How gastric banding surgery is carried out   About gastric bands A gastric band can help you to lose excess weight if you're very overweight (morbidly obese).
A member of the American Society for Metabolic and Bariatric Surgery, the Society for the Surgery of the Alimentary Tract, the Society of American Gastrointestinal and Endoscopic Surgeons and the International Federation for the Surgery of Obesity, Dr Spaniolas is an active researcher with multiple publications, and has presented in multiple major national gastrointestinal meetings.
He is also trained in surgery for primary and revisional hiatal hernias and reflux disease, common conditions in the overweight and general population. This can only hold a little food, which means that you eat less because you feel full more quickly. He is an Assistant Professor of Surgery at the division of gastrointestinal surgery at the Brody School of Medicine, and the co-director for the bariatric and minimally invasive fellowship program. The band contains a circular balloon, similar to a tiny tube, which is then inflated through a port placed just under your skin. When you eat, the pouch fills up quickly and the band then slows down the passage of food into the lower part of your stomach. If your GP thinks weight loss surgery could be beneficial to you, he or she will refer you to a bariatric surgeon (a doctor specialising in obesity surgery) to talk about your options. For example if you smoke you will be asked to stop, as smoking increases your risk of getting a wound infection, a chest infection or a blood clot and slows your recovery.
This is particularly important before a gastric band operation as being very overweight increases your risk of complications after your operation. This helps to shrink your liver and makes it easier and safer to perform keyhole (laparoscopic) surgery and put the band in place. At the hospital your nurse will check your heart rate and blood pressure, and test your urine. This is your opportunity to understand what will happen, and you can help yourself by preparing questions to ask about the risks, benefits and any alternatives to the procedure.

This will help you to be informed, so you can give your consent for the procedure to go ahead, which you may be asked to do by signing a consent form. He or she will use small instruments, guided by a laparoscope (a long, thin telescope with a light and camera lens at the tip), to place the band around the top part of your stomach. The band is then connected by a piece of fine latex tubing to the injection port, which is placed just under your skin. Your surgeon can add or remove saline from the band after your operation through the injection port. This controls the size of the opening from your stomach and therefore how quickly the pouch empties. You're likely to have the volume of fluid in your band adjusted two or three times in the first few months after your operation. These adjustments are made to make sure you're steadily losing the right amount of weight, but can eat a reasonable amount without being sick. If you feel well enough, you can start to drink small amounts of water soon after your operation. You will be encouraged to get out of bed and move around as soon as you feel able as this helps prevent blood clots developing in your legs, and chest infections. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice. However, because food is absorbed normally after a gastric band operation, if you are following a healthy diet, you shouldn’t need to take vitamin supplements long term. Your surgeon will give you all the information you need about what foods to eat and how much. These are to check that you're getting all of the vitamins, minerals and nutrients you need to stay healthy.

You're likely to have some bruising, pain and swelling of the skin around your healing wounds. The possible complications of any operation include an unexpected reaction to the anaesthetic, excessive bleeding or developing a blood clot, usually in a vein in the leg (deep vein thrombosis – DVT). This may mean your surgeon has to convert to an open operation by making a larger incision.
This won't affect how well the operation works, but it may mean that you take longer to recover from the operation. Eating small amounts of healthy foods that are low in fat and sugar will help you to lose excess weight and keep it off. You should also try to have four to five small meals in a day rather than three normal-sized meals. The feeling of fullness you get after a gastric band operation may be different from the feeling you had before. This will help you to maintain your weight loss and to get all the nutrients and energy you need to stay healthy. Eat four or five portions of fruit and vegetables a day and low-fat foods, such as skimmed milk and low fat cheese.
If you’re interested in cosmetic surgery after your gastric band operation, discuss your options with your doctor.

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