Gastric Band Surgery

Everything You Should Know About Gastric Band Surgery

In this guide we’re going to look at the gastric band procedure, how it’s accomplished, the reasons why it has fallen out of favour in some places and what we consider to be superior alternatives. Before we wrap we’ll also take a look at the wisdom of going abroad for your bariatric surgery.

What is a Gastric Band

The first gastric bands developed in the late 1970s were rigid devices wrapped around the upper part of the stomach to create a kind of roadblock between it (the upper part) and the rest of the stomach. Early gastric band results were encouraging for weight loss but it was obvious refinements were needed. Those refinements initially took the form of different materials. Dacron, marlex, a silicone covered mesh and even the popular outdoor-wear material Gore-Tex were all introduced, although most of these materials are no longer in use today.

However, even the most sophisticated of materials was still prone to failure because doctors were having difficulty adjusting these bands to the precise diameter required for different individuals. Other issues that arose during this time included gastric band slippage, food intolerance, pouch dilation, chronic vomiting and more. On the plus side, it was determined during this period that silicone was likely to be the best material for this procedure and it remains the preferred one to this day.

The final refinement was the development in the early to mid-80s of the adjustable gastric band which increased the amount of weight loss experienced by patients while simultaneously reducing the severity of some complications and eliminating others.

The Banding Procedure

This is a “laparoscopic” surgery so named because of the camera – called a “laparoscope” – that is used to allow the surgeon to see inside your midsection throughout the procedure. Prior to the procedure you may be advised to adopt a gastric band pre-op diet although that will be determined on an individual basis. On the day of the procedure you will receive a general anaesthesia meaning you will be asleep during the gastric band operation and unable to feel anything. Once you are properly anesthetized surgery will begin.

  • The surgeon will make anywhere from 1 to several small incisions in your abdomen intended to accommodate the laparoscope as well as any instruments needed to perform the operation. Once the surgeon is satisfied with the placement of the camera the operation will proceed.
  • The band is then wrapped around the upper portion of the stomach directly beneath the esophagus effectively dividing the stomach in 2 and creating a small upper pouch and a large lower section.
  • Once the band is in place a tube is inserted through one of the incisions and attached to the band. This will allow the surgeon to tweak the tightness of the band to what he considers the optimal setting.
  • Saline is the fed through the tube to fill the band and perfect the fit. Once the fit is deemed to be optimal the tube is withdrawn along with the camera and any other instruments. Incisions are closed and the patient is moved to the recovery room.

This type of surgery as we mentioned earlier does not require any cutting of the stomach or other elements of the digestive system nor are there any staples left behind inside the patient. The entire process typically takes less than an hour particularly if you have an experienced surgeon. Once you get back to eating after you recover your stomach will fill up faster than it used to which will reduce the amount of food you can consume and cause you to lose weight.

Recovery

Make no mistake, although this procedure is often referred to as a “non-surgical” process incisions are necessary in order to perform the procedure. Those who bandy the term “non-surgical” about with regards to gastric banding are simply splitting linguistic hairs. The fact that there are incisions made in your belly during the procedure and that those incisions are susceptible to infection means the gastric band recovery time may be longer than you imagine. This is just one of the factors that must be taken into consideration when discussing the recovery process and gastric band aftercare. Other considerations include:

  • Adhering to the advice of the medical team – Those who experience the most difficulty when it comes to banding are often those who choose to ignore or pay little heed to the recommendations of the medical staff. The procedure is fraught with enough potential difficulties as it is without making things even more problematic by not following the guidance of those who know best.
  • Avoiding overexertion – Some individuals assume that because they were able to return home so quickly after having the device installed that this means they’re able to immediately resume their normal physical activities. This is a mistake. The surgeon and/or the medical staff will provide the patient with very specific guidance regarding their level of physical activity following a private gastric band installation and patients are well advised to heed this advice. This usually includes the recommendation that the patient not return to work for 2 to 3 weeks.
  • Diet after gastric band – The fact that the surgery seems relatively fast and simple doesn’t mean an individual has a green light to consume whatever they want when it comes to eating after gastric band. In fact for the first week or more after surgery the gastric band diet will be restricted to clear liquids like broth, skim milk and perhaps fruit juice. Solid foods will be a distinct no-no during this period and will only be slowly introduced once the body has acclimated to the presence of the band and it’s clear there are no serious complications.
  • Potential adjustments – In the weeks immediately following the installation of the band the surgeon will be watching to determine if the band is set properly. It’s entirely possible that some type of adjustment will need to be made after the evaluation period. Which brings us to our next point.
  • Communication – It’s important to maintain communication with the medical team in the aftermath of this type of surgery. The patient can’t receive the help they may need if they don’t let someone know what is going on with them. Likewise the surgeon won’t be able to make an accurate assessment of whether the band is properly set if the patient does not provide feedback on how they are feeling and what is going on with them.

