Gastric band surgery is a surgical treatment primarily aimed at reducing weight in patients with severe obesity. This procedure involves placing an adjustable silicone band around the upper part of the stomach to create a small gastric pouch, which delays food passage and increases satiety. The main candidates are patients with a BMI over 35 accompanied by metabolic diseases, or those who have not responded to long-term non-surgical treatments. The surgery is highly reversible, and the band can be removed if necessary, making it a common choice for moderate obesity.
Gastric bands are divided into non-adjustable and adjustable types, with modern use predominantly of inflatable silicone bands. The procedure is performed laparoscopically, suturing the band around the upper third of the stomach to form a gastric pouch of approximately 50-100 milliliters. The air chamber within the band can be adjusted via subcutaneous injection to control the pressure and the size of the stomach outlet. The weight loss mechanism involves reducing food intake, prolonging food retention in the stomach, and stimulating the vagus nerve to decrease hunger.
Unlike gastric bypass surgery, this treatment does not alter the structure of the digestive tract. It mainly relies on behavioral changes combined with physiological restriction to achieve weight loss. Postoperative care includes guidance from a nutritionist to gradually establish a diet that adapts to the new food intake capacity.
The primary candidates are patients with a BMI ≥ 35 with metabolic syndrome (such as type 2 diabetes, hyperlipidemia), or those with primary obesity with a BMI ≥ 40. Strict criteria must be met: having tried non-surgical treatments for more than 6 months without success, no drug addiction or psychological disorders, and understanding the need for long-term follow-up after surgery. Special cases such as those with joint damage or sleep apnea may also be considered.
The surgery is usually performed laparoscopically, requiring a hospital stay of 1-3 days. Postoperatively, the band pressure needs to be adjusted every 2-4 weeks by a physician injecting or withdrawing saline solution using a Hb1c syringe. The number of adjustments depends on individual eating responses, typically 3-5 times within 6-12 months after surgery. Patients are advised to follow a diet of 6-8 small meals daily, each not exceeding 150-200 kcal.
This treatment significantly improves blood sugar control, with 70% of diabetic patients reducing medication within one year post-surgery. Its minimally invasive nature results in a short recovery time, with about 2 weeks needed to resume light activities.
Immediate risks include anesthesia complications, internal bleeding, or intra-abdominal infection. Long-term issues may include band slippage, esophageal dilation, or inflammation around the band. About 15-20% of patients may experience esophageal obstruction symptoms, requiring urgent pressure adjustment or removal. Other common side effects include:
Contraindications include severe cardiopulmonary insufficiency, coagulation disorders, or inability to adhere to dietary regulations. Postoperative requirements include:
Women should inform their physician if pregnant, as the band pressure may need to be temporarily reduced. Patients with a history of band infection should prolong antibiotic prophylaxis.
Interactions with medication are minimal, but use of NSAIDs may increase the risk of gastric ulcers. Compared to gastric bypass, this treatment does not affect nutrient absorption but results in slower weight loss. If combined with diabetes medication, dosage adjustments should be reassessed within 6 months post-surgery.
Long-term studies show that patients lose an average of 40-50% of excess weight within 2 years after surgery. The International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) recommends this treatment for patients with BMI 35-40, with about 85% maintaining weight loss over 5 years. However, approximately 15% may require band removal or conversion due to complications or insufficient results.
Alternative surgeries include Roux-en-Y gastric bypass, sleeve gastrectomy, or non-surgical options such as gastric balloon placement. Pharmacological treatments like GLP-1 receptor agonists (e.g., Liraglutide) can be used preoperatively or as maintenance therapy. Behavioral therapy combined with physical fitness training can enhance long-term success of surgical treatments.
Patients need a comprehensive health check, including cardiac and renal function assessments. Fasting for 8 hours before surgery is required, and patients must inform their doctor of all medications, especially anticoagulants. On the day of surgery, a family member should accompany the patient, and an informed consent must be signed to acknowledge understanding of potential risks.
What dietary principles should be followed during recovery?In the first week post-surgery, a low-fiber liquid diet such as rice milk or vegetable juice is recommended, avoiding carbonated drinks and hard foods. In the second week, soft foods can be gradually introduced, with careful chewing. Physicians typically advise eating 6-8 small meals daily to prevent gastric distension or vomiting.
How should I respond if I experience gastroesophageal reflux after surgery?Adjust the band’s inflation pressure and elevate the head of the bed by 15-20 cm to reduce reflux. Short-term use of H2 receptor antagonists or proton pump inhibitors may be employed, but long-term reliance should be avoided. Avoid eating within 2 hours before sleep and reduce caffeine and greasy food intake.
What is the success rate of band adjustment or removal?Clinical studies show that about 70-80% of patients achieve a BMI reduction of over 25% within one year post-surgery. Success is closely related to adherence to dietary and exercise plans; non-compliant patients may only see 40-50% weight loss.
How often should follow-up visits occur after treatment?Follow-up visits are recommended every 4-6 weeks for the first 3 months to adjust band pressure, then every 3 months thereafter. Immediate medical attention is necessary if severe abdominal pain or bowel obstruction occurs. Long-term follow-up should continue for at least 2 years to monitor nutritional status and digestive function.
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