The operation in detail
How is the gastric band implanted?
The gastric band is implanted laparoscopically (‘keyhole’ surgery) and usually takes around 30-45 minutes. The procedure is done under general anaesthetic. This is for two reasons; your comfort during surgery and also to achieve the muscle relaxation in the abdomen that is necessary. On this page we give a technical breakdown of how the procedure is done.
The gastric band operation in detail
Once in theatre, and 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 organs that sit within, thus creating space for the surgeon to work.
The surgeon then makes small horizontal incisions (usually 3 or 4) 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 camera that are required to undertake the operation. These incisions are about 1cm long.
The images taken by this camera are visible to the surgeon and operating team on screen in the operating theatre.
The liver is moved gently to one side to reveal the upper part of the stomach. A narrow tunnel is created behind the upper part of the stomach through which the gastric band is passed. The band is then wrapped around the stomach, rather like a wristwatch, and the ‘buckle’ closed. It is then stitched securely in place by 3 or 4 stitches.
The 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 outside of the abdomen, and between the fat and the muscle layer.
Once a space has been made for the port it is secured in place either by stitches or by mesh fixation. Both methods are equally effective.
To complete the procedure, the small skin incisions are closed with sutures and/or glue, and covered with dressing.
After the gastric band operation
After your gastric band surgery you will be taken to the recovery area where you will be monitored for 30-60 minutes before returning to your room on the ward.
When you wake up after the operation you are likely to feel a little 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 is the larger. It is also quite common for some patients to experience pain in the left shoulder after the procedure. This pain is usually mild and is 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.
If your procedure has been unremarkable (as expected) it is likely you will able to go home the same day after a short period of monitoring in your room. That is the case for over 90% of band patients. 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.
During the first 24-hours you should have only water. You must drink slowly but regularly in small sips and not drink more than 100mls at a time.