Gastric Band

The Gastric Band is a surgical option used by leading surgeons around the world for the treatment of serious obesity. The aim of the Gastric Band System is long-term weight loss, achieved by reducing the capacity of the stomach.

The silicone adjustable band component of the Gastric Band System is placed around the upper part of the stomach, forming a small gastric pouch to limit the intake of food and slow the emptying process from the stomach into the intestines. No cutting or stapling of the stomach is required, and there is no need to bypass portions of the stomach or intestines.

 
The Gastric Band System has been designed for laparoscopic placement, which offers the advantages of reduced trauma, reduced post-operative pain, shortened hospital stay and quicker recovery. If for any reason the Gastric Band System needs to be removed, the stomach generally returns to its original form.
 
Am I a Candidate? 
Not everyone who has a weight problem should consider surgery. It depends on whether or not you are overweight, obese or morbidly obese. One way to tell is by your Body Mass Index (BMI). Your BMI depends on both your weight and your height. An ideal BMI is between 19 and 25. If your BMI is between 26 and 29 you are thought to be overweight. If it is higher than 30 you are obese. That means you are at risk for health problems. If your BMI is 40 or more, you are said to have severe or "morbid" obesity and you might be a candidate for surgery. For some people with a BMI between 35 and 40, surgery might also be a choice if you have other medical conditions.

To calculate your BMI:

Formula: (lbs/inches2) * 704.5
Example: 158lb, 58" person would have a BMI score of: 33 height feet inches
weight lbs.

Besides a BMI of more than 40 or more than 35 with other medical problems, the Gastric Band may be right for you if:

1) You are between 18 and 60 years of age.
2) You weigh twice your ideal weight or you weigh at least 45 kilos (100 lbs.) more than your ideal weight.
3) You have been overweight for more than 5 years.
4) Your serious attempts to lose weight have had only short-term success.
5) You are not suffering from any other disease which could have caused you to be overweight.
6) You are prepared to make substantial changes in your eating habits and lifestyle, and to continue being monitored by the specialist treating you.
7) You do not drink alcohol in excess.

The Gastric Band System is not right for you if:

1) You have an inflammatory disease or condition of the gastrointestinal tract, such as ulcers, esophagitis, or Crohn's disease.
2) You have severe heart or lung disease that makes you a poor candidate for surgery.
3) You have some other disease that makes you a poor candidate for surgery.
4) You have a problem that could cause bleeding in the esophagus or stomach. That might include esophageal or gastric varices (a dilated vein). It might also be something such as congenital or acquired intestinal telangiectasia (dilation of a small blood vessel).
5) Your esophagus, stomach, or intestine is not normal. For instance you might have a narrowed opening.
6) You have a large hiatal hernia. This is a hernia that happens when a part of your stomach pushes through the diaphragm muscle. It could make it so the Gastric Band device could not be put into the correct place.
7) You are pregnant. (If you become pregnant after the Gastric Band System has been placed, the band may need to be deflated or removed. The same is true if you need more nutrition for any other reason, such as becoming seriously ill.)
8) You are addicted to alcohol or drugs.
9) You have an infection that could contaminate the surgical area. The same is true if you need a procedure that could do the same thing.
10) You use aspirin or non-steroidal anti-inflammatory drugs often.
11) You cannot or do not want to follow the dietary rules that come with this procedure.
12) You might be allergic to materials in the device.
13) You are not emotionally stable.

How we do it
In this procedure the capacity of the stomach is made smaller by placing an adjustable band around the upper part of the stomach. No cutting or stapling is required to create division between the upper stomach pouch and lower stomach. You achieve the feeling of satiety (fullness) when the small stomach pouch above the band is full. The result: Food intake is limited. The band, unlike the stomach stapling or bypass, is designed to be adjusted as your situation requires.

It is a Laparoscopic Procedure: Of all the operations for severe obesity, the Gastric-BAND System method is considered to be the least traumatic. The operation can usually be performed using laparoscopy (using small incisions and long instruments rather than a single large incision).

The procedure requires no cutting or stapling of the stomach.

*Adjustability: In many cases, no follow-up operation is necessary to modify the diameter of the stomach.

*Avoids irreversible damage: If the Gastric Band System needs to be removed for any reason, the stomach generally returns to its original form.

*Reduced hospital stay: Patients normally leave the hospital within 23 hours of the laparoscopic operation.

*Quicker recovery: After the laparoscopic procedure, patients usually resume normal activities within a week, if there are no complications. Quicker recovery: After the laparoscopic procedure, patients usually resume normal activities within a week, if there are no complications.

How do I get ready for Gastric-BAND Surgery? 

It is our aim to have the best-educated and most knowledgeable group of patients where this type of surgery is concerned. You need to contact our clinical staff to set up an initial office screening evaluation. You can contact us locally at 706-272-6668 or toll-free at 866-552-SLIM(7546). During this initial evaluation we will concentrate on making sure that you know as much as possible about this laparoscopic procedure. We will show you a teaching video-tape, give you an informative brochure and discuss in length all details.

If you are interested in the procedure you will undergo a medical evaluation, including lab tests, X-rays of your chest and stomach (UGI series), an EKG, a nutritional evaluation, and psychological evaluation. After these initial screening you will meet with our Bariatric Surgeons who will answer any questions you may still have and schedule your surgery if there is no contraindication.

If you live out-of town and have made contact with our clinical staff, we can arrange a full evaluation and screening the day before your surgery, and in most cases you should be able to drive or fly back in a couple of days after surgery.

