Added by Anne Beckett on 06.08.2020

Gastric Band Overview

Although one of the most established forms of bariatric surgery, gastric bands have largely fallen out of favour with most bariatric surgeons in recent years and these procedures are now seldom performed. Other types of bariatric surgery such as the mini gastric bypass and gastric sleeve are considered better alternatives. Some of the reasons for this are highlighted in this article. For those people who feel they still want gastric band surgery, it is best to discuss this with and be guided by the advice of the surgeon.

Overweight girl reading book

Currently, there are different kinds of weight loss surgeries available, the doctor after consultation will help to choose the best option for the patient

 

Gastric Band - what is it?

A gastric band is arguably one of the best-known procedures of weight loss surgery. It belongs to the group of surgery procedures known as bariatric surgery. In addition to gastric band surgery, this also includes such procedures as gastric bypass, gastric sleeve, and gastric balloon among others.

So, what is bariatric surgery? This group of procedures is concerned with making, sometimes quite drastic, changes to the digestive system in order to make it easier for the patient to lose weight. This often involves decreasing the size of the stomach and/or reducing the length of the intestines.

Whereas some other types of stomach reduction surgery involve stapling or sewing in order to decrease the overall size of the stomach, gastric band surgery uses a band to ‘pinch’ in the stomach at a certain place so that the stomach is divided into two parts with a small stomach pouch created at the top.

Gastric band surgery is therefore a type of weight loss surgery. The gastric banding procedure was first carried out in 1978 and has gone through a number of changes since that time. One of the most significant changes was the introduction of a band made of silicone which meant that the whole procedure could be performed laparoscopically…. and so the term lap band surgery was coined.

CH_gastric_band_820x450

What is laparoscopic surgery?

An operation performed laparoscopically uses an instrument called a laparoscope.

This is a long rod with a camera and a light at the end of it. It allows surgeons to perform, what is colloquially known as, keyhole surgery. This means that rather than cutting a large hole in the skin, the procedure can be performed with just a few small incisions. The skin healing process is much quicker and potentially less problematic.

Gastric band vs vertical banded gastroplasty surgery

It is important not to confuse the gastric band/lap band with vertical banded gastroplasty surgery.  This is a different procedure that involves not only placing a band around the stomach but also stomach stapling. This means that a very small pouch, holding between ½oz and 1oz of food is created. This procedure, although still performed, is also less popular than it was a few years ago.  For more information on this procedure please look at our separate article – vertical banded gastroplasty surgery.

Hypnotic gastric band – what is it?

Hypnossis

On the internet, there are loads of information about the hypnotic gastric band- which is simply a behavioural theory which suggests subconscious that patient has a gastric band fitted around the stomach

A quick trawl through the press or internet websites will reveal numerous references to a hypnotic gastric band process. This hypno gastric band, as it is sometimes referred to, is a non-surgical gastric band.

In simple terms, a trained hypnotherapist, using suggestions and cognitive behavioural therapy, will assist the patient in the weight loss process by suggesting that a gastric band exists. Does gastric band hypnotherapy work? As with all hypnotherapy, gastric band hypnosis does not work for everybody and does require some determination from the patient to succeed. The hypnotic gastric band is only a tool, some willpower is still required. However, for some people, it works as well as, possibly even better, than stomach surgery, while for others it does not work at all.

The advantages of gastric band hypnosis are:

  • There is no invasive surgical treatment and therefore no surgical side-effects or complications. This is ideal for anybody who is either scared of, or for some reason cannot have surgery
  • Costs are considerably lower than for surgical treatment
  • As no changes are made to the stomach or digestive system it is 100% reversible!

The disadvantages of gastric band hypnosis are:

  • It will not work for everybody
  • It requires several hour-long sessions with the hypnotherapist
  • The patient must be 100% committed, otherwise, no amount of hypnotic suggestion will help

Costs for gastric band hypnotherapy will vary greatly from therapist to therapist, however, costs will normally fall within the range £1000 – £2000.

