Restrictive surgeries -- like gastric banding -- are operations used to produce weight loss. In a restrictive surgery a surgeon uses one of a variety of techniques to reduce the size of the stomach. After restrictive surgery, a person feels full faster, eats less, and loses weight.
The full names for the two types of restrictive surgery for weight loss are:
Laparoscopic adjustable gastric banding -- the most common restrictive surgery
Laparoscopic gastric banding is the second most common weight loss surgery, after gastric bypass.
Gastric banding surgery involves the following:
Using laparoscopic tools, the surgeon places an adjustable silicone band around the upper part of the stomach.
Squeezed by the silicone band, the stomach becomes a pouch with about an inch-wide outlet. After banding, the stomach can only hold about an ounce of food.
A plastic tube runs from the silicone band to a device just under the skin. Saline (sterile salt water) can be injected or removed through the skin, flowing into or out of the silicone band. Injecting saline fills the band and makes it tighter.
In this way, the band can be tightened or loosened as needed. This can reduce side effects and improve weight loss.
Laparoscopic adjustable gastric banding leads to loss of about 40% of excess weight, on average. For example, someone who is 200 pounds overweight could expect to lose an average of 80 pounds after gastric banding. However, these results vary widely.
Gastric banding is considered the least invasive weight loss surgery. It is also the safest. The procedure can be reversed if necessary, and in time, the stomach generally returns to its normal size.
Gastric banding surgery has a low complication rate. The most common problems after gastric banding surgery include:
Nausea and vomiting. These can often be reduced by adjusting the tightness of the band.
Minor surgical complications occur less than 10% of the time. These include problems with the adjustment device, wound infections, or minor bleeding.
The risk of death due to gastric banding surgery is about one in 2,000.
Unlike gastric bypass surgery, gastric banding does not interfere with food absorption. For this reason, vitamin deficiencies are rare after gastric banding.
Vertical Banded Gastroplasty (VBG)
Vertical banded gastroplasty also involves a plastic band placed around the stomach. In addition, the surgeon staples the stomach above the band into a small pouch.
Vertical banded gastroplasty results in less weight loss, compared with other surgeries. It also has a higher complication rate. For these reasons, vertical banded gastroplasty is less common today. Only 5% of bariatric surgeons still perform this surgery.
Mixed Surgeries (Restrictive and Malabsorptive)
Restrictive surgery is an important part of nearly all weight loss surgeries. In the most common weight loss surgery, gastric bypass surgery, restrictive surgery is first done on the stomach. This "stomach stapling" creates a small stomach pouch.
The new stomach pouch is reconnected to a part of the small intestine further down. This leads to less food eaten (restrictive) and less food absorbed (malabsorptive).
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