What is the Gastric Band?
The Gastric Band Device
The adjustable gastric band (also known as the Lap-band) has two main parts. The first is the band itself which is a small, hollow silicone band that is placed around the stomach. The other part is the access port which is small and disc shaped. It is usually about 0.5cm deep. The band and the port are connected by a tube.
So, when you have a band adjustment, we access the port by injecting into it with a syringe. We inject a small amount of saline (salt water). As we inject more fluid into the band it tracks up the tubing and causes the band to tighten around the stomach. Equally, by removing fluid from the band we can cause it to loosen around the stomach.
There are several high quality gastric bands available in the UK, and all have the necessary CE marks to prove their safety.
At Healthier Weight we favour the Apollo Lap-band and the Cousin Bioring. We have measured outcomes for both and they are equally good.
About the Operation
The gastric band is implanted laparoscopically (‘keyhole’ surgery) and usually takes around 30-45 minutes. On this page we give quite a technical breakdown of how the procedure is done.
- 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.
- 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 re 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 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.