In summary, if, for any reason, a patient cannot have surgery and is determined to lose weight, then a hypnosis gastric band is certainly worth a try. Likewise, for anybody who has tried hypnotherapy successfully for any other issue, or simply does not want alterations made surgically to their stomach, a hypnotic gastric band is a good choice. Overall, it is less successful than conventional surgery, but is cheaper and, where unsuccessful, can be followed up by surgical intervention.

As always, it is best to do some research to ensure that the hypnotherapist is a registered practitioner and is experienced in this type of therapy.

How does a gastric band work and what is its effectiveness?

Nowadays, most surgical gastric band procedures are performed using the Laparoscopic Adjustable Gastric Band or LAGB. An inflatable band, rather like a child’s inflatable swimming ring, is placed around the upper part of the stomach, so that a small pouch is created in the top half of the stomach. Food eaten sits above the band, in the stomach pouch which has been formed, giving the patient the feeling of being full. Gradually the food will ‘squeeze’ it’s a way through to the rest of the stomach where it goes through the normal digestion process. When the level of inflation in the band is increased, it can tighten around the stomach and so weight loss can be increased, or, when the inflation is decreased, it will loosen thereby reducing the potential weight loss. This is achieved with a saline solution (rather than air) that is used to fill the band so that it compresses around the stomach.

Despite the fact that the stomach size has been altered, as with any surgery for obesity, the effectiveness of the gastric band is partially dependent on how well the patient manages their eating habits. Although the ability of the stomach to digest food has been considerably slowed down and the patient will feel fuller much quicker, there can still be a big difference between eating a small amount of healthy food and eating a small amount of sugary/fatty unhealthy food. The gastric band procedure, unlike some other bariatric procedures, does not reduce the ability to absorb minerals and nutrients from the food. All food is digested and absorbed as normal.

How is a gastric band fitted?

Getting a gastric band is a relatively simple procedure, although it does require a general anesthetic. Gastric band surgery is done by a bariatric surgeon, usually laparoscopically. One to five small incisions are made in the abdomen and the silicone band is inserted around the top of the stomach. A tube is attached to the band which connects it to a port just under the skin of the abdomen. This port is used to inject a saline solution into the band in order to inflate it. The port is not visible from the outside but can be located by pushing on the skin. The whole operation takes around 60 minutes and, providing all goes well, the patient will be able to go home the same day or the next day.

Is a gastric band permanent?

The gastric band is designed to be a permanent fixture and can be regulated over the years as necessary, by using the port to adjust the amount of saline solution in the band. There are reports of problems with gastric bands as they age. The ‘oldest’ inserted silicone gastric bands are now about 30 years old, so any research on their longevity within the body is limited to this time period. Realistically some patients may have a silicone band in-situ around their stomach for 60-70 years and what will happen over this period of time is mainly conjecture. There is currently little evidence available on the very long-term effects, however, with recent scares about breast implants and hip joint replacements, the medical profession is understandably cautious when it comes to inserting ‘foreign objects’ into patients’ bodies, especially when alternatives are available. This is one of the reasons why gastric banding has declined in popularity. The procedure is reversible, however, the reversal operation can sometimes be more risky than the original procedure.

How to prepare for the surgery

As with any surgical procedure, it is advisable to prepare the body for a gastric band operation- so the first step is bariatric surgery consultation. The operation of any type carries a very small risk of severe complications or even death, and this risk increases with obesity. The bariatric surgeon, sometimes with the assistance of a dietitian, will advise what specific steps are required for each patient individually. Generally, at least 2 weeks before the procedure, patients should stop smoking, if applicable, and avoid drinking alcohol. Often the surgeon will expect the patient to go on a pre bariatric surgery diet in order to:

  • Prepare the body for surgery
  • Minimize risks – lower body weight means a lower risk of complications
  • As a practice run for the eating plan required after the surgery

It is really very important that the patient can show some sort of pre-op diet weight loss, otherwise, the surgeon may decide that the success of the surgery, in terms of weight loss, will not be achieved. The surgeon may either set a percentage target i.e. 10% of body weight, or specific weight, that they will expect the patient to achieve before the operation.

