Gastric banding is the installation of a silicone ring on top of the stomach in such a way as to divide it into two parts: the upper and lower. The stomach is shaped like an hourglass. At the same time, the upper part in the volume is up to 30 cm3, the lower part is slightly larger. A very small lumen is formed in the place of coverage of the stomach ring. However, it allows food to pass from the upper part of the stomach to the lower part and does not interfere with the digestive system.
Gastric banding scheme
At the same time, food passes through this lumen rather slowly. As a result, after taking a few spoonfuls of solid food, the upper part of the stomach stretches and the patient feels full.
The installation of the bandage is a laparoscopic operation and has all the advantages of this low-traumatic method of surgery. Therefore, operational risks are significantly reduced. Also, for the patient, the degree of discomfort decreases, and the results of weight loss reach high indicators.
The ring installed on the stomach can be changed in diameter. Thereby weakening or, on the contrary, strengthening the effect. For these purposes, there is a reservoir on the inside of the ring. To access this reservoir, a small device is implanted under the patient’s skin and connected to the bandage using a thin tube (its diameter is 2 mm). If you need to reduce the ring, a saline solution is injected into the tank through the device. Using the same technique, the ring is enlarged if necessary.
The material for making the ring is medical silicone, which is biologically inert. The bandage is designed for lifelong use. On average, after a year from the moment of its installation, the patient gets rid of 50% of the extra pounds.
Appearance of the bandage
It should be borne in mind that sweet lovers and those who can not clearly follow all the recommendations on the diet, the effect of wearing a bandage is lower than in disciplined patients.
Locations of trocars Locations of trocars when performing laparoscopic gastric banding.
Installing a bandage can lead to complications. They are divided into three groups depending on the time of development:
- intraoperative-appear during the operation;
- complications that developed in the early postoperative period;
- complications that developed in the late postoperative period.
Intraoperative complications can develop during any operation. One of the most dangerous complications of this type is damage to the stomach wall or bleeding. However, such cases are extremely rare.
Complications in the early postoperative period develop for such reasons as: violations in the regulatory system, infection of the bandage, the development of infection in the wound area.
In the late period, functional disorders may develop, erosion of the gastric mucosa in the area of the standing bandage, as well as violations of the regulatory system. In practice, all of these complications are very rare.
Most often, among the complications, there is a displacement of the” Slippage ” of the ring. The complication manifests itself in the fact that a section of the stomach slips through the ring. This leads to the displacement of the ring and the expansion of the upper part of the stomach. This complication can lead to: non-compliance with the doctor’s recommendations, violations during the operation of the bandage, violations during the operation. With the development of this complication, the patency of solid food is disturbed, vomiting, burning and pain behind the sternum appear, the patient feels weak, unwell. In such cases, it is necessary first of all to consult a specialist. To eliminate the problem in 50% of cases, the use of conservative methods allows. If the effect of the measures taken is absent, they resort to repeated surgery to remove the bandage.
In the second place in the frequency of occurrence is the perforation of the ring wall of the stomach. This complication is noted in patients with bulimia syndrome (pathological overeating). Other common complications are inflammatory reactions in the port area, which may result in suppuration. With these complications, a second operation is performed to remove the bandage.
Gastric banding has been a very common operation in European countries and Israel since the early 90s. Since the beginning of 2005-2007, this operation has been treated selectively, as more effective operations (SLEEVE-I, SLEEVE-II) have replaced it.
Currently, different models of bandages are produced (you can see them in the section types of bandages). Some of them are made in such a way that they reduce the risk of any complications. However, regardless of the technical parameters and features, they have the same principle of operation.
It is necessary to say separately that after the operation of gastric banding, after 3-5 weeks it is necessary to adjust the bandage (in general, from 3 to 5 times). The procedure is simple, takes about 5 minutes in total, and is an injection of saline solution into the port, by injection through the skin. It can be performed by a specialist accompanied by a radioscopy. The purpose of adjusting the bandage is the optimal choice of the diameter of the ring, which to a lesser or greater extent narrows the lumen of the stomach under the ring, before the appearance of a feeling of early satiety when eating small amounts of food.