Gastric Band

The placement of gastric band is a procedure that is meant for limiting the intake of food. During the procedure a special fillable medical band is attached to the upper part of the stomach. The band can be adjusted by filling it with more liquid and therefore restricting food intake even more. The procedure is not invasive and that means a quicker and easier recovery after surgery.

We have a Specialist Bariatric Nurse Judith Jobling in the United Kingdom calling our patients regularly in the first month after surgery to monitor their recovery. Judith gives professional support and advice to each patient and since she has had bariatric surgery herself, she can be of true help and counsel.

She is also a Laparoscopic Gastric Band Adjuster so all our gastric band patients can have their band fitted in a network of clinics all over the United Kingdom where Judith has her appointments. Regular band adjustments are vital to the success of the band. She guides each patient in a friendly way to achieve each person’s weight loss target whilst maintaining a healthy lifestyle.


Surgeon	Dr. Rein Adamson
Required body mass index	BMI starting from 30 (depending on the comorbidities)
Anesthesia	General
Surgery duration	1 hour
Nights at hospital	2
Sick leave	2 weeks
Expected weight loss	40%-50% of overweight
Pros	* GI tract is not opened * Adjustable & removable * Complications are rare
Cons	* Total weight loss smaller * Weight loss process is slower * Band needs to be adjusted several times
Operation reversible	YES
Price	€4690 (all-inclusive package, including a support person in the UK)
Medical loan	starting from €127 per month. Apply here.
	Ask for more information

What is gastric band?

Gastric band– surgical procedure limiting the amount of food intake at once. This procedure became very popular in many countries all over the world during the 90’s.

Gastric band surgery is considered for people who are obese, defined as having a BMI of 30 or higher with other serious health conditions taken into account that are associated with obesity.

Measure your BMI

Why gastric band?

Why has gastric band become the preferred surgical method for many patients and surgeons?

It is a fast and safer procedure in comparison to all other methods, a safer procedure.
It can be performed by means of laparoscopy (no big abdominal incision required).
The size of the inner diameter of the restriction created on your stomach can be adjusted to the course of your weight loss.
Gastric band is fully reversible. No changes to the anatomy of the gastrointestinal tract are done.

Why do “gastric band patients” eat less after surgery?

57% of patients feel satiety after eating small amounts of food.
56% are experiencing a kind of pressure.
33% stop eating too much in order to avoid vomiting
6% of patients do report about other sensations that make them stop eating.

What weight loss can I expect after gastric band surgery?

The loss of weight is again influenced by many factors. Your surgeon/physician will provide you with the right feedback on your loss of weight. The inflatable ring around your stomach can be adjusted to your personal needs and requirements.

Most of the loss of weight takes place during the first two years after surgery. The surgical intervention is considered to be successful when at least 40-60% of your excessive weight is lost during the first two years after surgery.

The gastric band procedure

A medical grade long-term inflatable ring implant is put around the upper portion of your stomach. This can be done in a minimal invasive way of surgery, big incisions of the abdominal wall are avoided. This benefit usually comes along with a much better, faster and less painful postoperative recovery of patients.

The implanted gastric band will cause you to eat less after the procedure. On the first postoperative year you will need to see your surgeon 3-4 times. This is when your surgeon will check your course of losing weight and if required, adjust the inflatable ring accordingly to your specific needs.

Patient benefits

The most important benefits of the gastric band procedure versus all other surgical options offered today are as follows:

It is reversible, no cutting required, surgical reconnecting, shortening of the intestinal tract is done.
It is in comparison to all other surgical options a less risky procedure (serious complication rate is much lower).
It provides a less drastic but stable weight loss. The total weight loss is usually achieved after 24 months. It leaves all options open for other more invasive surgical options in case sufficient weight loss is not achieved.

After the gastric band procedure

This operation will have a major impact on your lifestyle.

You will be put on a diet straight after surgery. For the first days after surgery you will be allowed to take liquid to mashed food only. The following days you will have soft food added to your diet. Some foods will be difficult to eat and most will need to be carefully chewed.

This food intake pattern after surgery is important, to allow your body to heal. Adhesions are built during these days, holding the implant where it should be for a long time! Patients who eat solid food too soon after their operation run the risk of dislocating the band.

Diet reconstruction after the gastric band procedure

2-3 days after the operation only liquid to semi-liquid (porridge like) nourishment may be consumed.

These include:

Tea
Fruit juice
Vegetable juice
Lean/non-fat soup and pureed sauces
Puree
Fruit pulp
Dairy products, quark cream
Buttermilk, yogurt, whey drinks

After these 3 days the patient may change from semi-liquid to soft foods:

Pureed vegetables,
Well/soft cooked vegetables,
Well/soft cooked pastas (ribbon noodles, or any type of small/thin shaped pasta)
Mashed –potatoes or dumplings
Porridge, compote, bananas, berries
Pudding, semolina pudding, rice pudding
Crust free bread, fat free quark spread
Cream cheese

During this phase it is extremely important to forget the consumption of raw fruits (except bananas) and raw vegetables as well as abrasive coarsely ground full grain products.
Subsequently, after ca. 3-4 weeks, it is possible to gradually move on to firmer foods. However, particularly at the beginning, difficulty may occur when consuming some foods.

