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The Gastric Banding

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Principles of Metabolic Surgery

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Abstract

One of the treatments for pathological obesity is adjustable gastric banding. An adjustable gastric band is applied to the stomach via laparoscopy ( laparoscopic adjustable gastric banding – LAGB). This is one of the so-called restrictive surgical methods for treating obesity and, in comparison with other techniques of bariatric surgery, is the least invasive for the anatomy of the gastrointestinal tract. The gastric band is used worldwide. It is most popular in Australia, Europe, and South America and is less used in the USA and Mexico. The procedure is based on the idea of dividing the stomach into two parts, the upper part of which has a capacity of 20–50 ml. The width of the passage between these two parts is regulated by filling the gastric band with fluid, making it possible to control the rate of passage of the gastric content from the upper to the lower part of the stomach. Filling of the “upper” stomach produces the feeling of satiety, perceived by the patient as a signal to stop eating. In this way, the volume of food intake and, consequently, the amount of energy supplied to the organism is reduced. Advantages of the gastric band include the small extent of injury associated with the surgical procedure, short duration of the surgery and anesthesia, preservation of the natural anatomy of the gastrointestinal tract, no anastomoses, and preservation of the natural route of the food. Additionally, the possibility of regulating the width of the passage between two parts of the stomach makes it possible to control the rate of weight loss. The disadvantages of the method include the presence of foreign bodies (the gastric band and port), inconvenience for the patient associated with the necessity of periodic regulation of the band volume, complications resulting from compression of the gastric wall by the band (migration), possibility of band displacement (slippage), the presence of the port (causing problems with plastic surgery of the abdominal wall – if it is located on the abdomen, it interferes with physiotherapy and NMR imaging). Moreover, many authors claim that weight loss with this method is insufficient, and it should therefore not be used in patients with a BMI exceeding 50 kg/m2.

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Authors
  1. Tomasz Szewczyk MD
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  2. Bogdan Modzelewski MD
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Editors and Affiliations

  1. Abt. Allgemein- und Viszeralchirurgie, Universitätsklinikum Freiburg, Hugstetter Str. 55, 79106, Freiburg

    W. Konrad Karcz  & Oliver Thomusch  & 

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Szewczyk, T., Modzelewski, B. (2012). The Gastric Banding. In: Karcz, W.K., Thomusch, O. (eds) Principles of Metabolic Surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-02411-5_17

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  • DOI: https://doi.org/10.1007/978-3-642-02411-5_17

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-02410-8

  • Online ISBN: 978-3-642-02411-5

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