Two facts are irrefutable when it comes to gastric banding: the first few weeks will play a huge role in determining an individual’s chances of long term success and, by not being mindful of the above listed considerations patients make the process of adjusting to a band – which is already difficult enough even under ideal circumstances – much more difficult. So the takeaway here should be to heed the advice of the medical team at all points during the gastric band recovery process, keep the lines of communication open with members of the medical team and support staff and be patient.

Who Is a Candidate for a Gastric Band?

In most cases individuals with a body mass index (BMI) greater than 40 are good candidates for this type of procedure. So too are individuals who are more than 45 kg above what is considered an ideal body weight. In addition, if an individual with a slightly lower BMI of say 35 is also beset by other medical conditions related to their weight such as diabetes or hypertension this procedure may be justified.

Most surgeons also consider it important for the person to have a history of unsuccessful weight loss efforts using other, more traditional methods. People under 18 years of age are also considered to be ineligible and all potential patients must also demonstrate full awareness of the implications of the surgery.
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How Much Does Gastric Band Surgery Cost?

So how much is a gastric band? In the UK it averages about £7,000 if all major cities are taken into account. A quick look around at the cost of gastric band in various European cities where you can still get it shows that gastric band prices vary from a high of nearly £9,000 in London to £6,000 in Helsinki to £4,400 in Ljubljana and slightly more, £4,500, in Bucharest. For truly cheap gastric band surgery you may even have to look as far afield as some cities in the US. In addition, the gastric band removal cost is roughly the same as the installation cost.

Why We Recommend Against It

After reading the above description and details of the actual procedure you may be asking yourself “Why would anyone recommend against having it? It seems fast and effective.” It’s a simple question with an equally simple answer: complications. That is, even though gastric band cost has come down the complications that made early iterations of the band problematic for a lot of people have never been fully addressed. In fact it’s estimated that as many as 1/4 of patients who undergo the procedure experience fairly significant complications. Some of the most common gastric band complications include:

  • Vomiting – This is the most common side effect/complication that results from this procedure and studies indicate that it occurs in nearly 30% of cases. In many of those cases the vomiting is serious enough to warrant the use of antiemetics to try and bring it under control.
  • Indigestion – Nearly as many patients suffer from serious indigestion in the wake of this procedure as suffer from vomiting.
  • Acid Reflux – Reflux is a serious condition that is experienced in nearly 15% of individuals who undergo the procedure.

While the above represent the most common complications there are quite a few more potential gastric band side effects that, while not as common, are still experienced by some who undergo banding. These include:

  • Infection of the incisions
  • Gastric band pain
  • Band malfunctions
  • Esophageal dilation
  • Blood clots
  • Breathing difficulties
  • GI abrasions and leaks
  • Bowel obstructions
  • Diarrhoea
  • Gallstones
  • Hypoglycaemia
  • Vitamin and mineral deficiency
  • Ulcers
  • GERD (reflux)
  • Food intolerance
  • Pneumonia
  • Dilation of the pouch
  • Death (rare but it does happen)

And as a result of these complications and the nature of the band itself (see next section) an increasing number of patients are undergoing gastric band removal, opting out of having the procedure to begin with or having the band removed and undergoing a second, more “traditional” weight loss procedure such as gastric sleeve or classic Roux-en Y gastric bypass.

The Band Itself

Problems with the band itself are another significant issue when it comes to this type of procedure. Gastric band problems may take many different forms such as the need for frequent follow up visits to the doctor to adjust the band. In some cases patients never seem to achieve any sort of comfort level with the apparatus. The fact is that if the band is too loose it may be comfortable but it will be ineffective when it comes to creating the smaller upper pouch in the stomach. On the other hand if the band is too tight there will undoubtedly be weight loss, but chances are the patient will never be comfortable. There are plenty of gastric band stories about people who find themselves beset by things like chronic nausea, acid reflux, indigestion and more. Gastric band slippage symptoms can also be difficult to detect which just exacerbates any problems.