Therefore at the start you should avoid:

Fibrous or stringy meats and sausage products (beef, bacon…).
Fruits that are high in cellulose (citrus fruits, grapes, plums, cherries…).
Vegetables that are high in cellulose (woody asparagus, viper’s grass, rhubarb, lettuce, sauerkraut, … and the skins of vegetable types such as tomatoes).
Leguminous plants.
Fresh bread, pastas (especially spaghetti and spiralled noodles) and rice.
Fried foods (schnitzel, fried fish, french fries, deep fried vegetables covered in batter).
Hot spices/vegetables (garlic, onions, pepper, chilli, concentrated vinegar).
Carbonated drinks.

General guidelines after gastric band

Eat 5 fixed meals a day

You can herewith lessen the risk of uncontrolled eating and hunger pangs. The habit of snacking between meals also falls away.

Eat small portions only

One meal should have the volume of ½ a bread roll; in other words the intake of 3-4 dessert spoons. It helps to eat meals with a teaspoon, making it seem as though your meal lasts longer.

Thoroughly chew every bite (30 times!)

The patient may only swallow the food once it has reached the semi-liquid state in the mouth. This prevents clogging the stoma (= narrow area where the Gastric Band is placed). The compatibility of various foods depends not only on the quantity consumed but especially on sufficient chewing.

End your meal on the feeling of saturation

Signs of saturation:

Pressure of a feeling of fullness in the centre of the stomach directly under the chest.
Pains in the shoulder or chest area.
Feeling of revulsion.
Nausea.

Discontinuing a meal at the slightest feeling of saturation is conditioned and shows that the Band restricts the volume of food intake. An overfilling of the stomach causes expansion and can lead to nausea, prolonged vomiting and heartburn.

Plan a time frame of 30-40 minutes per mealtime

Drink 1.5-2 litres of low calorie/calorie free fluid per day

Do not drink in glumps, but instead in small manageable sips. A sufficient supply of fluid supply is especially important in the catabolism of fat because numerous metabolic products need to be flushed out.

Drink either before or after meals

Drink ¼-½ hour before meals and ½ hour after meals. A fluid supply during meals results in the acceleration of the food as it passes along the passage therefore increasing capacity intake and/or causing the feeling of a full stomach.

Do not lie down after meals and do not eat lying down

Lying down during or after eating results in a longer chyme retention period in the reservoir created by the gastric band. This then mixes with the naturally produced stomach lim which in turn can result in a feeling of pressure with subsequent vomiting.

General nutritional guidelines after gastric band

Avoid food that causes trouble.
Dietary fibre should only be taken in refined form (full grain, whole wheat pasta, …).
Under no circumstances l ower the quality of food you buy.
Bear in mind that drinks such as fruit juices, lemonades and alcohol contain calories that are ingested.
Make yourself aware of the sugar and fat content contained in foods. Count the calories.
Preparation methods of food should be low fat or fat free. Therefore stay away from butter, olive oil, vegetable oil etc.

Possible complications for gastric band

Contraindications for gastric band surgery?

Age of less than 15 and older than 65 years.
Alcohol and/or drug addiction.
Psychosis Patients, who will not be compliant during the required postoperative follow up.

It is very important to understand that surgery is always associated with some risks. There is no guarantee for success for each and every individual. It is absolutely crucial for you to be aware of the complication risks.

Please ask your doctor to explain these risks to you, since he will know your individual situation best.

Possible side effects and general advice

Constipation

Many patients feel constipated after surgery. This is mainly due to the fact that the reduced food intake leads to less faeces and thus less bowel movements. Please ask your doctor for the suitable selection of laxatives, in case required.

Pregnancy

The period between surgery and weight stabilisation is considered as a period of starvation. It is therefore not advisable to become pregnant during this period. Should you nevertheless get pregnant, it is then advisable to remove all fluid from the system. Once your weight has stabilised, pregnancy is no longer a problem.

Medication

Tablets must be broken down into small pieces or crushed before they are taken. Please consult with your doctor about the adjusted (in most cases reduced) amount of medication after surgery.

Vomiting

Patients occasionally vomit or feel pain after food intake. This may be caused either by poor eating behaviour or by the narrowing of the opening between the two divided gastric pouches, following the injection of fluid into the adjustment port, which is located under your skin.

Please eat slowly and chew your food carefully. This will help you avoid this problem. Regular vomiting is definitely a warning sign in which instance you should consult your doctor. The opening between the two gastric pouches may need to be readjusted.

Vitamins

It is advisable to take vitamin supplements during the rapid phase of weight loss.
A liquid vitamin mixture containing multivitamins is recommended for at least the first 6 months following the surgery.

A few more tips you should take on board

Always write a shopping list. This helps you avoid those little buying mistakes.
Never go grocery shopping hungry!
Always have an ample supply of low sugar/low fat foods at home.
Allocate certain times during the day to you meals. Religiously make an effort and only eat at those allocated times. AVOID SNACKING BETWEEN MEALTIMES!
Find your own personal meal place and sit down for every meal.
Do not open yourself to distractions during your meal time (television, newspaper etc).
Weigh yourself at least once a week. Always at the same time under the same conditions.

Gallery with before/after pictures

The gastric band surgery is performed by a specialist Dr. Rein Adamson who is the most experienced bariatric surgeon in Estonia. Ask for more information.