Cancer

Adjustable gastric band is one of the commonest operations performed worldwide.

Why is it called ‘adjustable’?

Adjustable gastric band consists of a plastic ring with a balloon, which goes around the upper part of the stomach. This is connected to a port underneath the skin. The balloon in the band offers the ‘adjustability’. The band is filled with saline to cause a small gastric pouch above the band. This will make patients feel full even after small meals. The optimal amount of inflation or filling of the band varies with each patient. If the band is under filled you are able to eat more. On the other extreme you will not be able to swallow if the band is over filled. Therefore, it is important to achieve a happy medium. This can take anywhere from a few months to a year.

What are the risks?

This procedure is safe and most of the patients will be able to go home either later the same day or after overnight stay. There are however some risks as with any other operations. Specific to this operation, there is a chance of injury to the stomach, spleen and liver during the operation. Liver diet will go a long way to minimise the chances of injury to the liver.

The port site under the skin can get infected. This infection can then track down to the band and may only be treatable by removal of the band. Therefore careful aseptic technique should be employed while filling or de-filling of the band.

Slippage, erosion, infection

In the long run, there are chances of the band slipping over the stomach. This can result in vomiting, unable to swallow, and or weight regain. In some instances this can lead to the band eroding into the stomach. Patient can become very unwell as a result of the erosion. Urgent medical help from an expert is essential in this situation. The port can also get infected as a result of the erosion with the infection tracking from within.

How successful?

Overall, adjustable gastric band can achieve significant & sustained weight loss. Gastric band matches and in some cases can do better than a gastric bypass in terms of weight loss. Patient with diabetes can see improvements in the condition as they loose weight.

Gastric Bypass combines the effects of both restriction & a mal-absorption. In this operation, stomach is reduced in size and bowel is re-routed in a fashion that food bypasses stomach and enters small bowel (often called roux-en-Y).

Following Gastris Bypass, patients not only feel full even after small meals but their calorie absorption is decreased. Research has shown that, gastric bypass also results in a number of changes in the gut hormone signals. The collective effects of these changes include early satiety (feeling full) and decrease in hunger. This results in healthy eating and assist patients to loose weight effectively and more importantly results in sustained the weight loss.

Gastric Bypass improves all obesity-associated conditions. The effect on diabetes is most striking. Type 2 Diabetes improves almost immediately after Gastric Bypass. This effect on Diabetes is unique to Gastric Bypass (of all the weight loss operations). High blood pressure, high cholesterol, reflux, weak heart improve in over 90% of the patients after Gastric Bypass. A recent study has confirmed that heart condition also improves following gastric bypass. Quality of life improves with patients more active in their day-to-day life, at work and in society.

Risks of this operation include join leaks, injury to bowel, stomach, liver and spleen. Mr Jayanthi performs Gastric bypass using keyhole techniques. Patients can be discharged after 48hrs.