It’s also the case that in many individuals the band ceases to be effective after a few years and the weight begins to creep back. In this case the patient has the worst of both worlds. They have the restrictions imposed by the banding along, perhaps, with side effects like GERD and at the same time they are not enjoying any benefits and are regaining the lost weight. In cases like this people usually wind up having the band removed and throwing in the towel. It sounds dramatic but in reality it’s an all too common series of events. Some resilient souls will take a while to allow for adequate gastric band removal recovery time before deciding to undergo a more reliable bariatric procedure like the ones we’ll be profiling below. These people usually wind up having happy endings to their story but they could have saved themselves a world of aggravation if they’d simply made the wiser choice to begin with.

In a Nutshell

The whole issue of the gastric band gone wrong serves to draw attention to 2 important aspects of any weight loss procedure. First, it’s important that people find the right procedure for their circumstances. And second it’s essential that patients comply with the guidance provided them by the medical staff before and after they have their weight loss procedure. Regardless of the type of weight loss surgery you choose you’ll still need to make the necessary lifestyle adjustment to ensure long term success. The ongoing issues with banding also raise the question of why it hasn’t been phased out and why some surgeons continue to recommend it for their patients.

While there’s no doubt that the number of bands being installed has fallen in recent years it’s estimated that gastric banding still accounts for as many as 5 or 6 percent of all weight loss surgeries worldwide. In fact thousands are performed every year in countries like the US where, while debate as to gastric band pros and cons continues, insurance companies continue to cover the procedure. And as long as insurance companies are willing to pay people will continue to believe this is a safe and effective procedure, even if the evidence suggests that may not necessarily be the case.

Doing the Right Thing From the Start

Instead of hoping that you won’t experience serious complications from having this procedure, instead of having to have the band removed and giving up on your dream of a slimmer, healthier you, instead of opting out of weight loss surgery completely take a few minutes and consider the alternatives. It’s our considered opinion at Weight Loss Riga that any one of the following procedures is a more effective long term solution for overweight or obese individuals and that by choosing the right procedure to begin with you can save yourself a lot of time, money and aggravation.

And the Right Thing Is?

There are 3 primary alternatives to gastric band surgery and we would recommend any of them over banding for all the reasons already enumerated above. Still, simply saying something is better isn’t much good unless we explain what those procedures are and what makes them the popular, highly regarded surgical weight loss solutions they are today. So without further ado let’s take a look at what we consider to be the 3 alternate “right things”.

Gastric Bypass

When weighing gastric band or bypass the discussion starts with what is considered by many to be the gold standard of weight loss procedures: Roux-en Y gastric bypass. This is a procedure with a long history that evolved from other, unrelated procedures to become the go-to weight loss surgery in hospitals and clinics around the world.

During the procedure a small pouch is carved out of the upper portion of the existing stomach where it attaches to the esophagus. This new smaller stomach will impose a limit on how much the person can eat. Once the stomach has been modified the upper portion of the small intestine is divided with the end that leads to the large intestine attached directly to the new stomach pouch. This provides a direct path for food products from the new pouch to the intestines where nutrients will be absorbed. The large portion of the stomach is left in place and the portion of the intestine connected to it is reconnected to the new intestinal path further down. This enables digestive juices to be drained from the large, now unused portion of the stomach.

Roux-en Y gastric bypass works in much the same way most bariatric surgeries work: by limiting the amount a person can eat. Less food equals fewer calories equals lost weight. Also because the newly redesigned stomach pouch is so small and the active portion of the newly reconfigured intestine shorter than it was previously fewer calories and nutrients are absorbed by the body and again, you lose weight. As a bonus rerouting the digestive process in such a way alters the balance of hormones in the stomach and promotes a sense of satiety while suppressing hunger. It’s a procedure that has proven its effectiveness and safety countless times over the decades since it was first introduced.

