Gastric band - Further information
When is a gastric band used?
Extreme obesity not only limits the quality of life, but also leads to a reduction in life expectancy due to accompanying illnesses. If the weight could not be reduced in the long run by conservative measures, a gastric band can be considered in order to avoid or improve accompanying diseases.
A gastric band is used in severely overweight people with a body mass index (BMI) of more than 35, if accompanying illnesses or complaints are already present. In addition, all conservative measures for weight reduction (including a health cure or diet) must be exhausted. It is also recommended for people with a BMI over 40.
The German health insurance funds will cover the costs of a gastric band surgery if the aforementioned conditions are fulfilled and the person concerned can prove an attempt at weight loss under medical supervision.
In some cases, a gastric band is also used to support a previously placed gastric bypass.
The following factors indicate that gastric band surgery is not advisable:
- congenital abnormalities or severe inflammation of the gastrointestinal tract
- stomach ulcers
- Crohn's disease
- severe heart or lung disease
- Alcohol and drug addiction
- severe mental disorders
- eating disorders
- silicone allergy
Psychological and hormonal causes of overweight must also be ruled out before surgery can be recommended.
How is a gastric band surgery performed?
Nowadays the gastric band is inserted during a minimally invasive laparoscopy (the so-called "keyhole procedure").
A gastric band is a tube made of silicone that is placed around the upper part of the stomach. This forms a small pouch that can only absorb small amounts of food and therefore quickly signals a feeling of satiety. The artificial stomach pouch prevents the affected person from ingesting large amounts of solid food at once.
Nowadays, only adjustable gastric bands with a fluid chamber are used. This chamber can be filled from the outside with sterile saline solution via a balloon inserted under the skin (a so-called port system). By changing the amount of fluid, the band width can be adapted to the individual therapy goal of the affected person. Via several small incisions, the surgeon inserts the gastric band and the balloon, which is connected to the fluid chamber via a small tube. After about a month, the gastric band is adjusted for the first time by injecting saline solution into the balloon with a special syringe: The more saline solution is injected, the stronger the constriction of the stomach and vice versa.
In most cases, a gastric band can remain in the body of the affected person for life, but it can also be removed again if necessary.
Complications and risks of gastric band surgery
There is an increased risk of complications mainly due to the overweight and the accompanying illnesses of the person affected. In order to keep the risk as low as possible, a detailed screening is carried out prior to the procedure to assess the individual risk. Specialized clinics have a mortality rate of less than 0.1 percent. As with any surgical procedure, wound healing disorders and infections can occur after the surgery. Especially in the area of the injected material, inflammation foci can develop which require the removal of the gastric band. As with any surgery in the abdominal cavity, the scar tissue can form adhesions.
Further specific complications of gastric bands are:
- Injury of the upper stomach when inserting the gastric band
- narrowing or obstruction of the passage in the stomach due to oversized food pieces
- Increase in the size of the stomach formed as a result of a supply of large amounts of food
- slippage of the gastric band
- formation of pus ducts as a result of infections or allergic reactions
- silicone intolerance
- Damage to the system used
If one of these complications is diagnosed, a further intervention is usually necessary.
For long-term success, eating and lifestyle habits must be changed
Successful weight reduction with the gastric band requires the cooperation and motivation of the person affected. Without a long-lasting change in diet, weight loss cannot be achieved with a gastric band. Large quantities of sweets, ice-cream, pudding or sweetened drinks should be avoided, as these can pass through the created bottleneck without triggering a feeling of satiety.
In many cases the eating habits are not "normal" even after a surgery, because old eating rituals are partly replaced by new ones. These can have a positive effect on weight reduction, but can also be harmful. Particularly in cases where eating habits are disturbed due to stress, anxiety or imbalance, it may be advisable to have long-term support from qualified nutritionists and therapists or a rehabilitation measure.
Since a lack of physical activity often plays an important role in the development of overweight, sports programs are usually linked to these measures.