Gastric Banding
Gastric banding is a type of surgery for morbidly obese people, which reduces the amount of food the stomach can hold. The smaller upper compartment of the stomach is thus referred to as a "pouch". The gastric band is usually fitted via keyhole surgery, using specially designed surgical implements, although open surgery can be used under certain circumstances.
The gastric band itself is an adjustable band that is made from silicon. Once the band is in position, the size of the pouch can be adjusted by adding or removing fluid via an access port reservoir. The port stays under the skin and will be adjusted around six weeks after surgery, after the intial swelling has resolved.
Once the band is in place, only small amounts of food can be eaten, and a feeling of fullness is achieved quickly. This means that less calories are consumed, and so weight loss occurs. The operation requires that you spend at least one night in hospital, and will require a general anaesthetic.
What will it be like after the surgery?
For the first day afterwards you will only be allowed to drink clear fluid (eg water but not tea with milk). You may stay on a liquid diet for a little longer or you may start to eat small portions of pureed food. You will be offered pain killers if you are feeling sore. You may have drains attached to drain any excess fluid from the operation site. You will be encouraged to get out of bed early and move around as this will make you less likely to suffer from DVT (Deep Vein Thrombosis). In the long term, you will have follow your doctor's advice regarding drastic changes to your eating habits - you will feel very uncomfortable if you try to eat too much and you will be sick.
How safe is the operation?
As with all surgery, there are risks involved in gastric banding. However, the risks of remaining obese are higher than the risks of surgery. Nevertheless, you need to make yourself aware of the possible risks before having surgery so that you can make an informed choice.
Side effects are the after effects of surgery, including bruising, swelling and soreness, which wear off as healing takes place. You may need to take a multivitamin tablet as your diet will be restricted after the surgery.
Risks of the surgery itself include:
- The risks of having a general anaesthetic, which can be greater in obese people. These include chest infections and DVT which in the worst case scenario can lead to death from a pulmonary embolism (blood clot in the lung). These risks are increased in smokers.
- Infection of the operation site.
- Other organs may be damaged during the surgery.
- The band may slip out of its position, necessitating another surgery to replace it.
- You may not lose as much weight as you hoped to, especially if you "cheat" by pureeing chocolate bars and the like.
- If you lose a lot of weight quickly, you may develop gall stones which can require additional surgery.
You will need to discuss all these points with your surgeon, as the risks are more relevant to some people than others.
Can I get gastric banding on the NHS?
Gastric banding is recommended for people with a BMI in excess of 35, if their weight is posing an extreme health risk. For example, they have other risk factors such a type 2 diabetes or diseases of the cardio vascular system. According to the NHS, gastric banding is classified as a "cosmetic" procedure. However, you may be able to get the surgery on the NHS if you satisfy the following criteria:
- You are aged over 18 years
- You have tried to lose weight by conventional methods but have been unsuccessful
- You don't have any preexisting physiological or psychological contraindications (eg heart problems or body dysmorphia).
- You understand what it means to have a gastric band fitted and are prepared to reduce your calorific intake for the long term.
In order to qualify for the surgery on the NHS, your GP will need to refer you to a plastic surgeon and you will then be assessed by a psychiatrist. Only after you have been fully assessed will the specialists decide whether there are sufficient benefits to be gained from you having the surgery.
If you decide to have gastric banding performed in the private sector, the cost is normally in the region of £8,000.