Gastric bypass advantages include:

  • Patients can reasonably expect to lose 60 to 80 percent of their excess weight.
  • Produces an altered hormonal landscape in the gut that leads to appetite suppression.
  • Compels patients to develop a healthier relationship with food.
  • Has a high degree of long term success.
  • Is typically free of many of the more odious side effects of banding.

Gastric bypass disadvantages include:

  • You will likely need to take vitamin and mineral supplements long term.
  • You will not be able to be discharged the same day as you would with banding.
  • There is no getting around the need to develop new eating habits.
  • Your digestive tract will undergo significant alteration that cannot be reversed.

While some patients are uneasy with the notion that the procedure is not reversible they should consider the overall outstanding long term success rate enjoyed by the gastric bypass procedure and weigh that against the myriad potential complications that come with banding.

Sleeve Gastrectomy

Sleeve gastrectomy – also known as laparoscopic sleeve gastrectomy – is a surgical procedure during with 75 – 80 percent of the stomach is removed leaving a slender, tube like stomach that resembles a shirt sleeve or, some would say, a banana. The procedure has not been around as long as the classic gastric bypass procedure but it is quickly gaining believers due to the fact that there is considerably less remodelling of the digestive tract involved than there is with Roux-en Y.

As with Roux-en Y gastric bypass the newly reduced stomach cannot hold nearly as much food as it did before. This compels the patient to eat less and less food equals fewer calories equals weight loss. Perhaps the most compelling feature of sleeve gastrectomy is that the intestine is not severed so the body retains its natural digestive flow from esophagus to stomach to intestine without interruption or redirection. The process also promotes a rebalancing of gut hormones that promote satiety as well as stable blood sugar levels.

There is convincing evidence that sleeve gastrectomy is every bit as effective as Roux-en Y gastric bypass when it comes to weight loss. In addition, because it promotes greater balance of blood sugar levels it’s also praised for its ability to improve quality of life for those with type II diabetes. Finally, while there are perhaps a few more potential side effects than there are with classic gastric bypass there are still far fewer than with banding.

Sleeve gastrectomy advantages include:

  • Greatly reduced stomach capacity.
  • Weight loss is typically fast and significant.
  • Fewer surgical alterations to the digestive tract.
  • Patients are typically home 2 days after surgery.
  • Promotes healthier gut hormone levels and more balanced blood sugars.

Sleeve gastrectomy disadvantages include:

  • Like Roux-en Y a sleeve gastrectomy is irreversible.
  • Patient may have to rely on long term vitamin supplementation.

Sleeve gastrectomy has been finding favour with patients and surgeons everywhere due to its relative simplicity, the fact that it generates fewer surgery related complications, its ability to promote a healthier gut environment where appetite is suppressed and the fact that it tends to help stabilize blood sugar levels for those with type II diabetes. It also entails far fewer side effects – both serious and incidental – than banding.

Mini-Gastric Bypass

The mini-gastric bypass is an offshoot of classic Roux-en Y gastric bypass surgery. In effect it occupies a kind of middle ground between Roux-en Y and gastric sleeve surgery. With the mini gastric bypass the stomach is divided in a way that leaves the upper portion looking very much like the banana-shape associated with the sleeve gastrectomy. However, instead of actually slicing the intestine in two the lower portion of the newly reconfigured stomach is simply connected to the side of the intestine some ways beyond where it connects naturally to the stomach.

Like other types of bariatric surgery mini-gastric bypass compels the patient to eat less by reducing the capacity of the stomach. The mini gastric bypass is most often a primary weight loss choice, although many who have decided to remove their gastric bands opt to have a mini gastric bypass afterward. It’s safe, effective and although it still requires modification to both the stomach and intestine, the intestinal modification is far less intensive and impactful.

In the hands of an experienced talented surgeon the mini-gastric bypass can sometimes be completed in about an hour. During recovery there are fewer potential complications to deal with than with classic gastric bypass simply because there has been less cutting and reshaping of the digestive tract. Mini gastric bypass is typically cheaper than standard gastric bypass as well.

Mini gastric bypass advantages include:

  • Perhaps surprisingly there is evidence to suggest the mini gastric bypass actually produces more reliable and predictable weight loss than standard Roux-en Y bypass.
  • Weight loss is particularly rapid in most cases.
  • There are no adjustments needed to a band after the fact.
  • It tends to produce more stable blood sugar levels in patients with type II diabetes. Some in fact may be actually be freed of the affliction altogether.
  • It’s fast, safe and effective with far fewer potential side effects than gastric banding.

