An adjustable silicone band is placed around the very upper portion of the stomach creating a small pouch about the size of a walnut or a golf ball. The band allows patients to become satisfied with the consumption of smaller portions of food, and the band also seems to decrease hunger. The band is fluid-filled, and is connected via a long thin tubing, to an access port that is sutured under the skin, onto the strong tissue layer surrounding muscle called the ‘fascia’. Fluid can be easily added or removed to the band by introducing a special needle into the access port, through the patient’s skin. This procedure takes seconds and is performed in the office during a follow-up visit. Patients are often anxious about their first adjustment, but it is less painful than having a blood sample drawn from an arm vein.

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What is the Recovery Time?

The hospital stay for the adjustable gastric banding procedure is often less than 24 hours. Some patients stay overnight while others are able to return home the same day as surgery. Recovery is usually very short. Many patients who have sedentary jobs often return to work within 1-3 weeks. Patients with jobs that require more physical effort may be out of work for 3-6 weeks.

What are the Pros and Cons of Bypass vs. Banding?

Even though both gastric bypass and banding are restrictive procedures performed laparoscopically, they have many differences, and each has its own distinct advantages and disadvantages:

Gastric bypass involves rearranging the gastrointestinal anatomy using surgical staplers. A small stomach pouch is created. The surgery lasts around two hours and usually requires two nights in the hospital. The weight loss after surgery occurs over one to two years. Because the stomach and small intestine is stapled and divided, there is a risk for leaking and bleeding at the staple lines. There is therefore more risk of life-threatening complications with the gastric bypass compared to banding. Because most of the stomach and part of the small intestine are bypassed, patients are at risk for anemia, osteoporosis, vitamin B and other deficiencies, and must take several vitamin and mineral supplements several times a day for the rest of their lives.

Banding involves placing a silicone device, or band, around the top of the stomach. The device is connected by tubing to a port that is placed under the skin. There is no cutting or rearrangement of the anatomy. The surgery lasts around one hour and usually the patient goes home five or six hours later, although some patients spend a night in the hospital. The weight loss after banding occurs over two to three years. By using a special needle to access the port, the band can be adjusted by adding or removing saline solution. The adjustment changes the opening in the stomach at the level of the band and, therefore, controls how much food can be eaten. Banding requires more frequent follow-up visits during the first two years, during which adjustments may be performed.

In summary, both Bypass and Banding can help patients achieve significant sustained weight loss; however, patients must adhere to a proper diet and exercise program in order to maximize results. Bypass patients usually experience faster weight loss, but there are more risks from surgery. Banding is safer, less-invasive surgery, but more follow-up is required and the weight loss is usually slower.

Both Bypass and Banding require lifelong follow-up by a bariatric team, which includes monitoring for compliance with a healthy lifestyle including healthy eating and exercise, and screening for complications from bariatric surgery.