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Gastric band surgery


Expert reviewer, Mr Stephen Pollard, Consultant General Surgeon
Next review due, March 2022

Gastric band surgery is a common type of weight loss (bariatric) surgery for people who are very overweight (obese). It involves putting an adjustable band around the top part of your stomach, which means you can’t eat as much. This helps you to lose weight.

How does a gastric band work?

When you have a gastric band, it creates a small pouch at the top of your stomach above the band. When you eat, this part of the stomach fills up quickly, making you feel full earlier than normal and for longer. This reduces the amount you eat, helping you to lose weight.

Your surgeon can tighten or loosen the gastric band by injecting liquid into a tube connected to the band. This affects the rate at which food passes from the pouch into the lower part of your stomach. This will make sure that you steadily lose the right amount of weight.

Success of the operation depends on you sticking to a healthy lifestyle after the operation, including changing your eating habits and being more active. This includes being careful with high-calorie drinks, including alcohol, which would not be restricted by your gastric band.

Who can have a gastric band?

You usually have to meet certain criteria to be considered for gastric band surgery. These include:

  • having a body mass index (BMI) of 40 or more, or between 35 and 40 with a health condition such as diabetes or high blood pressure
  • having tried all other treatment options first, such as dieting and exercise
  • being generally fit enough to have a general anaesthetic and surgery
  • being committed to long-term follow-up, including regular check-ups and making lifestyle changes
  • being prepared to attend regular follow-up appointments

You may not be able to have gastric band if you have certain long-term health problems, such as inflammatory bowel disease or heart disease, or a psychological disorder. You may need to have a psychological assessment if there are any concerns about your mental health.

If you’re obese, your GP may refer you to a specialised obesity management service that can assess whether surgery may help you. If you meet the criteria above, you may be able to have gastric band surgery on the NHS, although this depends on availability in your local area. Another option is to have the surgery privately. Private surgery may be available at some NHS centres, or in private hospitals.

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Deciding on gastric band surgery

A gastric band is a major operation. It’s important to understand exactly what’s involved in the procedure, including any potential complications and what to expect afterwards.

If you’re considering having a gastric band, your doctor will go through this with you. They’ll also talk to you about other types of weight loss surgery you might be able to have, including a sleeve gastrectomy and gastric bypass. Your surgeon can help you to make a decision about what’s right for you.

Here are some points to consider.

  • A gastric band helps many people to lose weight. It may also help to reduce your risk of various health conditions, including diabetes, high blood pressure and high cholesterol, or improve them if you already have them.
  • The amount of weight lost varies from person to person, but most people lose about half their excess weight over about two years. Not everyone loses as much as they want to.
  • There’s some evidence that other types of weight loss surgery might be better over the long term.
  • It’s possible that you may need to have your gastric band removed or replaced, for example if the band slips down or leaks. See complications for more information.

Take some time to make sure you’re happy with your decision to have a gastric band – make sure you ask your surgeon any questions you have. If you decide to go ahead, you’ll be asked to sign a consent form – so it’s important to make sure you feel properly informed.

Preparing for gastric band surgery

You’ll need to have some assessments and blood tests to check you’re fit for the surgery. These may also show whether you have any health conditions related to your obesity.

If you smoke, you’ll be asked to stop – preferably at least six weeks before your surgery. Smoking can affect wound healing and can also lead to complications. You may be asked to follow a low-fat, low-carbohydrate diet for a short time before your operation. This will help to shrink your liver and make it easier and safer to put the band in place.

A gastric band is done under general anaesthesia, which means you’ll be asleep during the operation. You need to fast before having a general anaesthetic. You’ll be given clear instructions about when to stop eating and drinking. It’s important to follow this advice.

On the day of your procedure, your surgeon will meet with you to check you are well and still happy to go ahead. The staff at the hospital will do any final checks and get you ready for surgery. This may include asking you to wear compression stockings and/or having an injection of an anticlotting medicine to help prevent deep vein thrombosis (DVT).

What happens during gastric band surgery?

Your gastric band will be fitted using keyhole (laparoscopic) surgery. This means your surgeon will perform the surgery using instruments inserted through several small cuts in your tummy (abdomen), rather than one large cut.

Your surgeon will insert the band, and place it around the top part of your stomach to create a small pouch above the band. A piece of fine tubing connects the band to an injection port, used to tighten or loosen the band. Your surgeon will stitch this into place, just under your skin. Your surgeon will then close the cuts in your abdomen. This is usually with dissolvable stitches but may be with clips, which will be removed a week or so later.

What to expect afterwards

At the hospital

You’ll need to rest until the effects of the anaesthetic have worn off. You may also need some pain relief to help ease any discomfort you may have.

You’ll have a drip into a vein in your hand or arm to give you fluids, until you’re well enough to drink. You’ll be encouraged to get out of bed and move around as soon as you feel able to. This will help to reduce your risk of getting a chest infection and the risk of blood clots developing in your legs. Your nurse will give you advice about caring for your healing wounds before you go home and give you a date for a follow-up appointment.