Mini gastric bypass disadvantages include:

  • The need for long term vitamin and mineral supplementation.
  • The risk of anaemia in women of child-bearing age.

One particularly vexing myth that has made the rounds concerning mini gastric bypass is that it increases your risk of developing esophageal cancer or GERD (gastrointestinal reflux disease). It’s unclear where or with whom this fallacy originated but there is simply no scientific evidence that this is the case.

Why These Procedures are Superior to Banding

While we’ve just taken a closer look at the various procedures we believe to be superior to gastric bands we’ll now try to summarize why they as a whole represent a more sensible alternative to the banding process. That is, what is it about these types of bariatric surgery that make them a better choice:

  • Ability to produce significant weight loss – The procedures outlined above are known for being able to produce substantial weight loss in short order. That often entails hundreds of pounds being lost over the course of the first post-surgical year. Contrast that to gastric band weight loss results that oftentimes stall after the first 30 or 40 pounds and are often unsustainable.  
  • Increased longevity – According to the US National Institutes of Health obese individuals typically live 14 fewer years than people with an optimal body mass index. That’s a lot of years. However being able to enjoy a longer life because you’ve lost much or all of your excess weight is dependent on your ability to keep that weight off. As difficult as it may be to contemplate the idea of an “irreversible” procedure the fact is that such surgical solutions provide the best chance to both lose the weight you need to lose and, more importantly, to keep it off in the long run.
  • Reduction in comorbidities – With any of the above outlined surgical weight loss procedures you have a reasonable expectation that other weight related conditions will be reduced in severity and perhaps even cleared up entirely. That includes things like ankle, knee and hip problems, risk of heart attack and even type II diabetes. With banding you may lose some weight but you may in fact develop other problems like GERD, bowel obstructions, blood clots and respiratory problems that will make your weight issues seem relatively minor.
  • Fewer ‘do-overs’ – As we mentioned earlier many people who have undergone banding have encountered such severe side-effects that they’ve opted to have the band removed. Disheartened, some have simply given up on finding a solution to their weight loss issues. Others have decided to try again using a different approach such as mini-gastric bypass or sleeve gastrectomy. Having to change horses in midstream and go in an entirely different direction can be extremely stressful. Not to mention a huge waste of time, money and effort.
  • Affordability – Speaking of wasted money: banding, while still available in quite a few countries, is not always covered by insurance companies in those countries. As such, there is a very real possibility that you’ll have to pay for the procedure out of your own pocket. Contrast that to the various types of bariatric surgery outlined above, most of which are covered by insurance. In fact it’s likely the NHS will cover the cost of your gastric bypass, even if you have the procedure performed abroad.  
  • Accessibility and accountability – The bariatric procedures we outlined above are now available in every developed country on the planet. By contrast gastric banding is being dropped by more and more hospitals and clinics either due to what are considered excessive side effects or because many health plans simply refuse to cover it any more. You want your weight loss surgery to be performed by someone reputable, not someone trying to fly under the radar by offering a type of surgery that is no longer sanctioned by a country’s health authorities.

The bottom line is that gastric bypass, mini gastric bypass and gastric sleeve are all ascendant because they are proven procedures with fewer complications than banding.

Why You Should Have Your Bariatric Surgery at Weight Loss Riga

The fact is that if you live in the UK and are in need of gastric bypass to address pressing weight-related issues like type II diabetes, hypertension or joint problems you’re looking at a year or more of delays in most cases as your application winds its way through the bureaucracy. Because of the unfortunate truth of that statement many people look abroad for solutions and thousands have found it in the form of Weight Loss Riga.

While it has taken some time to chip away at the resistance many western Europeans had to medical facilities in places like Latvia time and experience have finally begun to win out. The fact is the quality of care you’ll receive at Weight Loss Riga is comparable to anything you’ll receive in London or Dublin or Paris or anywhere else. Here are just some of the reasons more and more people are making their way to Weight Loss Riga for their bariatric surgery.

