Swedish Adjustable Gastric Band

Want to know more about the Swedish adjustable gastric band? Read on to find out if this weight loss solution is suitable for you…

Swedish laparoscopic adjustable gastric band surgery is one solution to the problem of obesity that seriously threatens to endanger a patient’s health and wellbeing. SAG-Bands are designed to promote weight loss by limiting food consumption. In early implementations about 10,000 patients had undergone the surgery required to implement this solution. Most of those surgeries were performed in Europe. The Swedish adjustable gastric band was approved for use in Belgium on the basis of international data confirming its efficacy and safety.

Two somewhat different gastric banding devices are in use currently. Toward the end of the last decade of the 20th century around 200 morbidly obese patients underwent bariatric surgery with the laparoscopically placed Swedish adjustable gastric banding system at the University Hospital Ghent, Belgium. Patients in this group submitted to psychiatric screening and gastroesophagoscopy where required. Every patient chosen for surgery had a history of repeated failure with dietary regimens designed to induce weight loss.

The actual surgery required to implement Swedish adjustable gastric banding involves laparoscopic looping of a nonradiopaque silicone band around the fundus (the top portion of the stomach). This creates a small proximal gastric pouch with a stoma to the remainder of the stomach. This pouch has a capacity equal to approximately one-twelfth of a normal sized stomach. As is to be expected the smaller pouches reach capacity very soon after food is consumed.

As well, the passage of food through the stoma to the lower (normal) stomach is considerably slowed down by the band. Since the upper stomach registers a “full” signal to the patient’s nervous system consumption of food is greatly reduced.

Different patients require different capacities for the pouch and different flow rates for the stoma created by the surgery. For this solution to work as required it is necessary for the stoma size between the upper pouch and the lower portion of the stomach to be adjustable. The inner surface of the band is inflatable and connected by a thin silicone tube to a radiopaque access port with a self-sealing membrane.

It is also necessary for the access port mentioned above to be sutured in the anterior rectus sheath, typically below the caudal part of the left rib cage. This is done during the same surgical session.

If all goes as planned and patients begin to lose weight, their silicone band will require periodic adjustments, or “fills”. That ensures not only efficacy of the treatment but the comfort of the patient as well.

There exists a potential for complications and laparoscopic surgery using a Swedish adjustable gastric band is not indicated for any patient except those who are morbidly obese. This approach does not necessitate cutting or the removal of any part of the digestive system. Hospital stays are typically shorter, as are recovery times. Although post-surgical adjustments are almost invariably required, surgery is not required to effectuate them.

 

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