Adjustable gastric banding is a safe and effective weight loss technique with one key difference from the other procedures: it is not permanent and can be easily reversed. Suitable candidates for gastric banding should have a Body Mass Index (BMI) of 40 or higher, or between 30-40 with at least one obesity-related health condition (e.g., sleep apnea, high blood pressure, type 2 diabetes). To find out whether you are a suitable candidate for gastric banding, please contact Dr. David Buchin today.
Gastric banding involves placing a silicone band around the top of the stomach to create a small pouch with a narrow passage into the larger lower remainder of the stomach. The small passage slows the emptying of the food into the stomach and intestines. Because of these factors, the stomach can only hold a small amount of food comfortably, and the patient feels fuller on less food. This prompts steady, rapid weight loss.
The band itself is hollow; it is has a long, thin tube connected to a small port, placed under the patient’s skin by the umbilicus. When Dr. Buchin initially places the band around the stomach, he inflates it with a saline (saltwater) solution. The band can be periodically tightened or loosened, depending on the patient’s needs. If weight loss has stalled, the band can be tightened by injecting more saline into it. This will reduce the size of the stomach pouch and the amount of food that can be consumed, triggering additional weight loss. On the other hand, if the patient is losing weight too quickly, the band can be loosened by removing some saline. This increases the size of the stomach pouch and the amount of food that can be consumed.
In addition to being minimally invasive and reversible, gastric banding has other advantages. The nature of the band does not interfere with the absorption of nutrients; therefore, patients are less likely to develop a vitamin deficiency. Also, the health benefits of weight loss are well-documented. Losing excess weight can improve or even resolve type 2 diabetes, sleep apnea, high blood pressure, asthma and high cholesterol.
Once the surgery has been scheduled, the patient is placed on a special diet of all-protein shakes and clear liquids to prompt weight loss. This diet also puts the patient’s body into a state of ketosis, a normal metabolic process that occurs when the body does not receive enough carbohydrates for energy, and is forced to get energy from stored fat. When preparing for surgery, this is helpful because the fat is taken from the liver, thereby shrinking it. With a smaller liver, the risk of liver injury is reduced. Also, this boosts the chances of a safe, fast and effective surgery.
The placement process is usually done laparoscopically. Several small incisions are made, and weight loss surgeon Dr. Buchin
uses a tiny camera and small instruments to place the band around the stomach. Periodic adjustments (called “fills”) can be conveniently performed at our office and do not require a hospital visit.
After surgery, patients need to follow a clear liquid diet (with one protein shake per day) for two weeks to promote proper tissue healing and nutrition. Slowly, solid foods are incorporated back into the patient’s diet. Soft foods are introduced around week three, and raw fruits and vegetables can be introduced around week six. Drinking from a straw and consuming carbonated drinks are discouraged.
Patients may not lift more than 20 pounds after surgery; they also cannot drive for five days. Sedentary desk jobs can be resumed within one to two weeks. Physically demanding jobs are considered on a case-by-case basis in coordination with our team.