Gastric Banding in India :
Minimally Invasive Surgery
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About a gastric band operation
A gastric band operation involves placing an adjustable band around the upper part of your stomach to create a pouch. This pouch fills up quickly and the food you eat then passes slowly through a narrow opening created by the band, into the lower part of your stomach. The food then passes normally through the rest of your digestive system.
Surgery is usually recommended only if non-surgical treatments, such as diet, exercise and medicines haven't worked.
What are the alternatives?
An alternative surgical option is to have gastric bypass surgery. Your surgeon will explain your options to you.
Preparing for your gastric band operation
Your surgeon will explain how to prepare for your operation. For example if you smoke you will be asked to stop, as smoking increases your risk of getting a wound infection and slows your recovery.
The operation usually requires an overnight stay in hospital and is performed under general anaesthesia. This means you will be asleep during the operation.
You will be asked to follow fasting instructions. Typically you must not eat or drink for about six hours before a general anaesthetic. However, some anaesthetists allow occasional sips of water until two hours beforehand.
At the hospital your nurse may check your heart rate and blood pressure, and test your urine.
Your surgeon will usually ask you to sign a consent form. This confirms that you understand the risks, benefits and possible alternatives to the procedure and have given your permission for it to go ahead.
You may be asked to wear compression stockings to help prevent blood clots forming in the veins in your legs. You may need to have an injection of an anti-clotting medicine called heparin as well as, or instead of, stockings.
About the operation
The gastric band is usually fitted using keyhole (laparoscopic) surgery. Your operation will usually take 30 minutes to one hour.
Your surgeon will make a four to five small cuts on your upper abdomen. He or she will then use small instruments that are guided by a special telescope with a camera to secure the band around the top part of your stomach. The band is locked so that it can't come undone. Afterwards, the cuts are closed with two or three stitches.
The size of the opening from the pouch determines how quickly food leaves your stomach and is adjusted by adding or removing fluid to/from the band. A thin tube connects the band to a 'port' that has been placed under the skin of your chest or below your ribs. The band is adjusted by your surgeon a few weeks after the operation, leaving time for the swelling caused by the surgery to settle down. You are likely to have your band adjusted two or three times in the first few months after your operation.
The position of a gastric band and access port |
What to expect afterwards
You will need to rest until the effects of the anaesthetic have passed. You may need pain relief to help with any discomfort as the anaesthetic wears off.
You may have a catheter to drain urine from your bladder into a bag. You may also have fine tubes running out from the wound. These drain fluid into another bag and are usually removed after a day or two. You may also be given fluids through a drip overnight.
You may have an X-ray taken the morning after your operation to check the gastric band is in the correct position, but this isn't always necessary.
On the first day, you may have to wear special pads, attached to an intermittent compression pump, on your lower legs. The pump inflates the pads and encourages healthy blood flow in your legs and helps to prevent deep vein thrombosis (DVT).
You will be encouraged to get out of bed and move around as this helps prevent blood clots in your legs and chest infections. You may also have a further heparin injection to prevent blood clots.
For the first 24 hours you will only be allowed to drink clear fluids. After this your surgeon or dietitian will start you on a liquid or pureed diet for the first few weeks.
You will need to follow a strict diet and make some lifestyle changes to get the best results from your operation. Your dietician and surgeon will give you more advice about what you can and can't eat or drink and what changes you need to make.
You will usually be able to go home the day after your operation. You will need to arrange for someone to drive you home.
Your nurse will give you some advice about caring for your healing wounds before you go home and give you a date for a follow-up appointment. You will need to make several repeat visits to the hospital for band adjustments.
Dissolvable stitches will disappear on their own in seven to 10 days. Non-dissolvable stitches are removed a week after surgery.
Recovering from a gastric band operation
If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Follow the instructions in the patient information leaflet that comes with the medicine and ask your pharmacist for advice.
General anaesthesia can temporarily affect your coordination and reasoning skills, so you should not drive, drink alcohol, operate machinery or sign legal documents for 48 hours afterwards.
Follow your surgeon's advice about driving and please contact your motor insurer so that you are aware of their recommendations. You shouldn't drive until you are confident that you could perform an emergency stop without discomfort. This is usually about two weeks after the operation.
Full recovery from a gastric band operation can take two to three weeks.
What are the risks?
A gastric band operation is commonly performed and generally safe. However, in order to make an informed decision and give your consent, you need to be aware of the possible side-effects and the risk of complications of this procedure.
These are the unwanted, but mostly temporary effects of a successful treatment, for example feeling sick as a result of the general anaesthetic.
You are likely to have some bruising, pain and swelling of the skin around the healing wounds.
