Gastric band

The Gastric band is one of the most popular bariatric surgical procedures and is intended to help extremely overweight patients lose weight when all conventional methods have failed.

The goal of the minimally invasive, laparoscopic procedure is to narrow the stomach diameter at the stomach entrance, which from now on allows the patient to eat less food and thus reduces his weight and the risk of secondary diseases. Although the complication rate of gastric band operations is less than one percent, long-term complications occur relatively frequently after the operation, such as those that can result from a slipped band, a port infection or increased vomiting.

What is the gastric band?

In bariatric surgery, gastric banding is a minimally invasive and restrictive procedure intended to help patients who are very overweight to reduce their weight.

In bariatric surgery, gastric banding is a minimally invasive and restrictive procedure intended to help patients who are very overweight to reduce their weight. In principle, the procedure can be expected to reduce the original weight by around 16 percent, making it one of the most promising methods of bariatric surgery.

The operation can be used to treat morbid obesity in particular, which dietary and other conventional methods of weight loss have already failed. The gastric banding is one of four standardized obesity surgical procedures, which is often combined with one of the other three standard procedures.

The gastric sleeve must be distinguished from the gastric band, which, like the gastric band, aims to minimize the stomach, but unlike the band, it requires the surgical removal of entire parts of the stomach. Gastric bands are usually removed again after a long time because of the high long-term complication rate, whereby the explantation is often combined with a second procedure such as gastric sleeve surgery.

Function, effect & goals

The aim of the gastric band is the narrowing of the stomach entrance and stomach diameter. Such a narrowed stomach diameter prevents excessive ingestion of food and thus helps the patient to lose weight. The procedure does not necessarily require the patient to be admitted as an inpatient, but can in most cases be carried out on an outpatient basis as long as there are no contraindications.

After a consultation and the marking of the necessary incisions, the doctor usually puts the patient under anesthesia. During the operation, he performs an operation at the entrance to the stomach with the help of an optical instrument. This procedure is also called laparoscopy and is part of the minimally invasive procedures of surgery.

In gastric band laparoscopy, the doctor puts a silicone band around the gastric fundus. The opening of this silicone band is adjusted by adding liquid to the band.

In the wall of the abdomen or in front of the breastbone, the doctor sets up a so-called port chamber, i.e. an access. Gastric bands can be completely removed again. In about half of all cases, an explantation is absolutely necessary within ten years because the strap slips or the associated hose system leaks. An explantation of the gastric band is often accompanied by the creation of a tubular stomach, in which the doctor removes between 80 and 90 percent of the patient's stomach under general anesthesia and transforms the tube-like rest into a closed system with laparoscopic sutures.

Risks, side effects & dangers

Since gastric bands are placed in a minimally invasive procedure, the procedure is associated with far fewer risks for the patient than invasive surgical procedures. Although anesthesia generally leads to a higher risk of complications for overweight people, the complication rate with gastric banding, especially under the guidance of experienced surgeons, is below one percent.

In this case, an experienced surgeon is someone who has performed more than 50 equivalent operations on the stomach. Although the operation itself is hardly risky, various complications can arise after the operation. For example, larger chunks of food can clog the gastric band passage. Expert nutritional advice is therefore a crucial point for the continued success of the surgical procedure. An infection of the port can also occur as a long-term complication after the operation.

Under certain circumstances the gastric band cuts into the stomach or the band slips and has to be readjusted in an additional operation. One of the common complications is increased vomiting, which can cause tooth damage and other health consequences for the patient. Because of these risks, a professional consultation in a specially set up consultation center is irreplaceable before the procedure. Like all other obesity surgery procedures, gastric bands are not an option for everyone.

The basic requirement is a BMI over 40 or over 35 if there are diseases related to obesity. People with psychosis or addictions are generally not considered candidates for gastric banding. As a rule, the procedure is only performed on people with a biological age between 18 and 65 years, whereby the patient must have already tried all conventional methods of weight reduction without success. Potential gastric band patients must be fully motivated to lose weight and be fully informed of all available methods and risks.

The risk of the operation must not exceed the risk of other available interventions for the individual patient. Compared to obesity surgery such as the sleeve stomach, the gastric band primarily offers the advantage that it can be completely revised. On the other hand, an operation like the sleeve stomach is associated with fewer long-term complications in the long term.