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Weight Loss Solutions – Gastric Banding

 

What is Gastric banding?

Gastric Banding is a type of weight-loss surgery developed in the 1980s’ and is one of the main weight loss procedures performed at OClinic. (Click here to watch a real gastric band procedure.)

Gastric Banding has been performed in Australia since 1992, and more than 60,000 Australian patients have benefited from it. Worldwide, it has been used in over 650,000 patients and has a long and proven track record for safety.

It is also highly effective, with the average OClinic patient losing 62% of their excess weight within 18 months. Many patients overcome the medical conditions associated with obesity such as type 2 diabetes, sleep apnoea, joint pain, and infertility, and therefore enjoy a much better quality of life.

One of the main reasons Gastric Banding is more popular than other forms of weight-loss surgery is because it can be reversed. Unlike other weight loss procedures, which involve permanently cutting and stapling the stomach, the Gastric Band can be removed at any time. Another advantage is that it does not lead to deficiencies in vitamins and minerals.

The Gastric Band is particularly effective in people who have excessive hunger and/or need big portions to feel satisfied. Patients who can lose weight quite easily with diets and exercise but struggle to keep it off tend to do very well with the gastric band, which helps end the yo-yo cycles and is more powerful than diets and exercise alone.

Proper clinic support is essential after the gastric band- At OClinic you will feel fully supported by an experienced and well-trained team to help you get the results you deserve. As you lose weight you will need your band size adjusted to maintain your hunger and portion control. You will need regular support from experienced dietitians so that blockages and other food problems can be avoided. Regular check-ups with your surgeon will allow any band issues to be picked up early and avoid corrective surgery.
 

How does the Gastric Band work?

The Gastric Band allows you to eat much less but still enjoy your food and feel satisfied. It works by:

  1. Reducing background hunger (satiety)
  2. Allowing you to feel full with smaller meals (early satiation)
  3. Preventing overeating (restriction).

The Gastric Band is made from high grade medical silicon, a safe and inert material. It is placed around the top of the stomach by laparoscopic (keyhole) surgery. The operation takes about one hour, and is performed under a General Anaesthetic. Four very small (5mm) incisions are made on the upper abdomen, the Gastric Band is placed around the stomach, and a few holding stitches are placed around the band to keep it in the correct position (this reduces the chance of band slippage).

Next, an adjustable access-port is placed deep under the skin through one of the incisions and connected to the Gastric Band by special tubing. (Remember as there is no cutting or stapling involved, Gastric Banding can be reversed at any time.) The skin incisions are closed by absorbable sutures which are invisible and do not need to be removed.

Patients usually recover very quickly and are able to walk around the ward and drink liquids within a couple of hours of waking up. The procedure is even sometimes performed as day surgery, although we like to keep our patients in hospital overnight.

We recommend taking one week off work to recover, but most patients usually feel well enough to do gentle day to day activities such as driving within a couple of days.

Data from our own experience shows that the average OClinic gastric band patient sheds 62% of their excess weight within 2 years (approximately 30-50kg is a typical average), and studies show that this is maintained long term. The majority is lost within the first 12 months. Well-motivated patients may lose more than the average- up to 100% of their excess weight. Regular participation in our Total Care program is the key. We view it as a partnership.
 

Am I Eligible?

Gastric Banding may be suitable if:

  • your BMI is over 30 (click here to check your BMI), and;
  • you have genuinely tried to control your weight through diet and exercise
  • your weight problem is not caused by an underlying endocrinological disorder or medication
  • you are at least 16 years of age (no upper age limit)
  • you are prepared to participate in ongoing medical follow-up

If you also have type-2 diabetes, high blood pressure, sleep apnoea, or other obesity related medical disorders, or have a family history of these problems, weight loss surgery may be especially beneficial in improving your health and longevity.
 

Are there any risks with the Gastric Banding Procedure?

No surgery is completely risk free - however Gastric Banding is very safe. In our experience, the risk of a serious complication during surgery is less than 1 in 500. It is much safer than other types of weight loss surgery, which is the main reason why it is the preferred option for the overwhelming majority of Australian patients.

It is important, however, that your surgeon is well trained and experienced in the Gastric Banding Procedure- don’t be afraid to ask how many Gastric Banding Procedures he/she has performed and what their complication rate is. Dr Craig Taylor has performed more than 2000 gastric banding procedures with an overall rate of complications or problems, both short and long term, of 3.4%. With the new technique which we pioneered in 2009 this has fallen even further to 1.2%. 

