• The Procedure
• Benefits
• Risks
• Contraindications 

The Procedure

Adjustable gastric banding limits food intake by placing a constricting ring completely around the stomach below the junction of the stomach and esophagus. While early bands were non-adjustable, those currently used incorporate an inflatable balloon within their lining to allow adjustment of the size of the stoma to regulate food intake. The small gastric pouch (the size of a golf ball) restricts the amount of food that can be consumed at a meal. Ingested food consumed passes through the digestive tract in the usual order, allowing it to be fully absorbed into the body. Today, gastric bands are placed through laparoscopic surgery, decreasing wound complication rates and time spent in hospital to less then one day (over 95% are done as outpatient surgery in our state-of-the-art facility), with patients returning to work within 7 days. Adjustment is undertaken without the need for surgery by adding or removing an appropriate material through a subcutaneous access port. As a restrictive procedure, gastric banding avoids the problems associated with malabsorptive techniques such as anemia, dumping and vitamin/mineral deficiencies.

Benefits

• multiple studies involving many patients demonstrate excess weight loss ranged averaging 50% at 5 year post surgery
• during pregnancy the band can be deflated to allow sufficient nutrient intake

In addition to weight loss, if you have any of these conditions, they will improve or resolve after the surgery:

• Diabetes
• Hypertension
• Sleep apnea
• Dyslipidaemia
• Asthma
• Low back pain and vertebral disk disease
• Weight-bearing osteoarthritis of the hips, knees, ankles, and feet
• Skin fold dermatitis
• Urinary stress incontinence

Finally, the health benefits gained with weight loss surgery can reduce your risk of death by as much as 62% compared to staying morbidly obese. For more details click "It's not just weight loss. It's health gain".

Risks

General risks from the published literature"

• overall death 0.05%
• band erosion into the stomach (1 in 200 patients)
• port site infection (1 in 50 patients)
• band slippage, pouch or esophageal dilatation (1 in 100 patients)
• reservoir deflation/leak (1 in 50 patients)
• persistent vomiting (variable)
• failure to lose weight (variable and dependent on patient compliance)
• acid reflux (variable)
• esophageal or gastric perforation (1 in 100 patients)
• band removal/conversion to other weight loss surgical procedure (1 in 100 patients)

Specific risks based on our own personal experience:

*All case adjustable gastric banding death rate=0.05%

Contraindications

• Pulmonary disease requiring oxygen therapy
• Extremely limited mobility  
• Endocrine disorders such as Cushing's Syndrome and Prader Willi Syndrome
• Psychological instability
  • Drug or alcohol abuse
  • Inability to cope with the changes in diet and life modification after surgery
  • Refusal to be assessed by psychologist or psychiatrist

Complex medical conditions increase the risk of surgery and are considered on a patient-by-patient basis.