The gastric band diet before surgery may take many forms and lots of help and advice will be given where necessary. Any reputable diet may be used providing it will allow the patient to reach their target. In some cases, this may require a diet for quick weight loss before surgery.

Some suggested eating plans pre-bariatric surgery include:

  • Milk diet – the milk diet, as its name suggests, consists of drinking 2 liters of milk a day. This is usually semi-skimmed milk, but may also be skimmed or sweetened soya milk. Non-sugar flavourings are allowed as well as unlimited water, tea, coffee, and unsweetened fruit drinks.
  • Under 1000 calorie diet plan as the name suggests this diet consists of minimising the calorie intake.
  • The Ketosis Plan diet – this eating plan forces the body to burn fat instead of carbohydrates. Typically, about 70% of calories are derived from fat, less than 10 percent from carbohydrates and less than 20 percent from protein.
  • The Soup, Yogurt, and Milk this is also known as a liquid diet
  • Protein shake dieteating only protein shakes commonly available in the shops

A pre op diet weight loss will also reduce the amount of fat in and around the liver. With a laparoscopy the liver has to be gently pushed to one side in order to work on the stomach. The less fatty and more pliable the liver is, the easier it is for the surgeon to do this.

So, a pre bariatric surgery diet is important for three main reasons:

  • To reduce the risks associated with the operation
  • To prepare the patient for the necessary dietary restrictions after the operation
  • To facilitate the operation by making the liver softer

Gastric Band Recovery Time

lady in bad with grey eyes

Recovery time after gastric band surgery is different depends on the body’s reaction to the surgery and anaesthetic

The gastric band procedure takes about 60 minutes and most patients are sent home the same day or the next day. As with every operation, the gastric band recovery time will vary from person to person depending on the body’s reaction to the surgery and anaesthetic. The usual post-operative instructions apply to gastric band surgery i.e. start walking about as soon as possible to prevent blood clots in the legs or lungs, begin a gentle exercise, and drink plenty of water. Most patients will begin to feel back to their normal selves in about 2-3 days, although surgeons generally advise taking at least a week off work to ensure total recovery. There may be some lingering pain after the operation, particularly at the site of the port, which is often located a few inches under the ribs on the left side. This can be managed by over-the-counter painkillers or other medication given by the medical team. During the coming weeks, the patient will follow a gastric band diet plan. For the first week or so this will mean a 100% liquid diet, so it is advisable to take plenty of rest during this time, as the effects of the operation/anaesthetic and the liquid diet may leave the patient feeling quite weak. The section on aftercare and diet gives more specific information on the gastric band diet plan.

Gastric Band Adjustments and Removal

Initially, the silicone band is not inflated, so it is only after checks have been made post-operative confirming that everything is in order that these adjustments can be made. In cases where everything has gone to plan, the first gastric band adjustment will take place any time between a few days and a few weeks after the procedure. Using the port located under the skin a measured amount of sterile saline solution is injected into the tube and the silicone band is filled to the required level. There is a considerable variation in how often a gastric band needs to be adjusted, particularly in the first 12 months. For some patients once will be enough, for others, an adjustment may need to be made every couple of months. A gastric band which is over-adjusted (very tight) can be dangerous, increasing the chances of it slipping or other complications. A gastric band which is too loose will not yield the required weight loss results and may also cause complications. Sometimes many adjustments will be necessary to ‘fine-tune’ the level of inflation.

Ongoing, the gastric band will continue to require adjustments. When a gastric band is too loose, the patient may still feel hungry, want to eat more and not lose the expected amount of weight. Adding more saline solution will lead to gastric band tightening, thus reducing the appetite and making the stomach feel fuller quicker. When a gastric band is too tight, the patient may feel uncomfortable, have a reduced appetite and may suffer from reflux heartburn. How often adjustments are required to the band after the first 12 months very much depend on the individual.

