Introduction
Gastric band surgery, also known as laparoscopic adjustable gastric banding, is a minimally invasive weight-loss procedure designed to help individuals with obesity reduce their food intake and achieve sustainable weight loss. The surgery involves placing an adjustable silicone band around the upper portion of the stomach, creating a smaller stomach pouch that holds less food.
The procedure in Gastric Band Surgery does not involve cutting or stapling the stomach or intestines, making it less invasive compared to other bariatric surgeries like gastric bypass. Understanding how the procedure is performed step by step can help patients feel more informed, prepared, and confident in their decision to undergo this surgery.
Procedure in Gastric Band Surgery
- Preoperative Evaluation and Preparation
Before undergoing gastric band surgery, patients are thoroughly evaluated by a multidisciplinary team, which often includes a bariatric surgeon, dietitian, psychologist, and sometimes a cardiologist or endocrinologist. A complete medical history, physical examination, and diagnostic tests such as blood work, ECG, and imaging studies are performed to ensure the patient is a suitable candidate for the procedure. Patients are also counseled about dietary changes, the importance of physical activity, and the commitment required for long-term success. Some individuals may be placed on a low-calorie diet for one to two weeks before the surgery to shrink the liver and reduce surgical risks. - Anesthesia and Operating Room Preparation
On the day of surgery, the patient is admitted to the hospital and taken to the operating room. General anesthesia is administered to keep the patient unconscious and pain-free during the procedure. Once anesthesia takes effect, the surgical team prepares the abdomen by cleaning it with antiseptic and draping the surgical field. The surgery is performed laparoscopically, meaning small incisions are made rather than one large open cut, which reduces healing time and complications. - Creating Access Points for Laparoscopy
The surgeon creates multiple small incisions typically four to five across the upper abdomen. Through these incisions, trocars (thin tubes) are inserted to allow the insertion of a laparoscope (a camera) and other specialized instruments. The laparoscope projects images onto a monitor, guiding the surgeon’s movements inside the abdominal cavity. Carbon dioxide gas is used to inflate the abdomen, giving the surgeon more room to view and operate. - Placement of the Gastric Band
Once the abdominal cavity is fully visualized, the surgeon carefully dissects the tissues around the upper stomach to create a tunnel behind it. The silicone gastric band is then introduced through one of the trocars and gently wrapped around the upper portion of the stomach, approximately 2 to 3 centimeters below the gastroesophageal junction. When the band is securely positioned, it forms a small upper stomach pouch that holds only a small amount of food. The rest of the stomach remains below the band but will receive food more slowly, helping the patient feel full sooner and longer. - Attachment of the Access Port
The gastric band has a thin tube connected to it, which leads to a small device called the access port. The surgeon places this port beneath the skin, usually on the abdominal wall just under the ribcage. This access port allows saline to be injected or removed later to tighten or loosen the band. The position of the port is carefully selected to make future adjustments easier and less uncomfortable. Once the band and port are in place, the surgeon tests the system to ensure proper placement and flow through the tubing. - Closure of Incisions and Recovery Room Transfer
After confirming that everything is in place and there are no complications, the surgeon deflates the abdominal cavity by removing the carbon dioxide gas. The instruments and trocars are removed, and the incisions are closed using sutures or surgical glue. A sterile dressing is applied over the wounds. The patient is then transferred to the recovery room, where they are closely monitored for several hours as the effects of anesthesia wear off. - Immediate Postoperative Recovery
Most patients are able to go home the same day or stay overnight in the hospital depending on their individual case. During the first few hours post-surgery, pain, bloating, or discomfort around the incision sites is common, but these symptoms are typically manageable with medications. Patients are encouraged to walk soon after surgery to reduce the risk of blood clots and promote healing. They are also started on a liquid diet and gradually transition to pureed, soft, and then solid foods over the next few weeks, under dietitian guidance. - First Adjustment of the Band
The first band adjustment usually takes place 4 to 6 weeks after surgery. Using the access port, the surgeon injects a small amount of saline into the band to begin restricting food passage. This process is known as “band filling.” The adjustment can be done in an outpatient setting and is often guided by fluoroscopy or clinical symptoms. The goal is to reach an optimal level of restriction that limits food intake without causing discomfort, vomiting, or difficulty swallowing. Additional adjustments are made over time depending on weight loss progress and symptoms. - Monitoring and Long-Term Follow-Up
Gastric band surgery requires ongoing monitoring and lifestyle changes for long-term success. Patients need to follow a structured diet, eat slowly, chew food thoroughly, and avoid drinking fluids during meals. Follow-up visits are scheduled regularly for band adjustments, weight tracking, and nutritional support. In some cases, if complications such as band slippage, erosion, or infection occur, surgical intervention may be necessary. However, with proper follow-up and care, many patients experience significant and sustained weight loss over time.
Conclusion
The procedure involved in gastric band surgery is a sophisticated yet relatively safe and minimally invasive technique that supports long-term weight management. From preoperative assessments to laparoscopic placement of the band and ongoing follow-up, each step plays a vital role in ensuring patient safety and success. For individuals committed to making lifestyle changes and attending regular follow-up visits, gastric band surgery can be an effective tool in the fight against obesity. Understanding the procedural steps not only prepares patients mentally but also helps them take an active role in their journey toward better health.
