1 March 2019 The adjustable gastric band acts restrictively, and so this procedure limits the amount of food that can be ingested. Adjustable gastric band: what is this surgical procedure? The adjustable gastric band is a surgical procedure for the treatment of obesity. Obesity surgery, or bariatric surgery, is performed by general surgeons. In this procedure the stomach is divided into two parts (an upper pouch with reduced capacity, and a larger pouch below this). This division is formed with an adjustable band or ring, which is placed just below the point where the oesophagus meets the stomach. The stomach takes on the form of an asymmetric hourglass , in which the upper part has a very small volume (30-50 ml) in relation to the lower part. The two parts communicate with each other through a larger or smaller channel, which can be regulated by adjusting the band. The device required for adjusting the band is placed under the skin on the abdominal wall. The band is adjusted by the injection of physiological saline into the device, since the size (diameter) of the device varies depending on the amount of physiological saline inside it. What are the advantages? The advantages of this procedure include: Can be done laparoscopically; Technical simplicity; Does not change intestinal anatomy and physiology; Does not involve gastric resection and is therefore reversible; Short recovery period; Band can be adjusted to the needs of the patient; Band can be removed, also via laparoscopy. How is food consumption reduced by the gastric band? The reduction in the amount of food ingested is achieved by two mechanisms: Obstruction mechanism: the low volume of the upper section creates a direct obstruction to food intake (solids); A satiety induction mechanism: movement of the food from the upper bag is slow. This makes it necessary to ingest food slowly, which means that the user will start to feel full - which usually happens about 20 to 30 minutes after the start of a meal - after only a small amount of food has been ingested. Unfortunately, it has been observed that this second mechanism rarely functions, and as such the mechanism of obstruction predominates. Does it really work? Approximately 30% of patients reach their normal weight with the use of an adjustable gastric band, and around 80% lose some weight. On average, the weight loss achieved is around 40% to 50% of the initial excess weight. Weight loss is faster during the first year and slows down after this. This article was written with the support of physicians and other clinical professionals from the Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