You may feel or be sick after eating, especially if you try to eat too much. Your restricted diet may cause some shortage of nutrients so you may need to take multivitamin tablets.
This is when problems occur during or after the operation. Most people are not affected. The possible complications of any operation include an unexpected reaction to the anaesthetic, excessive bleeding or developing a blood clot, usually in a vein in the leg (DVT).
Complications specific to a gastric band operation are listed here.
Infection : Antibiotics are usually given during surgery to prevent infection. If an infection doesn't respond to antibiotics your band may need to be removed.
Damage to other organs in your abdomen : You may need further surgery to repair any damage.
Band problems : Your band may slip out of place, leak, or work its way through the stomach wall. If this happens, your band may need to be repositioned, removed or replaced.
Gallstones : There is a risk you may develop gallstones if you lose weight quickly. These can be painful and you may need surgery to remove them. Your surgeon may advise removing your gallbladder when you have your operation.
There is a chance your surgeon may need to convert your keyhole procedure to open surgery. This means making a bigger cut on your abdomen. This is only done if it's impossible to complete the operation safely using the keyhole technique.
Around one in 10 people with a gastric band may need another gastric band operation in the future. It's also possible you may fail to lose sufficient weight or regain weight you have lost. If this happens your surgeon may recommend you have gastric bypass surgery.
The exact risks are specific to you and will differ for every person, so we have not included statistics here. Ask your surgeon to explain how these risks apply to you.
Gastric Banding FAQ
How will my life change after having weight loss surgery?
After weight loss surgery, the majority of patients experience a great increase in wellbeing and quality of life. As they lose weight they are capable of more physical activity, experience better general health and are less at risk from obesity related diseases such as heart disease, diabetes and high blood pressure and other weight related problems. The effects will be enhanced the more weight you lose.
What is weight loss surgery?
Weight loss surgery reduces the amount of food you can eat by reducing the size of your stomach or bypassing your stomach. There are several main type of surgery that can help you to lose weight and maintain weight loss.
We perform keyhole surgery to minimise recovery time and reduce the risk of infection and scarring. Your consultant surgeon will :
- Gastric band
- Gastric bypass
- Sleeve gastrectomy
- Duodenal switch
Weight loss surgery treatments are clinically proven to work, with excess weight loss of up to 50% with gastric bands and up to 60% with gastric bypasses after two years.
- Assess your individual needs and risks
- Discuss which option would be right for you to get the best results
Am I eligible for weight loss surgery?
If you are over 18 and have a BMI of over 35, weight loss surgery could help you lose weight. Nuffield Health Hospitals is also experienced in helping those patients with very high BMI’s (over 40) as our specialist centres are able to provide extra medical support to ensure that your safety and individual needs are taken care of. We offer all types of weight loss surgery delivered by internationally renowned surgeons, backed by experienced nurses and dietitians.
How long will I have to stay in hospital after weight loss surgery?
Our hospitals have specialised facilities to make your stay safe and as comfortable as possible. Expect to stay overnight for a gastric band and at least three nights for bypass surgery.
How long will I need to take off work?
Most patients need at least two weeks off work but the length will be determined by consultation with your surgeon and your individual progress. All our hospitals are comfortable and you’ll have a television and phone to keep in touch with friends and family. Our staff pride themselves on caring not just about your condition, but about how you feel during and after your surgery.
Cost of weight loss surgery
To make life as easy as possible, we agree the total price of your treatment. The price includes the following :
We guarantee that the price won’t change even if you have to stay in hospital longer than expected; so you can concentrate on losing weight and enjoying your new life.
- Follow-up appointments
- Support from your clinical team
What happens if I decide to go ahead?
If you are suitable for surgery and have decided to go ahead, you will meet your specialist consultant surgeon who will talk through your options in details and perform a detailed medical examination. Your surgeon will answer any questions or concerns you have and discuss the best route for you. You will be made fully aware of the associated risks and benefits of the specific weight loss surgery suitable for you.
Expect your diet to change
Surgical operations cannot cure obesity but they make it easier for you to learn new eating habits. With the advice of your dietitian, you can lose weight and maintain weight loss. Weight loss will only be successful with your commitment to follow dietary advice, Regular follow-up appointments and meetings with your dietitian will help you to adjust to your new weight and diet. Your dietitian will talk you through an eating plan and help you make the changes in your eating habits so that your weight loss is a success. The week before surgery you will need to go on a low fat, sugar and carbohydrate diet ready for your surgery. After your procedure, your dietitian will give you advice as to what you can eat. Your diet will initially consist of liquids or pureed food and finally small portions of nutritious healthy food.
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