Benefits of Gastric Band Surgery and Indications for the Procedure
Severe obesity not only restricts quality of life. It can also cause serious comorbidities (e.g., diabetes mellitus, high blood pressure, or other physical and psychological conditions) that may shorten life expectancy.
Initially, affected individuals should attempt to reduce their weight through conservative measures. If this is not possible, a gastric band may be considered in cases of obesity to prevent or improve comorbidities.
Requirements for implantation of a gastric band include:
- a body mass index (BMI) of at least 35
- the presence of comorbidities and symptoms, and
- lack of success with conservative measures under medical supervision
Individuals with a BMI over 40 require immediate treatment.
In some cases, a gastric band is used to provide additional support to a previously placed gastric bypass.
What does the treatment cost?
Gastric band surgery is not generally covered by statutory health insurance, but German insurers may cover the costs of gastric banding under certain conditions if the listed requirements are met.
Otherwise, self-pay prices vary depending on the complexity and duration of the procedure. The best option is to seek counseling from specialists in a dedicated obesity center regarding the surgical method.
The gastric band is a surgical method designed to suppress natural hunger in obese patients @ bilderzwerg /AdobeStock
Contraindications for gastric band surgery include:
The physician must also rule out psychological and hormonal causes of obesity before surgery. Certain physical and psychological conditions, substance addictions, or untreated eating disorders are additional reasons why gastric banding may not be appropriate.
Today, gastric bands are implanted using a minimally invasive laparoscopic technique (keyhole surgery). The procedure is performed under general anesthesia.
The gastric band is a silicone tube that surgeons place around the upper part of the stomach. The adjustable band creates a small pouch, allowing the stomach to hold only very small amounts of food (20–30 ml). This causes the patient to feel full more quickly.
Filling of the pouch prevents the patient from consuming large amounts of solid food at once.
Nowadays, only adjustable bands are used. These have a fluid chamber (port), through which the gastric band is filled.
This allows doctors to adjust the fluid volume to the patient’s individual treatment goals using a balloon connected to the port by a small tube.
During surgery, the surgeon makes several small incisions in the abdominal wall and stomach to insert the gastric ring and balloon.
The procedure is performed under general anesthesia and typically takes about 60 minutes. From day one, dietary reintroduction and nutritional adjustments begin. Hospital stays usually last only a few days.
It is important to follow dietary guidelines and supportive measures in the weeks after surgery. How long you will be on medical leave depends on your individual situation, but expect about four weeks. After surgery, there are no restrictions on physical activity.
Stepwise Adjustments of the Gastric Band
Doctors adjust the gastric band for the first time after one month. This is done with a syringe that injects saline solution into the balloon.
The more saline solution is injected, the tighter the constriction of the stomach, and vice versa.
In most cases, a gastric band can remain in the body for life. If necessary, it can be removed.
The risk of complications is mainly due to the patient’s obesity and existing comorbidities.
To minimize risk, a comprehensive preoperative screening is performed.
Specialized clinics report a mortality rate of less than 0.1 percent for gastric band surgery. As with any operation, wound healing problems and infections may occur.
Inflammatory reactions may also develop around the implanted material, sometimes requiring removal of the band.
As with all abdominal surgeries, adhesions may form due to scar tissue.
Surgery-specific complications may include:
- injury to the upper stomach when placing the band
- narrowing or blockage of the passage due to large food pieces
- enlargement of the pouch from overeating
- slippage of the silicone tube
- formation of fistulas due to infections or allergic reactions
- silicone intolerance
- damage to the implanted system
If such complications occur, further surgery is usually required.
Always ensure food is thoroughly chewed after surgery. Repeated vomiting, nausea, or rapid weight gain may indicate the need for a check-up.
Successful weight loss with gastric banding depends on the patient’s motivation and cooperation.
Without long-term dietary changes, weight reduction is not achievable even with a gastric band.
You should avoid large amounts of the following foods:
- sweets
- ice cream
- pudding
- sweetened beverages
These may pass through the restriction without causing a sense of satiety.
In many cases, eating behavior after gastric band surgery is not “normal,” as patients replace old eating habits with new ones. These may support weight loss but can also be harmful.
If stress, anxiety, or imbalance trigger disordered eating, qualified nutritionists, therapists, or rehabilitation programs may be helpful.
Lack of physical activity also often plays a key role in the development of obesity, making exercise programs an important component.
It is highly recommended to undergo thorough counseling and evaluation by specialists before gastric band surgery. Experience shows that in some cases, late complications require band removal.
Modern alternatives to weight loss without a band include surgical stomach reduction through a gastric bypass or a sleeve gastrectomy.
Another option is insertion of a gastric balloon. This approach does not require surgery and is often used alongside other weight-loss methods.
In addition to gastric band specialists, you will also find experts for other treatment options here.