Problems that may occur long term include:

  • Band slippage
  • Erosion
  • Access-port issues.
  • Gastric pouch enlargement
  • Reflux
  • Oesophageal dilatation

Fortunately most problems are quite straight forward to fix, allowing your Gastric Band to continue to provide ongoing hunger and portion control.

At OClinic we pride ourselves on supporting our patients longterm, and being readily available to help if any issues arise. However it is wise to maintain an appropriate level of health insurance so that any problems that may arise can be corrected at minimal cost to you.
 

Does my diet have to change?

Around the time of surgery, you will be asked to alter your diet, temporarily, to ensure you gain the best results from your procedure.

Before surgery: Optifast phase for 2 weeks

During your initial consultation with our dietitian, you will be asked to replace your regular meals with Optifast for 2 weeks prior to your surgery. The reason for this is to shrink the fat out of your liver, which will greatly improve access to the top of the stomach. This allows your surgery to be performed as safely and accurately as possible. It also provides and opportunity to properly visualise and repair any weakness or hernia in the hiatus area at the same time as placing your band.

There are a number of things you can also eat during this phase to keep it more interesting- vegetables, soup, yogurt, calorie free drinks, etc. Our dietitian will provide you with a handout explaining everything clearly.

In order to allow the Gastric Band to settle in, it is important to have liquids only during thefirst 2 weeks. This is usually quite easy as most patients find they are not hungry after surgery because of the normal swelling. You may have any type of fluid you chose, provided you drink it slowly. Our dietitian will provide you with clear instructions to guide you through this period.

Week 3 & 4 after surgery: soft food phase

During the third and fourth week after surgery you may increase the variety of your intake to include soft and pureed foods, as the swelling will now be settling. Our dietitian will see you again at the beginning of this phase to help and guide you. Remember this phase is only temporary- you will be able to eat a wide variety of regular foods from week 5 onwards.

Long-term Diet

Long term, you’ll find that you’re able to return to eating a wide range of everyday solid foods. The aim of the gastric band is to help you reduce your portion sizes, not your range. Provided you chew well and eat slowly you should be able to comfortably eat just about anything. There are a couple of problem food types though- doughy white bread, and tough red meats such as steak. Suitable substitutes for these foods include wholemeal and multigrain bread, and softer meats such as mince, veal, beef strips, chicken and fish. Our dietians will help you with this.

The three key guidelines for success are:

  1. Only eat when you’re hungry. Never eat just because of the time, because others are eating, or to prevent hunger later.
  2. Stop when you start to feel full. Generally a cup of food, or an entrée sized meal will be enough to fill you up.
  3. Avoid liquid calories. As solid food passes through the Gastric Band area, you will notice a sense of fullness building up. Liquids do not give the same sense of fullness as solids. It’s as if solids rotate a little turnstile as they pass through the band area, whereas liquids simply slide through without paying. You should try and keep alcoholic drinks, juices, cordials, milkshakes, ice cream and chocolate to a minimum for this reason. Calorie-free drinks such as water, tea, and coffee are fine- It’s important to keep well hydrated.
     

What will my recovery be like?

As the procedure is performed laparoscopically, post operative pain is much less than with conventional abdominal surgery. Patients are normally up and walking around about an hour after the procedure, and you’ll usually be asked to stay in hospital overnight just to be on the safe side.

However, it is normal to notice some temporary discomfort in the shoulder, particularly the left side, and sometimes patients notice a stitch-like feeling in the upper abdomen. Both are common and completely normal - these issues are usually not serious enough to prevent you from doing day to day things, and they generally resolve within a week after surgery.
Our new technique leaves minimal scars

At OClinic, we have pioneered a new approach that leaves virtually invisible scars. Most of the procedure can now be performed via the umbilicus, allowing the main scar to remain hidden and private. This technique is suitable for most patients, although rates of wound healing and scar formation differ from one person to another. Please ask for more details during your consultation on our new technique.
 

Band Adjustments

Everybody is different- one size does not fit all!

The adjustability of the Gastric Band is a significant advantage over other weight loss procedures, as it allows its effect to be customised for each patient to properly control hunger.

During your procedure, a small access port is placed deep underneath one of your abdominal scars. This port is connected to the Gastric Band by thin tubing. This port allows the size of your band to be adjusted with a high degree of precision using sterile saline.

Adjustments are performed in the clinic and only take a few minutes. You’ll be reviewed on a monthly basis in the first year or two to check on hunger levels and amount of food needed to feel full, the need for an adjustment will be based accordingly.

Once your goal weight has been reached, further adjustments are needed much less often, and clinic appointments can usually be reduced to once a year.



Click here to read about the Gastric Sleeve.