The adjustable gastric band is a plastic and silicone device that wraps around the top of the stomach, creating a small stomach pouch. The band that wraps around the stomach is attached to tubing, which is then attached to a port. The port sits on top of the abdominal muscle layer and is accessed by needle during an office visit. Saline and injected and removed from the band through the port to tighten and loosen the band.
How it works
The band slows the progress of food through the stomach, making it very difficult to eat large portions. It may also promote fullness by exerting pressure and receptors on the outside of the stomach.
The band is the easiest surgery to perform and therefore has less short term risk of bleeding, infection, damage to surrounding structures, and risks of anesthesia than the sleeve or the bypass. The band also carries a very low risk of ulcers and no risk of internal hernia.
The band has the lowest average weight loss, with an average excess weight loss of 40%. Resolution of medical problems with the band is 50%. Results can be inconsistent, with 10-20% of people losing more weight (80-100 pounds) and 10-20% of people losing very little to no weight at all. In addition, the band carries a number of long-terms risks, including slippage, erosion, tube and port malfunction, and esophageal damage, all of which would require another surgery to fix and result in a high likelihood of band removal.
You may be a candidate…
If you are a body mass index of 35 or more with one qualifying medical condition, or if you are a body mass index of 40 or more with no medical problems. These criteria are subject to variation depending on your insurance. This operation may also be a better choice for you if you take NSAIDs for pain control, since there is less risk of ulcer.
This may not be the best choice for you…
If you tend to eat small portions throughout the day. The band will help more with large portion eating but is not a good tool for controlling snacking.
You may also want to consider a different option if you would like to lose more than 50 pounds and are considering bariatric surgery mainly for resolution of medical problems. While there have been cases of 80-100 pounds weight loss and resolution of medical problems with the band, the chances of these outcomes are 50% or less and cannot be guaranteed with this surgery. This surgery is also not a good option for people who do not like needles and are unable to attend monthly office visits. Since the band is placed on the stomach empty and can only be accessed monthly for fills, and cannot be filled too quickly, it may take several months of diligent office visits to reach the ideal fill volume, which is individualized.
You may be a candidate…
If you are a body mass index of 35 or more with one qualifying medical condition, or if you are a body mass index of 40 or more with no medical problems. These criteria are subject to variation depending on your insurance.
What is the required work-up prior to having surgery?
We are proud to offer full service at our center and will assist you with ordering any testing and further evaluation that you need. We require that everyone considering surgery with us undergo preoperative testing and work-up including:
Labs, X-rays and EKGS
Evidence of up –to –date health maintenance (pap-smears, mammograms, and colonoscopies)
Evaluation by a dietician
Evaluation by a psychologist or psychiatrist
Completion of a medical weight management period, if required by insurance
Further testing and educational and counseling sessions may be required depending on the results of initial testing and evaluation.
Many insurance companies will also require a medical weight management period, consisting of monthly visits with a program dietician for 3-6 months. We currently offer these weight management appointments as well as psychological and dietician evaluations at our Lodi location.
I am interested in learning more. Where do I start?
We will be happy to provide you with more details on our informational forum, which you may attend free of obligation. Please fill out the form on this website if you would like more information on dates and times for the forum. We will contact you with further information.