Step 7: Laparoscopic Adjustable Banding System

This surgical approach consists of a silicone band that is placed around the upper part of the stomach. It creates a much smaller stomach pouch. The band also slows the passage of food from the stomach into the intestine. This allows you to feel full for a much longer time after eating.

During surgery, a port or reservoir is permanently positioned in your upper abdomen (under the skin, where it is not visible). The port is attached to the silicone band by tubing. A balloon within the band can be inflated by injecting a normal saline solution into the port. It is the balloon within the band that helps control the size of the opening of your stomach pouch:

• Inflating the balloon with the saline solution further restricts the opening through which food passes. This reduces the amount you can eat and slows the passage of food. You feel full longer after eating.
• Deflating the balloon by removing some of the saline solution increases the opening through which food passes. This can be helpful if you develop certain problems, like regurgitation of food.

The laparoscopic adjustable banding system is placed through small incisions or punctures in the abdomen. Each opening is usually less than half an inch in length. A miniature video camera is passed through one of these openings, allowing the surgeon to view your stomach on a monitor in the operating room. The rest of the surgical instruments are passed through the other tiny openings.

In rare cases, complications may require the banding system to be placed using a traditional open abdominal incision.

The benefits of the laparoscopic adjustable banding system

• The surgery doesn't require a large incision.
• The stomach itself is neither cut nor stapled during the procedure.
• The band can be inflated and deflated by the surgeon in response to the patient's needs. This involves minimal discomfort and no need for another operation.
• Many of the complications of obesity may resolve or improve after weight loss. These include diabetes, high blood pressure, sleep apnea, joint pain and incontinence.
• The average person loses over 40 percent of excess weight and experiences a drop in BMI of more than 10 points.

The potential complications of laparoscopic adjustable banding system

In addition to the usual risks of any surgery involving general anesthesia, the risks specific to placing a laparoscopic adjustable banding system include:

• Erosion of the silicone band
• Slippage of the stomach's position within the band
• Perforation of the stomach
• Balloon leakage
• Heartburn, regurgitation of food
• Erosive esophagitis, where backed-up stomach contents damage the lining of the esophagus (the tube that carries food down your throat and into your stomach)
• Insufficient weight loss, despite a correctly placed and functioning band
• Nausea and vomiting, especially if you overeat
• Stretching of the stomach pouch: If you continually overeat, you may slowly but surely increase the size of the stomach pouch, thus defeating the purpose of having undergone the surgery in the first place
• Excess skin after weight loss

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