Going home

You’ll usually be able to go home later on the day of your operation, or the following day. Make sure someone can take you home, and if possible, can stay with you for a day or so while the anaesthetic wears off. You can carry on taking over-the-counter painkillers at home, as you need them.

Your gastric band will be partly filled (primed) during surgery, so there will be a restriction on what you can eat straightaway. You’ll only be able to have fluids to begin with after your operation. Your surgeon or dietitian will advise you when you’ll be able to start eating. Read our FAQ below on what foods you can eat for more information.

It may take you a week or two to recover from gastric band surgery and get back to your normal activities. But this can vary from person to person, so it's important to follow your surgeon's advice.

You’ll need to go for regular follow-up appointments after your surgery to have your gastric band adjusted. This will make sure you steadily lose the right amount of weight.

Complications of gastric band surgery

Complications are unexpected problems that can happen during or after your procedure.

Possible complications of any operation include an unexpected reaction to the anaesthetic, excessive bleeding or a blood clot (deep vein thrombosis – DVT). Other complications common with gastric band surgery include the following.

  • Infection around your gastric band, the tube under your skin or in one of your wounds. Your skin may appear red or tender if this happens.
  • Injury to your stomach or other nearby organs, such as your liver or spleen, during surgery.
  • Your gastric band may slip out of place, leak and deflate, or slowly work its way through your stomach wall. If any of these happen, the band will need to be repositioned, removed or replaced.
  • If you lose weight too quickly, you may develop gallstones. These can be painful and you may need surgery to remove them.

Contact your doctor or surgeon if you develop any symptoms after your surgery, such as a fever, tummy pain, chest pain, breathlessness or you’re constantly vomiting.

Not everyone loses as much weight as they want to after the operation, and some people put weight back on after losing it. If this happens, your surgeon may suggest other treatments, such as gastric bypass surgery.

Frequently asked questions

  • A gastric band can be taken out if necessary because of complications, or if you decide you no longer want it. This can usually be done with keyhole surgery. But if you have it removed without having any alternative weight loss procedure, you're likely to put back on any weight you’ve lost.

    Having a gastric band fitted is a big decision, so it’s important that you’re aware of all the benefits and risks before going ahead. If there’s a problem with your band after it’s fitted, you may be able to have another band fitted, or an alternative procedure. These can include a gastric bypass operation or a sleeve gastrectomy, and can be done at the same time as your original band is removed, or at a later date. These can help you to maintain your weight loss. Ask your doctor for advice if you’re thinking of having a gastric band removed.

  • For the first couple of weeks after gastric band surgery, you’ll need to stick to a liquid diet. After this, you’ll be able to have puréed and soft foods, before starting to reintroduce more textured, solid foods. You’ll need to eat slowly, and chew your food thoroughly.

    Make sure you’re drinking enough fluids, but don’t drink around mealtimes, otherwise it can make you feel full before you start eating.

    If you eat too much or too quickly, it can put pressure on your gastric band and make you feel sick or vomit. There may be certain foods that you’ll still find difficult to eat once you have a gastric band, like meat and white bread. You may be advised to take vitamin and mineral supplements to make sure you get all the nutrients you need.

    You will be given printed information about what to eat and drink after your procedure, and your doctor will go through this with you.

  • Losing a lot of weight may mean that you’re left with folds of excess skin. Once it’s been stretched, skin loses its tightness. Depending on where you lose the weight, you may have folds of excess skin on your tummy, face, bottom, breasts, upper arms and thighs. You may find this extra skin uncomfortable or embarrassing, and your skin in these areas can also become inflamed, painful or infected.

    Cosmetic surgery can help to reshape the parts of your body where you have extra skin. But it's usual to wait at least a year after your gastric band is fitted before you have any cosmetic surgery. This is to make sure that your weight is stable and isn’t likely to change significantly.

    Removal of excess skin after losing a lot of weight is generally not available on the NHS, except in very rare circumstances. It’s something you will normally have to pay to have done privately.

    Cosmetic surgery also isn’t suitable for everyone so it's important to discuss your options with a plastic surgeon. If you’re considering a tummy tuck to remove excess skin from your abdomen, it’s important that you tell your plastic surgeon that you have a gastric band, and show them where the port is located.

    Read our information on Tummy tuck, Facelift and Breast uplift surgery for more information.

  • Yes, you can get pregnant. It’s possible that your chances of getting pregnant may actually improve if you lose weight with gastric band surgery. But it's best to wait at least a year or so, when you have reached a stable weight, before you try.

    If you do get pregnant, your doctor will closely monitor your weight gain and check that you're getting the right nutrients. You’ll probably have checks around every three months and may need to see your dietitian more often. You’ll also need to have your band adjusted during your pregnancy, or perhaps deflated altogether. This will make sure you gain the right amount of weight to keep you and your baby healthy.

    If you're planning to get pregnant or have found out you’re pregnant, speak to your doctor for advice.


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Related information

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  • Reviewed by Pippa Coulter, Freelance Health Editor, March 2019
    Expert reviewer Mr Stephen Pollard, Consultant General Surgeon
    Next review due March 2022



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