the abdomen. These trocars are hollow and allow the surgeon to pass long, thin instruments and a camera, so that the operation can be viewed on a video screen.
- The liver is moved gently to one side and the upper part of the stomach is identified. A narrow tunnel is created behind the upper part of the stomach to let the gastric band through. The band is then wrapped around the stomach – rather like a wristwatch. It is then locked securely in place. The band is then covered by stomach tissue which is held in place by 3 or 4 stitches.
- The gastric band usually has a very small amount of fluid left inside after the surgeon has washed (or “primed”) it. It will remain like this until the first band adjustment after approximately 5 weeks.
- Once the band is in place, the trocars are removed and a slightly longer incision is made in the abdominal wall to allow the access port to be placed in a secure position at the junction between the fat and the muscle layer.
- To complete the procedure, the small skin incisions are closed with sutures and/or glue.
After the operation
After gastric band surgery you will be taken to the recovery area where you will be monitored for 30-60 minutes before returning to the ward.
When you wake up after your gastric band operation you will have some discomfort. This arises from the small incisions through which we passed the instruments into your abdomen, especially the one where the band access port has been placed, which tends to be slightly larger. It is also quite common to experience pain in the left shoulder after the procedure. This pain is actually coming from the diaphragm – the large sheet of muscle separating the chest from the abdomen – but is “referred” to the left shoulder. It usually passes after a couple of days but can sometimes be a bit more persistent.
For the next 24-hours you will be allowed only water. You must drink slowly but regularly in small sips and not drink more than 100mls at a time. You will be given appropriate medication for pain relief and you will be asked to sit out of bed and walk as soon as you are able in order to reduce the risk of blood clots forming.