Gastric banding is a relatively new form of weight loss surgery first pioneered in Sweden in 1985 with the band being designed initially to be fitted using open surgery. The first laparoscopic surgery for the insertion of a gastric band was performed in France in 2000 and a year later in 2001 the Food and Drug Administration (FDA) approved the use of an American adjustable gastric banding system for use in the United States. Since then gastric banding has grown rapidly in popularity.
The laparoscopic adjustable gastric band is a form of restrictive gastric bypass surgery which many surgeons are beginning to favor as it avoids many of the nutritional problems associated with malabsorption surgeries. It also involves no cutting or stapling of the stomach and this, combined with the fact that the procedure can be performed laparoscopically, means that the death rate from surgery is about one-tenth of that seen in the widely used open Roux-en-Y form of surgery.
From the patient's point of view the laparoscopic adjustable gastric band means a relatively short stay in hospital and a quick recovery. Once in place the band can also be adjusted without further surgery so that the surgeon has much greater control of patient management in the critical weeks following surgery, making it possible to react quickly and easily to problems which the patient might experience.
The laparoscopic adjustable gastric band procedure is also fully reversible and, after removal of the band, the stomach will return to its normal pre-operative state.
As with most restrictive forms of surgery weight loss tends to be less dramatic than in malabsorption or combination surgeries and patients have to work a little bit harder in the early months following surgery to achieve a satisfactory rate of weight loss. However, because weight loss is not quite so easy and patients have to learn a strict set of eating habits, laparoscopic adjustable gastric band surgery tends to produce better long-term results and weight stability.
It is interesting to note that in Australia the vast majority of weight loss surgeries (over 90%) now involve the use of the laparoscopic adjustable gastric band. It is also significant that in one reported Australian study involving 2700 morbidly obese patients who underwent laparoscopic adjustable gastric band surgery not one single death has been reported which can be directly attributed to the surgery. This compares with Roux-en-Y surgery where, in a group of the same size, the average expected number of deaths would be in the region of 13 patients.
Laparoscopic adjustable gastric band surgery, like any other form of surgery, is not without its risks and complications and it would incorrect to conclude from this brief introduction to the procedure that it is a simple and routine procedure. Indeed, it is far from an easy option. Nevertheless, in comparison to the other forms of weight loss surgery available, it does represent an attractive option for many people who are contemplating surgery.
