Center of Overweight and Obesity  
  
 
 
 
 
 
 
Laparoscopic adjustable gastric banding for treatment of morbid obesity
 
The procedure is simple in its principle. A band is placed around the superior part of the stomach, thus creating a tiny pouch through which food will pass in a small but sufficient amount.

If the volume of absorbed food exceeds the size of the pouch, either in quantity or in quality (non masticated pieces), there will be a painful stop or a vomiting.
One can see on this picture that the ring is placed 2 cm below the oesophagus. It has two parts: an outer silicone rigid part, and an inner inflatable part. The latter is connected to a small subcutaneous port, allowing injection or deflation of saline serum.

There are currently two available bands, one is inflated with saline, the other with X-ray contrast. They vary according to their size, shape and capacity. There is no current evidence for a sheer superiority of either one.

The inner diameter of the band can thus vary according to the patient's needs : less if he vomits to often or looses too much or too rapidly weight, more if alimentation remains unrestricted without a satisfactory weight-loss. The port is placed for instance below the costal margin, on the left side, deep enough to prevent irritation.

However it can harm moderately for a while. The band is not inflated at first, then, one month after, 1 to 3 cm3 can be inflated under radioscopy, by a simple puncture with a small needle. This does not request any anesthesiology.

The adjustment is the core of the method, because it makes it possible to obtain a fine regulation of weight-loss, depending of the patient's will and abilities. Besides, this procedure can almost always be performed through laparoscopy.

 

 
 
 
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