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The Adjustable Gastric
Lap - Band
The Heliogast Adjustable Band

 

 

 

 

 

 

 

The Adjustable Gastric Laparoscopic Band

The most popular and sought after method of weight loss surgery.

The surgeons fit the inamed LAP-BAND® System. FDA approved over 300,000 have been fitted since 1990.

Careful consideration is required before deciding on which type of surgery is best for you. Please be aware that the adjustable gastric band can be more costly in the long term than other surgeries. It has the most eating complications and is difficault to get on with when compared with the Gastric Bypass, or Sleeve Gastrectomy. 80% of lap-band candidates have theirs removed within 10 years.

A higher level of aftercare is required, with the need for several refills in the first year. It is considered the least invasive procedure and is inserted using Laprascopic surgery. Statistics show that 12% of candidates opt to have their band removed after a few years and have further surgery for weight loss. This is usually because the candidate fails to reduce weight over a sustained period of time (over 6 years) or has problems with food intake. However many candidates have had their bands for longer periods. Our experiences go back over 30 years and many candidates are perfectly satisfied and happy with their adjustable gastric bands .

Positioning of the Adjustable Gastric Band

 

 

how fluid filling adjusts the Gastric Band

How the Gastric Band works

The band is adjusted by adding or removing fluid (water) using a syringe injected into a “port”. This subcutaneous port is located just to the left of the navel and a bit lower down. It can be felt underneath the surface of the skin and sits comfortably in its place. It won’t interfere or cause irritation. The fluid inflates the Band surrounding the top of the stomach limiting the amount of food intake. Strict aftercare and monitoring is required for this system to be effective.

The Lap-Band subcutaneous injection port

This consists of a subcutaneous injection port attached to the tube connecting the Lap-Band (see picture). The port is placed, under the skin below the navel. Access to these ports requires the use of a non-coring needle known as a Huber needle. A non-coring needle will minimise the damage to the silicon rubber covering of the port and therefore reduce the risk of leakage from the port.

Filling the Adjustable Gastric Lap Band

Please note that with Adjustable Gastric Lap Banding further adjustments to the lap-band are required; the first being 4 - 6 weeks after the band is fitted with approximately 3 further visits in the first year. Providing the candidate loses weight satisfactorily, further adjustments can normally be reduced to yearly adjustments.

The Lap-Band Fill or Adjustment

The Lap Band is filled or adjusted via the port. A syringe fitted with a Huber needle is used to fully withdraw all fluid in the Lap-Band. The quantity of fliud is measured. If the intention is to tighten the band, then slightly more fluid is pumped back into the port. A Lap-Band can normally be filled until slight resistance is felt this is then the optimum fill level. For example if 3 cc’s of fluid is removed and the band needs tightening then 3.5 cc’s may be put back in.
When filling, it is important not to overfill the lap-band as this may cause a blockage or restriction preventing the candidate from eating our taking fluids. If such a restriction occurs the band should be deflated immediately and half the fluid placed back in. Frequent adjustment of lap-bands is necessary.

A lap band candidate should be familiar with their refill centre and visit as often as necessary to be sure that all is going well and they are loosing weight satisfactorily. Lap-band candidates should be aware that air travel can adversely affect the band creating a blockage. Pressurisation and depressurisation of the aircraft can cause air bubbles to occur within the lap-band, leading to a restriction. If this situation occurs and the candidate cannot take on fluids then the lap-band must be deflated immediately. Once the band has been deflated half the fluid can be put back in. The candidate will need to return for a fill and adjustment after a few days.

the gastric lap-band filling port

 

What is Laprascopic surgery?

Laprascopic surgery is performed through a small tube. Many people are of the opinion that there is only one incision. This is not the case. Laprascopic surgery has normally three incisions. The smallest incision (about 2cm) is located in the navel so as to disguise any post operative scarring, through this opening a tube is inserted that inflates the stomach cavity like a balloon. This gives the surgeon space within the tummy cavity to see clearly and be able to carry out the procedure with ease and safety. Two incisions 2 - 3 cm long and located on either side of the tummy (depending on the procedure). One is for the camera lens which places the whole view of the procedure up on a wide screen TV in front of the surgeon. The second is for the instruments which are used to carry out the procedure. The advantages of a laprascopic procedure are the fast recovery, rapid healing process, and also the lack of scars afterwards.

Complications and Problems associated with the Adjustable Gastric Band

Gastric Lap-Bands can be problematical. Aproximately 80% of candidates will have their band removed within 10 years. 60% will become disenchanted with the lap-band in 6 years. For these people the lap-band will have not worked in the long term. Removal costs nearly half the price paid to have it fitted so the overall cost would have been higher than the cost of a gastric bypass. Overall not a great investment! All bands are fixed in place with stitches low on the oesophagus on the top of the stomach. However in some cases the band can slip. This usually occurs after several years of wear or when the candidate has tried to force too much food down. If the gastric band has moved out of place an X-Ray will be required to determine its position.

Another problem is associated with long haul flights, air bubbles may occur due to the cabin pressurisation, causing restriction. This may lead to the candidate not keeping down food and fluids. Most surgeons recommend deflating the band by half before undertaking long haul flights and refill on return.

In certain circumstances the adjustable gastric Laprascopic band can leak, this is usually occurs when the joint or connection to the subcutaneous port wears over time, or more commonly is damaged during the fill process. This is corrected by a minor surgical procedure.

Over time the gastric lap-band will deteriorate and become damaged, it may move or slip; it may also wear the area of the oesophagus and cause health problems.
If you are experiencing problems or are unable to keep down fluids or food, seek immediate assistance!

It is extremely unlikely that a gastric band is fitted incorrectly. In our experience of 6,000 adjustable gastric banding fitted over 30 years, none have been found to have been fitted incorrectly.

If you are not sure that an adjustable Gastric Band is for you then look at our other weight loss surgery procedures; the best of which is without doubt the Laprascopic Gastric Bypass also the Gastric Balloon and Gastric Sleeve. These procedures are more effective procedures for long-term weight loss and cheaper in the long term.

Also see our nutritional information and read the frequently asked questions.

Adjustable Laparoscopic Gastric Banding
Instructions For When The Patient Arrives Home

On the instructions of Dr Stefaan De Clercq, when the patient arrives home the following should be followed:

  • When the patient is able to move about normally, white anti-flebitis stockings must to be worn.
  • Ten days after surgery the patient should visit their GP, physician or nurse to check the wounds are healing normally. The wounds are closed intradermally with resorbable sutures.(dissolvable stitches have been used) These do not need to be removed.
  • Please be sure to follow strictly any dietary advice or instructions given by the dietician at the hospital.
  • The use of aspirin or non-steroidal inflammatory drugs (such as Ibuprofen, Nurofen) are prohibited as they can cause stomach ulcers.
  • In case of pain paracetamol or paracetamol with codeine may be taken.


Dr Stefaan De Clercq
UZA Hospital
Antwerp
Belgium

 

Also see..

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Read our Testimonials  Click here

See our reviews ncluding Trevor Macdonald's "Tonight" Program on ITV   Click here

Meridian TV's 4 part documentary on 16 year old Nathalie Cox & mother Cheryl Cox's Gastric Bypass Surgery  Click here

Read Their story in Closer Magazine  Click here

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