  • Expert surgeons – The surgical staff at Weight Loss Riga are among the most highly trained of any in Northern Europe. Every year they perform hundreds of bariatric procedures on people from all over the world and achieve a success rate that would be the envy of any British hospital or clinic. If you are looking for the most qualified individuals to perform your gastric bypass or other weight loss procedure your search is over.
  • No waiting – Who has time to spend 1 or even 2 years of their life waiting for bureaucrats at the NHS to process their application for weight loss surgery? Now you don’t have to. You can be at our state of the art clinic in a matter of days getting ready for the procedure you need to put your life back on track. In addition, if you have a BMI of more than 42 and you have sought help from your GP related to your weight, you may be able to have your surgery abroad on the NHS. With “may” being the operative word.
    You should also keep in mind that if you have a lower BMI – between 30 and 42 – and you can prove you have a weight-related condition that poses a serious threat to your health, NHS may judge you eligible to be compensated for the gastric band procedure. While that sounds like a lot of ifs and maybes there’s no need to despair. The professionals at Weight Loss Riga will help guide you step by step through the bureaucratic forest so that your application stands the best possible chance of success.
  • Unrivalled care – From the moment you set foot in the Weight Loss Riga clinic you’ll understand why so many of your fellow Britons have been making their way here for their bariatric procedures. The multilingual support staff are there for you 24 hours a day ensuring your comfort by attending to your every need. You can wait 2 years to be treated like a number at a UK hospital or you can come to Riga now and be treated with the care and respect you deserve.
  • Minimal effort – Riga is just 2 ½ hours flight time from London which means you can leave your UK home in the morning and be undergoing your weight loss procedure in the afternoon. You can also bring along a family member or friend to spend the night with you in our hotel style guest rooms. All accommodations are included in the price of the surgery and all of our rooms are equipped with flat screen TVs, wifi and a host of other conveniences.
  • Discover one of the hidden gems of Europe – Riga is not just home to one of Europe’s premier weight loss clinics it’s also an astonishing historical and cultural gem that has been at the crossroads of the European story for more than 8 centuries. The centre of the city itself has been designated a UNESCO World Heritage Site and there are architectural and artistic treasures to rival any in this part of the world.

When you choose to have your bariatric procedure at Weight Loss Riga you’re making a common sense investment in a healthier future. The level of care you’ll receive will be equal to or better than anything you could receive in London and when you return home staying in touch with the medical staff will be as easy as calling our UK patient coordinator. So leave the year long waiting lists to those with time to waste and contact Weight Loss Riga today to schedule you bariatric procedure in close, convenient Riga.

More About Riga

We touched on the Latvian capital of Riga briefly above but it really deserves a few more words of praise. Riga is one of those rare modern cities that manages to embody all the best modernist traits – openness, inclusiveness, excellent health care, a lively intellectual life, respect for history and technological innovation – without suffering the downsides of modernism that can include choking traffic, stifling bureaucracy, rampant crime, environmental degradation and out of control prices. The most common reaction most people have when visiting Riga for the first time is “Why didn’t I know about this place before?”

Riga can trace its origins back nearly 2,000 years when it was known as Duna Urbs and played an important role in seaborne and riverbourne trade in the area. During the middle ages it became an important Viking trading post. By the 12th century contemporary accounts were already referring to it as an “ancient port” attesting to its longevity. Today the city embodies the indomitable spirit of its people and has been recognized as a European Capital of Culture as recently as 2014. It boasts numerous EU offices, has played host to world class sporting events and NATO summits and boasts a city centre that has been recognized by UNESCO as a World Heritage Site. Scores of people come to Riga for weight loss surgery and come back for the love of the place.

Conclusion

Gastric banding has been around for years and will in all likelihood continue to be offered at a variety of hospitals and clinics in many countries for the foreseeable future. However, while it’s understandable why people would want to take the path of least resistance to sustainable weight loss the fact is the band is not that path. It’s a procedure which has been beset by myriad side effects and serious complications from day one. And while certain refinements have made the procedure quicker and easier to perform many of those same old side effects and serious complications remain.

Before you make a date to undergo gastric band surgery call our UK patient coordinator and discuss gastric bypass vs lap band surgery with her. She’ll provide you a range of affordable, reliable options that will get you where you want to be and save you a lot of money and aggravation in the process. Call 02070971772 today. A healthier, happy future is waiting for you.