Many patients pose the question – does your stomach shrink? The stomach is artificially shrunk with the gastric band but as soon as it is loosened or removed the stomach will gradually return to its usual size.

man reading book

After the required weight loss, the gastric band should stay in place throughout the patient’s life. This will need, constant maintenance from the point of view of adjustments and checks to ensure that it is still in place correctly

At the present time, these adjustments must always be made by a skilled practitioner (nurse or doctor) who has been trained in this procedure. Although there has been talking over the last few years about self-adjusting gastric bands, these are still in the trial stages and it is unlikely that they will be available in the very near future. Unfortunately, therefore, gastric band adjustment at home is still not a possibility.

Even after the required weight loss is achieved the silicone band should remain in place throughout the patient’s life. It will need, however, constant ‘maintenance’ from the point of view of adjustments and checks to ensure that it is still in place correctly. Although initial adjustments may be included in the surgery price, ongoing checks will cost money. This is another reason why lap bands are dropping out of favour with the medical profession and patients alike.

Gastric Band Removal

Generally, although the operation is reversible, it is expected that a gastric band will stay in situ throughout the patient’s life. When a gastric band is removed, the patient usually regains at least some, and in a few cases all, of the weight loss.

The usual reasons when a gastric band needs to be removed are:

  • Band intolerance
  • Port/band infection which cannot be cleared with antibiotics
  • Band slippage – this may be solved in other ways, however, sometimes complete removal is required
  • Severe heartburn which cannot be controlled in other ways

Major problems with the oesophagus such as dysmotility (expansion of the tissue) and dilation (lack of movement) or oesophagitis, which is inflammation of the oesophagus

In situations where there is very little weight loss or even some weight gain.

If the gastric band does not seem to be working for a patient and there is little or no weight loss, a conversion operation to another type of gastric procedure such as a gastric bypass or gastric sleeve is often suggested. Where possible, this is also proposed for many of the other situations where a gastric band removal is necessary, otherwise, with the removal of the gastric band most patients will gain weight again.

Whenever possible, a surgeon will perform a gastric band removal laparoscopically and like the original surgery, this will take about 60 minutes – sometimes less depending on any complications. It should be borne in mind that this is another operation requiring a general anaesthetic, so will carry the same risks as any surgical procedure where anaesthesia is used.

Generally, conversion from a gastric band to a gastric bypass or gastric sleeve is a one-stage operation in which the band will be removed and the bypass or sleeve created. In exceptional circumstances, where there is damage to the stomach, the two procedures may have to be done separately i.e. two operations.

Gastric Band Removal Cost

The cost of gastric band removal or conversion varies hugely depending on the reasons for the removal. For a very simple removal, the cost is can be £4000-£5000, however, if the removal is complicated by slippage and/or erosion for the stomach it could easily cost twice as much. Again, the cost of conversion surgery is difficult to quote as there are so many variables. In a one-stage process, a conversion from gastric band to gastric bypass may cost about £13,000. It is always advisable to get a clear, individual price from the surgeon before embarking on a gastric band removal or conversion.

Aftercare and Diet

Gastric band aftercare post-surgery is similar to any other operation. It is very important to look after the wounds. As most gastric band procedures are performed laparoscopically there should only be a few small incisions in the skin. In normal circumstances, the dressings can be left on for about a week, and then removed completely. Patients may also receive daily anti-blood-clotting injections and/or anti-embolism stockings which should be worn 24 hours a day for two weeks. As with all medical interventions, any concerns during the recovery period should be relayed to the appropriate doctor or nurse.

The gastric band medical procedure is only the first step in attaining the desired weight loss. The next step is starting and maintaining a gastric band diet. What can you eat after a gastric band procedure? During the first few weeks, the eating patterns are designed to allow the stomach and the body, in general, to heal after the bariatric surgery.

