How does the Surgery go?

Gastric band surgery is performed laparoscopically (keyhole surgery) about 99% of the time.  Conversion to open surgery is unusual and may be due to unforeseen circumstances such as difficult adhesions, bleeding or damage to the stomach or oesophagus.

You will be brought through into the operating theatre and moved onto the main operating table. We often use a special air mattress called a hover-mat to help move you. The anaesthetist will need to insert at least one intravenous line prior to putting you to sleep.

Typically, five keyhole ports ranging from 5mm to 15mm are used to insert the gastric band.  The largest incision scar is where the access port is placed under the skin (see surgical diagram below) which is most commonly in the upper abdomen.  This is also where the greatest post-operative discomfort is often felt.  Another source of discomfort which is occasionally felt after the surgery is felt in the shoulder tips.  This occurs because of residual gas from the laparoscopy irritating the diaphragm which then refers the pain to the shoulders.  It goes away within 24-48 hours after the procedure.

Surgical Images
Typical keyhole ports		Access port placement

We don’t usually need a bladder catheter or an ongoing suction tube (nasogastric tube) in the stomach with gastric banding surgery and it is usually unnecessary to have a drain coming from your abdomen afterwards.

The surgery starts with a special optical trocar to gain access to the abdominal cavity.

This will facilitate the use of carbon dioxide gas to insufflate the abdomen, creating the space to work with. A retractor for the left side of the liver is inserted to allow us to see the stomach. The band is placed by making a tunnel underneath the top of the stomach.  Either a standard instrument or a specialised device may be used to bring the band around through this tunnel. 

It is usual to suture the band into place by stitching part of the stomach below the band to stomach above the band.  The number of sutures used varies from surgeon to surgeon and some surgeons do not suture at all. 

The band sits just underneath the large muscle of the diaphragm.  It is common to have small weak areas of the diaphragm just where the oesophagus (gullet) comes through.  These are called hiatus hernias.  It is common practice in gastric banding surgery to repair hiatus hernias when the band is place and this is thought to prevent certain complications down the track.  Normally all that is required is one or two sutures although sometimes hiatus hernias can be very large. 

Call (03) 9895 7215 for more information on weight loss surgery.