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Gastric band operation

Published by Bupa's health information team, September 2008.

This factsheet is for people who are planning to have a gastric band operation, or who would like information about it.

A gastric band operation is a type of weight loss surgery where the size of your stomach is reduced using an adjustable band so that you can only eat small meals.

Your care will be adapted to meet your individual needs and may differ from what is described here. So it's important that you follow your surgeon's advice.

Animation - How gastric banding surgery is carried out
About a gastric band operation
What are the alternatives?
Preparing for your gastric band operation
About the operation
What to expect afterwards
Recovering from a gastric band operation
What are the risks?
Further information
Questions and answers
Related topics
Sources

How gastric banding surgery is carried out

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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.

Illustration showing the position of a gastric band and access port
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.

Side-effects

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.

Complications

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.

Further information

Association for the Study of Obesity (ASO)
020 8503 2042
www.aso.org.uk
British Obesity Surgery Patients Association (BOSPA)
08456 02 04 46
www.bospa.org