Time

Food type


Portion size per meal (3 meals a day)

First few days after surgeryLiquids only
Drink as much as possible but in small sips
Weeks 1-4
Puréed food only. It is advisable to start with quite a watery/thin consistency and gradually build up to a thicker consistency

2-3 tablespoons
Weeks 5-6

Soft/mashed food only
3-4 tablespoons
Week 7 onwards

Normal texture
3 small meals a day. Eat the food slowly and chew it well. It should take about 30 minutes to eat a meal

Hints and Tips for a diet after gastric band surgery

  • Do not drink water (or any liquid) with, immediately before, or up to 30 minutes after a meal
  • Drink 8-10 glasses of calorie-free/low-calorie fluids each day
  • Focus on eating healthy, nutritious foods
  • Aim to chew each small bite of food 20 times and then leave 60 seconds before placing the next piece in your mouth.
  • Avoid fizzy drinks – they may cause bloating and pain
  • Alcohol is not really recommended, however, patients should be aware that their body may react quite differently to alcohol than before the operation

Results

How long does it take your stomach to shrink? This is a question often asked when it comes to bariatric surgery. With a gastric band, the ‘size’ of the stomach is immediately reduced by the restriction of the band. Usually, the stomach will only be able to hold one ounce of food. However, one ounce of calorie-laden food is very different from one ounce of healthy food! In addition, it is possible to ‘stretch’ the stomach again.

The results of gastric banding vary wildly. Unlike the other weight loss procedures, there is no malabsorption with a gastric band, so as the patient is achieving their healthier weight, all the minerals, vitamins, and nutrients will continue to be absorbed.

Scale and meter

Like with all other bariatric surgeries, results will always depend on the healthy lifestyle changes. The patient can lose 35%-45% of excess weight within 12 months and if follows the diet and healthy lifestyle

As with all bariatric patients, results will always depend on the healthy lifestyle changes which are chosen after the operation. Providing patients adhere to a sensible diet with some moderate exercise, most will lose 35%-45% of their excess weight within 12 months and, if these lifestyle changes continue, weight loss can continue into the second and third years. Gastric band results give the slowest rate of weight loss compared to other bariatric procedures. e.g. gastric bypass and gastric sleeve patients expect to see most of their weight loss in the first year – possibly another reason why the popularity of the gastric band is on the decline.

Research conducted between 2004 and 2014 with 2246 patients who had their gastric band fitted in a UK private clinic recorded that, on average, patients had lost 43.1% of their excess weight after one year, 47.9% of their excess weight after two years, 52.4% of excess weight after five years and 57.1% of excess weight after eight years.

 

Gastric Band Pros and Cons

All bariatric procedures, whatever the risks, create the opportunity for weight loss for those people who are considerably overweight. For these people, weight loss means a better quality of life, lower cardiovascular risks, a possible disappearance of type 2 diabetes, an improvement in joint problems, and other chronic conditions as well as the prospect of a longer life. So, many positive results.

However, with gastric band surgery, there are some other benefits and disadvantages which need to be considered, particularly in relation to other bariatric procedures.

Pros:

  • Reduces the amount of food the stomach can hold, with many patients losing 40-60% of their excess weight
  • The surgeon has no need to cut into the stomach nor are the intestines altered in any way
  • Needs a shorter hospital stay compared to some other procedures, sometimes less than 24 hours
  • Can be reversed, and the band is adjustable
  • Carries the lowest risk of mineral and vitamin deficiencies
  • Has the lowest short-term rate of post-operation complications and death of all bariatric procedures

Cons:

  • A slower weight loss compared to other types of bariatric surgery with a greater percentage of patients not managing to lose up to 50% of their excess weight
  • It requires ‘foreign objects’ (i.e. the silicone band and port) to be placed in and remain in the body indefinitely
  • Possibility of band slippage or erosion into the stomach in a minority of patients
  • Overeating may cause problems like dilation of the oesophagus
  • Possibility of mechanical problems with the band, tube, or port in some patients
  • The highest rate of re-operation and long-term a higher rate of complications

Is gastric band safe?

In the long- term, gastric band risks are considered higher than other with procedures

As we can see from the above, the procedure does have some advantages over other types of bariatric surgery, however, particularly long-term, gastric band risks are considered higher than for these other procedures.

A gastric band pregnancy should not really cause any major problems. Generally, surgeons advise against getting pregnant for at least 18 months after surgery, initially to allow the stomach to heal and, obviously, allow the patient to lose some weight. Often a weight loss will increase fertility, so patients may wish to review their contraception arrangements.

