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Gastric banding

Gastric banding is one of the longest-used obesity operations. At present, supplementary (Swedish) banding is used. It's relatively simple, and suitable for patients at risk of, or already suffering from, health damage due to serious obesity. The reason for the operation is always the prevention or treatment of associated diseases, and the improvement in the quality and length of the obese patient's life.


It's performed in patients with class III obesity (BMI over 40) and class II obesity (BMI 35 to 39.9) who suffer from disease caused by obesity (high blood pressure, phlebitis, type 2 diabetes, degenerative joint and spine disease, female infertility, high cholesterol level, shortness of breath etc.). 
Patients with gastric banding feel full after ingesting a small amount of food. They usually lose approximately 2 kg per month; the overall loss obviously depends on the patient's initial weight. The banding can be left on the stomach permanently. It can thereby prevent a return to the old lifestyle, overeating and a yo-yo effect with new weight gain, which is so common after the non-surgical treatment of obesity. Patients have to go for continuous checkups; most frequently in the first year after the operation. After that, they're recommended at least 1 x per year.


Gastric banding does not restrict any activities. It doesn't prevent pregnancy in female patients; on the contrary, significant weight loss helps deal with problems during pregnancy which can accompany obesity. We only recommend that you do not plan maternity for a period of half a year after the operation. The banding material is not magnetic, so it's possible to undergo a magnetic resonance examination.

Operation

A minimally invasive operation is performed - laparoscopically, from five small incisions under general anaesthesia. So it is possible to quickly return to normal life.  A silicone cuff is implanted around the upper part of the stomach, thank to which the stomach assumes an hourglass shape. The upper part has a small volume (approximately 20 to 30 ml). After ingesting a small quantity of food, the patient quickly becomes full and feels satiated. On the side facing the stomach, the banding contains a small balloon which is filled by a hose leading from a small chamber hidden beneath the skin. During an outpatient procedure the surgeon can use a needle to insert fluid in the chamber, which increases the volume of the balloon and thereby regulates the tightening of the cuff. That is why the banding is called adjustable. The tightening is performed individually, i.e. it may not be performed at all or, on the contrary, it may be performed repeatedly.

After the operation

In the evening after the operation, the patient gets up from their bed and drinks tea. For the first day they get yoghurt and broth, they recover and, if their progress is free of complications, they go home. During the first week they receive only liquid food. For the next 3 weeks they eat blended food, and after this period they switch to normal food, taking into account dietary recommendations. The normal period of absence from work is 2 weeks. A suitable part of the treatment is physical activity, which is not overly restricted after the operation.


It's important that a patient with gastric banding co-operates with the clinic and complies with dietary restrictions. Most importantly it's important not to overeat, otherwise the upper part of the stomach can overfill, leading to vomiting, stomach damage and serious complications. It‘s also important to thoroughly chew every mouthful and avoid certain risky foods (undercooked chunks of meat, orange pulp etc.). Breaches of these rules can again lead to serious medical complications. One should eat at least five times a day, and limit very fatty foods.

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