How is my diet after surgery? 
After your surgery, you will need a new diet. Right after the operation, you can have an occasional sip of water or suck on an ice cube. You shouldn't drink more than this. The day after the operation, you can take a little more fluid. But you should take only a small amount at a time. Besides water, you should also choose liquids that have an adequate number of calories. To prevent nausea and vomiting, do not drink too much.

During the first one to four weeks only drinks and very soft foods are recommended:

clear broth or soup (with no vegetables or meat and not creamy)
low-fat yogurt
milk (preferably skim)
jello
fruit juice or pureed soft fruit.
As time goes on, you will slowly move to solid food based on your surgeon's and/or dietitian's advice.

When you can eat solid foods without problems after the initial four to six weeks, you will need to pay attention to your diet. Here are 10 rules for eating, drinking, and exercise that will help you get the best results possible with the Gastric-BAND System. How willing you are to follow a new way of eating is key to making the operation a success.

Eat only three small meals a day.
Eat slowly and chew thoroughly (approximately 15 to 20 times a bite).
Stop eating as soon as you feel full.
Do not drink while you are eating.
Do not eat between meals.
Eat only fresh food.
Avoid fibrous food.
Drink enough fluids during the day.
Drink only low-calorie liquids.
Exercise at least 30 minutes a day.

Follow-up after surgery 
You will be required to have follow-up visits periodically to assess your weight loss, ability to tolerate food and need to perform adjustments of your band. Adjustments are performed in the Hamilton Weight Management Center by our qualified staff. The adjustments are done under fluoroscopy so the reservoir can be clearly seen. Local numbing medicine may or may not be used at the port site. A fine needle is passed through the skin into the reservoir to add or subtract saline. This process most often takes only a few minutes and most patients say it is nearly painless.

Our programs features at no extra charge to our patients, Gastric BAND Support Group each month on the first Thursday, 6 PM in the Hamilton Weight Management Center, first year follow-up free, and our specially designed eating workshop, entitled, "The strategies of successful banded patients."

Why the Gastric-BAND System is a better weight loss solution.
The Gastric-BAND (Laparoscopic Adjustable Gastric Band) surgery is a safe, effective weight loss solution.

For instance, the complications associated with the RNY Gastric Bypass include:

Disruption of the staple line forming the proximal stomach pouch
Stomach or bowel leakage
Long-term nutrients and vitamins deficiencies
"Dumping syndrome"
These complications result from cutting and stapling the stomach and bypassing (shorting or rerouting) the small bowel.

The Gastric-BAND surgery, on the other hand, requires NO STAPLING OR CUTTING of the stomach, so there's no staple line to increase the chances for complications.

And it allows us to easily ADJUST the amount of food a patient can eat without the need for further surgery. (For example, the traditional gastric bypass can't be adjusted, even in cases where additional nutrition is required such as during pregnancy or severe illness.)

The Gastric-BAND surgery is performed LAPAROSCOPICALLY (with a camera) using small incisions rather than one large incision. Even though the gastric bypass can be done laparoscopically, the LAP-BAND procedure is considered the least traumatic of all the operations for severe obesity.

The Gastric-BAND AVOIDS IRREVERSIBLE DAMAGE to the stomach and bowel anatomy, and if for any reason it needs to be removed, the stomach generally returns to its original form. But the gastric bypass involves permanent cutting, bypassing or rearrangement of the digestive tract, which is tremendously difficult, risky and almost impossible to reverse.

Other Gastric-BAND advantages 

NO VITAMIN DEFICIENCIES associated with malabsorption of nutrition.
NO "DUMPING SYNDROME" related to the reconfiguration of the digestive tract.
REDUCED HOSPITAL STAY. Patients normally leave the hospital within 23 hours of the operation.
QUICKER RECOVERY. After the procedure, patients usually resume normal activities within a week, if there are no complications.
And most importantly, less chance of death than any other operation for severe obesity.

Why Hamilton is the best choice for your Gastric-BAND procedure.
Hamilton Medical Center has one of the largest gastric banding practices in the country. We're a nationally recognized Gastric-BAND center dedicated exclusively to this innovative and minimally invasive procedure.

And our success rate is well established. In our series, excess weight loss averages above 60%. (For any weight loss surgery, a standard scientific goal is to achieve at least 50% of excess weight loss.)

Our complication rate is outstanding as most of our patients' associated medical problems, such as diabetes, sleep apnea, arthropathy, or high blood pressure, have improved or disappeared completely after their Gastric-BAND procedure.

Dr. Jaime Ponce and his partners have already performed more than 1000 Gastric-BAND procedures. In fact, Dr. Ponce was one of just 20 surgeons in the country who participated in the last FDA clinical trail before the approval of the Gastric-BAND System for the treatment of morbidly obese patients in the United States.

Dr. Ponce also serves as one of only 12 member surgeons on the Council for Advances in Bariatrics, which provides strategic and editorial direction in the appropriate use of the Gastric-BAND surgery in the United States.

Our board-certified surgeons are Fellows of the American College of Surgeons and members of the American Society for Bariatric Surgery and the International Federation for the Surgery of Obesity.

Our clinical manager is fully accredited in the care of Gastric-BAND patients, and because of her experience she's been selected to instruct other centers around the U.S.

Web Links
www.lapband.com 
www.gastricbandinstitute.com 

**Jaime Ponce, M.D., in conjunction with Hamilton Medical Center Weight Management Center are one of the few FDA approved Clinical IDE sites in the United States for the use of the Laparoscopic Adjustable Gastric Band (LAP-Band®) to treat morbidly obese patients.**

Check out A.D.A.M.'s health library for additional Gastic Band information.