Usually, the gastric band is completely deflated during the pregnancy or at least for the last trimester. This is to ensure that both mother and baby are receiving enough nutrients. Deflation of the band does, of course, carry with it the risk of a sudden weight increase independent of the pregnancy.

Gastric Band Side Effects and Complications

Gastric band side effects can often be managed at home. Mainly they hinge on the digestive processes and are often caused by overeating or not chewing the food enough.

Sometimes constipation occurs during the first month post-surgery. Often this is simply due to the fact that much smaller portions of food are being eaten. Eating high-fibre foods such as cereals, baked beans, wholewheat crackers and plenty of fruit and vegetables will help, as will drinking plenty of fluids. Alternatively, occasionally diarrhoea can be a problem, but this is often due to eating too fast or eating foods with very high-fat content. Likewise, eating too fast may cause heartburn in some people. This can also be aggravated by fizzy drinks and/or too much fluid in the band. In addition, eating and drinking at the same time can cause bloating as will eating or drinking too much too quickly.

Slightly more serious side effects include blockages, again often caused by eating too fast or if the food is not well-chewed. It may also be as a result of the band being too tight around the stomach. Often this problem will either resolve itself or a small fizzy drink (the only time a fizzy drink is recommended) will settle the symptoms. If it persists, check with the doctor/nurse. Another problem caused by eating patterns is stretching of the stomach above the band.

Additionally, rapid weight loss using any weight loss method will always greatly increase the incidence of gallstones. A very strong right-sided stomach pain should always be investigated by the doctor.

Unfortunately, gastric band complications seem to increase in the long term.

In a study of patients who had gastric band surgery in Belgium between 1994 and 1997, over 40% of them had some type of major complication over 12 years later. Some may argues that procedures for this type of surgery have changed and improved over the intervening time, but the long-term complications still appear to be much higher than for other bariatric surgery. The main complications are:

  • Slippage (up to 22%) – this is caused by the gastric band slipping down the stomach. This can cause vomiting, gastric perforation and acid reflux. Often the slip can be corrected, but the chances of a reoccurrence are quite high
  • Movement of port (up to 20% of patients) – the port moves or turns onto its side so it cannot be accessed by the doctor – either a new port must be fitted or the original one stabilised
  • Oesophageal dilation (up to 14% of patients) – this most often occurs about 6 years after the initial surgery. The oesophagus becomes enlarged and loses its ability to push the food down into the stomach
  • Gastric Band Erosion (up to 9% of patients) the band rubs through the outer stomach wall, so it no longer restricts the size of the stomach. Should this cause an infection it can be life-threatening
  • Pouch Dilation (up to 9% of patients) – the stomach above the band stretches so that it no longer restricts the amount of food that can be eaten
  • Band Intolerance (around 7% of patients) – at times the body does not respond well to a ‘foreign object’ – the ultimate solution is the removal of the band and/or conversion to other bariatric surgery
  • Infection of the Port or Band (up to 4% of patients) – again the ultimate option is removal or conversion
  • Band or port leaks (up to 4% of patients) – this is caused by a breakdown in the band, tube or port so that saline solution leaks out.

The overall gastric band failure rate varies quite considerably among different research, however, it would seem that somewhere around 40% of gastric band surgery has to be corrected, converted or reversed after about 10 years. The compares very unfavourably with other types of bariatric surgery and is one of the most important reasons why this type of operation is performed less and less.

Alternatives to Gastric Band

So, if gastric band surgery is no longer the gold standard when it comes to weight loss surgery options, what are the alternatives to gastric band surgery? A few options exist, both surgical and non-surgical.

Firstly, let’s consider a couple of non-surgical alternatives:

Hypnotic gastric band

This involves a hypnotherapy programme to convince the mind that a gastric band exists around the stomach, although in reality there is no surgical intervention. The patient eats less because they believe the gastric band exists. (More details of this method are given at the beginning of this article)

Gastric band tablets

These are also known as gastric balloon tablets. They are still a relatively new treatment and long-term effects and complications are still not known. They are only available privately at a cost of around £3000. The patient swallows a small capsule which has a tiny balloon hidden inside and to which a tiny tube is attached. When the capsule reaches the stomach the capsule opens up and releases the balloon. The doctor checks the position of the balloon on an x-ray and then inflates the balloon with water, before removing the tube but leaving the balloon in the stomach. The whole procedure takes about 15 minutes and no anaesthetic is required. After a few months, the balloon is naturally excreted by the body. Initial research shows excellent results.

