A person who is severely obese may consider gastric banding. However, weight (minimum BMI) and age conditions must be respected.
Obesity surgery may be considered by people suffering fromclinically severe obesity as a last resort. Among the methods, there is that of the gastric band. What are the conditions for having a gastric band inserted? What minimum age? What weight loss to expect? What are the risks of this operation?
What is a gastric band?
A gastric band is a adjustable silicone ring placed around the upper part of the stomach to slow down the passage of food at this level. This restrictive surgical technique decreases stomach volume And slows the passage of food but without disturbing the digestion of food. The technique consists of placing a ring of changeable diameter around the upper part of the stomach, thus delimiting a small pocket. The food will flow very slowly according to the hourglass principle. The ring is connected by a small tube to a control box placed under the skin. This technique has the particularity of being adjustable and not definitive. This ring can be tightened or loosened by injecting a liquid into the case, through the skin. The ring can also be removed during a new operation in the event of a complication, ineffectiveness or at the request of the patient.
What weight loss to expect?
The technique of the adjustable gastric band allows a weight loss ofabout 20 to 30 kg. A weight regain is usually noticed when the ring is removed.
What are the conditions for having a gastric band inserted?
Obesity surgery concerns people who are very overweight. It is intended for adults with significant obesity with a BMI greater than or equal to 40 Or “between 35 and 40 when there are obesity-related complications” says Dr. Vincent Frering, bariatric surgeon in Lyon. “In France, in 2018, 1200 gastric bands were placedout of the approximately 50,000 obesity surgeries performed.”
What age to get a gastric band?
There HAS does not recommend considering obesity surgery in minors under the age of 13. In detail, she recommends being at least 15 years old (and on a case-by-case basis between 13 and 15 years old). In adolescents, bariatric surgery can only be considered after the failure of a multi-professional care followed and adapted.
How much does a gastric band cost?
On average, you have to count the price between 2,000 and 4,000 euros for gastric banding.
The choice of the surgical technique used is made collectively by the multidisciplinary team and the person concerned. Many criteria are taken into account, in particular the experience and the technical environment of the surgeonthe multidisciplinary team and the anesthesia team but also depending on the extent of obesity, BMI, age, medical and surgical history, associated digestive pathologies, the presence of type 2 diabetes, current treatments and eating disorders. “Preparation is essential, emphasizes Dr. Frering. It guarantees better results, less reflux. In adults, it must be done at least 6 months before the operation. It includes dietary monitoring, the resumption of appropriate physical activity and psychological monitoring if the patient is receptive.
The operation is done under General anaesthesia and most often in laparoscopy. The ring is placed around the upper part of the stomach and connected to a box placed under the skin which allows the ring to be inflated or tightened. “To tighten or loosen the ring is very simple, just prick through the skin” explains Dr. Vincent Frering. Following the operation under laparoscopy, people with a sedentary job can resume their activity generally after 2 weeks. The stoppage will be one month in the event of carrying loads of more than 25 kg. “In adolescents, even if all the techniques are possible, we favor gastric banding because this act is reversible. This reduces the long-term discomfort caused by the sleeve and the bypass” says the bariatric surgeon.
What are the dangers of a gastric band?
X-rays are needed to make sure the gastric band is in place and working properly. Nevertheless, the fitting of a gastric band can lead to unpleasant side effects : gastric lesions, esophageal disorders or problems around the control box. Complications can also arise if the patient neglects the follow-up and the advice following the operation, does not change his eating habits or does not compel himself to resume a sport.. “Slippage of the ring or a ring that is too tight are among the most frequent complications, says Dr. Frering. This occurs in 1-2% of operations. Patients may also suffer from gastric stasis. Nausea or vomiting are observed when the diet is not respected. It is important to remember that without follow-up, weight regain will begin, obesity will return. This is true for the gastric band but also for the other techniques.
What food after the installation of a gastric band?
“You can eat anything after gastric banding. You have to eat liquids in the week following the operationto integrate soft or mixed foods for 15 days then reintroduce all foods gradually. Carbonated drinks are inadvisable for life because they tend to dilate the pockets. So only exceptionally.”
What follow-up after the operation?
“Obesity surgery requires lifelong follow-up, as is the case with cancer. This is extremely important because obesity is a recurring disease” insists the bariatric surgeon. The follow-up associates a nutritionist doctor about once a year who follows the obesity disease, a dietician for daily advice “at a rate of once every three months at the beginning then every 6 months thereafter” and radiological monitoring.
Is there a risk of failure?
Failures can occur: they are notably linked to a lack of follow-up, to the fact of not respecting post-operative recommendations such as the need to modify one’s eating behavior and the non-resumption of regular physical activity.
Thanks to Dr Vincent Frering, bariatric surgeon in Lyon.