What happens during a gastric band surgery?
A gastric band surgery is typically performed as a minimally invasive procedure. The patient is put under general anaesthesia and remains unconscious during the surgery. It is usually done on an outpatient basis, and most patients can go later the same day after the procedure. It involves keyhole incisions, which means incisions that are smaller than those made in an open (conventional) surgery.
The surgeon makes one or more small cuts on the abdomen to access the stomach. Lap band surgery is performed using a laparoscope, is a long narrow tube with a camera attached to one. The images of internal organs from the camera are displayed on a monitor, which guides the doctor during the operation. Surgeon inserts surgical instruments through other incisions and place the band using them.
Once the gastric band is placed around the upper part of the stomach, it is secured into the required position. This forms a pouch in the upper part of the stomach. The band is connected the reservoir that contains the fluid that will be used to inflate it and placed beneath the skin of the abdomen. The saline solution in the reservoir is later used to inflate the band to adjust its size. The narrowing of the stomach inlet is done gradually.
This surgery takes 30 minutes to 1 hour on an average. The surgeon will recommend the length of stay at the hospital after the surgery according to the patient’s condition. After they recovery from anaesthesia, patients are suggested to walk or mobilized under the supervision of their medical team.
Lap band “fill” – It is a term used for gastric band adjustments. After the surgery, followed by a period of healing, the doctor will make the first adjustment. Usually, this is done around 6 to 8 weeks post operation. In this, a saline solution is injected into the port placed just under the skin and connected to the band. But before this can be done, there will be some modifications to the diet and appetite.
Band fills are typically painless and are performed at a scheduled follow-up appointment by the surgeon. The adjustments are made gradually in order to enhance weight loss, especially if the patient is in a plateau phase of weight loss. It may also be performed to overcome the side effects such as nausea and vomiting (if the band has loosened).
Prior to the surgery:
The patient is instructed not to eat from midnight before the day of this bariatric surgery. The preoperative preparation starts after the decision to undergo gastric banding surgery has been made. Before this a series of medical tests and examinations are conducted to determine the eligibility of the candidate for this procedure.
The doctor will make a comprehensive assessment to determine whether this surgery helps your complaints or not. During the consultation and preoperative period, patients need to inform about their prescription and over-the-counter medications, and obesity-induced comorbidities such as hypertension, diabetes mellitus and cardiovascular diseases.
Their overall health will be assessed by the medical team. These assessments will both the patient and doctor to prepare for the surgery in order to minimize the risks and complications that can be possibly arise during or after the surgery.
The doctor will:
- Review the health history
- Conduct a detailed physical examination
- Assess results of laboratory tests and radiology/imaging studies
- Anaesthesiologist will asses the risks by considering the medical tests to minimize anesthesia-related complications
Once it is verified that the surgery does not pose risk to the patient’s health, they will be asked to quit smoking (if they are a smoker). The doctor might also ask them to stop taking certain medications that may increase the risk of bleeding or other prescribed and over-the-counter medications, herbal products and supplements.
During the preoperative discussion, the surgeon will also discuss the expectations, length of recovery and post-operative care plan after the gastric banding surgery.