If neither of the above solutions appeals to you, there are other types of stomach surgery which may be considered.

Gastric Bypass/Mini gastric bypass

Clinic Hunter mini gastric bypass

Mini gastric bypass may be one of the alternatives for the gastric band

These procedures are quite similar to each other. they involve partitioning off a small part of the stomach and reconnecting the small intestine to this part. The gastric bypass is non-reversible, however it is possible to reverse the mini bypass. In addition to reducing the amount of food which can be digested at any one time, both these surgeries reduce the absorption of minerals, vitamins and nutrients. More information can be found in our articles on gastric bypass and mini gastric bypass.

 

Gastric Sleeve – (or sleeve gastrectomy)

This is now the most popular bariatric surgery in the UK and, indeed, worldwide. During the gastric sleeve surgery the surgeon physically reduces the size of the stomach by about 85% by cutting part of it away so that what is left is a long thin piece of stomach (which looks like the sleeve of a garment) with the connection to the intestines still in tact. Essentially, similar to a gastric band, the overall size of the stomach is physically reduced.

Gastric Balloon

During the gastric balloon procedure, an endoscope is used. This is a long thin tube inserted into the body through the mouth. A small balloon (deflated) is swallowed and, once the surgeon has checked it is in the correct position, it is inflated so that it part fills the stomach cavity. After a maximum of six months, the balloon is deflated, again endoscopically, and removed from the stomach. Usually, a local anaesthetic or relaxant is used.

To find out more about any of these procedures please check out our articles on each of them. Generally, all these surgical procedures can carry the normal risks of any operation, as well as specific side effects and complications associated with the particular surgery type. However, on a long-term basis, they do not carry as many complications as those associated with the gastric band or lap band.

Gastric Band on NHS

It is possible, in theory, to obtain gastric band NHS surgery, and other types of bariatric surgery NHS, free of charge in Britain. Certain criteria apply including having a BMI over 40, or between 35-40 where other conditions exist e.g. diabetes or high blood pressure. The NHS also likes to see some evidence that the patient has tried to lose weight using other methods. There is also the obligation to make lifestyle changes and attend regular check-ups after surgery. Indeed, this sort of requirement will exist in many private clinics. Additionally, the NHS may require the patient to participate in some sort of NHS weight loss program with weekly meetings featuring advice and help for up to a year before the surgery. Only after this period, will a patient know whether they have qualified for weight loss surgery or not. There are currently many demands on the NHS budget and bariatric surgery can prove to be quite expensive with the necessary follow-up required for most operations. Hence, the NHS weight loss surgery waiting list tends to get longer and longer. In essence, it is not always very easy to obtain this type of treatment through the local NHS Trust.

This situation often means that people need to find other solutions to source their weight loss surgery. UK private clinics are another option, although as mentioned earlier there are fewer and fewer that will offer gastric band surgery.

Gastric Band Cost

As with any surgery, weight loss surgery prices will vary greatly between clinics and surgeons. The gastric band cost UK is usually between £4000 and £8000. When obtaining a quote it is always advisable to check exactly what is included in the price. Remember, that a gastric band needs to be maintained throughout its life, but particularly in the first few years. What may appear to be a good deal, may in fact be more expensive in the end of the price does not include the price of adjustments, at least in the first year or two.

Gastric Band Cost Abroad

It is certainly true that weight loss surgery is much cheaper to source abroad. In many instances, savings can be up to 50%. However, the gastric band cost abroad becomes less economical when several return journeys are required post-surgery for adjustments to the band, although sometimes it is possible to arrange for a  post-operative treatment package in the patient’s home country.  What appears to be cheap gastric band surgery, in fact, can become quite expensive. Additionally, most overseas surgeons now choose the alternative bariatric procedures like a gastric sleeve or gastric bypass as the patient is not required to return so frequently to the surgeon. Moreover, the success rate for these procedures is better than the gastric band and the success rate of the surgery is just as important to the surgeon as it is to the patient.

