The gastric banding procedure is performed by key-hole surgery (laparoscopic) which is minimally invasive and involves 5 small incisions in the abdomen. The silicone band is placed around the upper part of the stomach to create a small pouch above the band. This allows only a small amount of food to be held by the stomach at any one time, and slows down the passage of food from the small pouch to the rest of the digestive tract which enables you to feel full for longer and helps reduce the urge to have large helpings and to eat between meals.Food is no longer the focus it once was. You are in control of your eating, rather than eating controlling you.

The inner surface of the band contains a small balloon which is connected by tubing to a reservoir which is placed under the skin in the abdomen during surgery. This makes the band adjustable. Adjustments are usually performed in the rooms by a medical practitioner. They use a needle to inject saline into the band through the port (reservoir). When saline is added, this increases the amount of restriction provided by the band.

The gastric band is intended for long term use. There is no evidence at this stage, that the band will need to be replaced except in the event of a complication. Gastric banding is a reversible procedure as the anatomy of the stomach is not permanently changed. However it is important to note that reversal surgery is not simple and weight gain has been observed in patients who have had their bands removed.

ADJUSTMENTS

The band has an inflatable inner balloon and is connected via a thin tube to a special reservoir or access port which is implanted on the abdominal wall under the skin. The access port allows the band to be adjusted, by adding or removing fluid and thus increasing or decreasing the level of restriction.

The first band adjustment occurs at 4 – 6 weeks following surgery. The procedure is usually performed in the surgeon’s rooms. The doctor accesses the port with a special needle through the skin and injects saline into the band. This procedure can also be performed under fluoroscopic (x-ray) control.

Following your band adjustment you will need to have a drink of water ensuring that the band is not too restricted prior to leaving the rooms. It is also necessary for you to remain on fluids for the next 24-48 hours, then purees for the following 24-48 hours before returning to a smaller amount of solid food.

If, for any reason, fluid is not tolerated after an adjustment, you must contact the rooms immediately. There should be no reason that an emergency adjustment is required if the regime is followed.
The frequency of adjustments and the amount of fluid placed in the band will be determined in consultation with the Circle of Care team and your surgeon.

A general indication that you may require an adjustment can be:
* Increased food intake
* Hunger soon after eating
* Ability to eat difficult foods e.g. steak, white bread
* Plateau in weight loss

Ongoing band adjustments are required for weight loss maintenance.

Similarly, if you are too restricted and require an adjustment to remove fluid, symptoms can be:
* Inability to tolerate any solid food or normal eating
* Night time reflux or night time cough
* Difficulty with swallowing anything other than fluids.
Most patients report minimal discomfort only during adjustments.
Information from http://www.1300weightloss.com.au/