Gastric band in Poland

Poland

Poland is an excellent choice for bariatric surgery, it is easy to access due to available flight connections and it is much cheaper comparing the UK or the USA

Poland is an excellent choice for bariatric surgery.  It is relatively close to the UK – only about 2 ½ hours away by plane – and generally served by many of the budget airlines who can sometimes offer tickets for less than £20 one way.  Many foreign patients to Poland are pleasantly surprised by the very high standard of these Polish clinics, often equipped with the latest cutting edge technology.  For many years English has been a compulsory subject in Polish schools so this means that many Polish people speak excellent English and certainly visitors will find very good English spoken by all the medical staff in the clinics.

There are a few clinics in Poland that still offer the gastric band procedure e.g. the KCM Clinic in Jelenia Gora.  Prices start at around £3000 for the initial procedure.  It is important to check with the clinic exactly what is included in this price particularly with regard to follow-up appointments.  Clinic Hunter consultants can advise on the most up-to-date status regarding the availability of gastric band surgery in Poland.

Gastric band in Turkey

It may also be possible to find some clinics in Turkey who are still performing gastric band surgery. Recently, the popularity of bariatric surgery in Turkey has continued to increase.  Similarly to Poland, many customers are surprised at the standard of the clinics – well-appointed and equipped with the latest technology. Doctors are well-qualified and English widely spoken.  Flights to Turkey are longer and often slightly more expensive than to Poland, but, of course, Turkey has the added benefit of beautiful beaches and resorts on the Mediterranean and Aegean coasts – great places to recuperate after the procedure.  Clinics in Izmir on the Aegean may still be able to offer gastric band surgery with prices starting at about £3100.

Summary

At one time the gastric band procedure was seen as the Gold Standard among bariatric surgeons. However, as the band is designed to remain on the stomach for life, it can become quite costly in maintenance terms. Advances in other types of bariatric surgery mean that their success rate is better than that achieved by the gastric band. More and more problems are also starting to appear with those bands which have been in situ for 10+ years. As a weight loss procedure, gastric band surgery is now falling out of favour and fewer and fewer surgeons are prepared to offer this operation.

Sources

The American Society for Metabolic and Bariatric Surgery: The Story of Obesity Surgery – https://asmbs.org/resources/story-of-obesity-surgery

The American Society for Metabolic and Bariatric Surgery: Bariatric Surgery Procedures –

Obesity Coverage: Lap Bands – https://www.obesitycoverage.com/gastric-bands-how-long-do-they-last

Research: Medium- and long-term results of gastric banding – https://bmcobes.biomedcentral.com/articles/10.1186/s40608-018-0189-1

Research: Gastric Band Complications – https://www.livescience.com/13349-gastric-band-surgery-complications.html

Lap Band Complications and Risks – https://bariatricsurgeryco.org/bariatric-surgery/lap-band-surgery/lap-band-complications-risks/

Dr Hillary talking about the new gastric band tablets – https://www.youtube.com/watch?v=XCM4cFqGxzU

NHS Website for Weight Loss Surgery – https://www.nhs.uk/conditions/weight-loss-surgery/

https://www.medicalnewstoday.com/articles/298313#other_options

https://medium.com/@mohitbhandari/what-is-adjustable-gastric-band-bariatric-surgery-671638025fa2

Anne Beckett

In the UK Anne was a professionally qualified trainer with many years of experience in the training industry. She mainly worked in the travel, tourism and leisure industries (including Thomas Cook and British Airways) as well as in other sectors.

Since moving to Poland  twelve years ago, Anne has become involved in other business sectors – teaching English as a foreign language and translating documents from Polish into English. She specialises particularly,  in  medical translations and  works closely with dentists, cardiologists and neurologists in translating and preparing articles for publication. She has also trained as a practitioner in the field of neuro-linguistic programming and is a qualified hypnotherapist.

Any spare time is spent renovating the house in Poland which Anne bought some years ago.

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