The adjustable gastric band is a silicone ring that reduces the stomach capacity to hold food at a volume below 50 cc that produces a rapid feeling of fullness and facilitates compliance with the dietary program for the patient.

In what cases is shown the adjustable gastric band?
The adjustable gastric band is indicated in patients with morbid obesity (BMI over 40) or severely obese (BMI between 35 and 39) when associated illnesses that will improve with weight loss is expected to achieve.

Recently, the intervention may be accepted with a BMI between 37 and 39, although no associated diseases exist as long as the patient so desires and there are no contraindications. This is due to the low rate of complications and rapid recovery from this operation.

The patient should be clear that the adjustable gastric band procedure is extremely effective and safe weight loss, provided they are accompanied by a behavior modification program supervised by our staff dietitian. The key to the success of the adjustable gastric band is the fulfillment of follow-up program.

What education do I need before surgery?
Before surgery, the patient is carefully studied by specialists in the team:

• SURGEON TEAM COORDINATOR: We performed a detailed clinical examination, and informs you of potential treatment options and adjustable gastric banding.
• CLINICAL PSYCHOLOGIST: through a series of tests will analyze their psychological profile, so that its approval is necessary for inclusion in the program.
• DIETITIAN: will explain in detail what, how much and how to eat after the implantation of the adjustable gastric band
• ENDOCRINOLOGIST: will visit you if you suffer any endocrinopathy in an unstable situation, and in which case recommended to delay the operation.
• Preanesthetic STUDY: consisting of complete analytical coagulation, electrocardiogram and chest radiograph. GI to rule out hiatal hernia or other gastric morphology alterations. Patients with a clinical history or suspicion of obstructive lung disease type were performed spirometry. In patients with specific symptoms indicate an abdominal ultrasound and / or gastroscopy.
• Anesthesiologist: will evaluate the outcome of preanesthetic testing and clinical examination, which is their anesthetic risk (ASA) and risk of intubation (MALAMPATI), assessing the specific requirements for anesthesia.

With the results of previous studies, computer specialists give their approval to the patient's inclusion in the program, or they will recommend a treatment or monitoring before surgery.

When do I can not operate?

• When the patient has a BMI of superobesity (> 50), it will recommend pretreatment with intragastric balloon.
• When the patient has questionable clinical characteristics for this treatment, dietary habits or psychological profile, you may be advised to assess their responsiveness to treatment as the adjustable gastric band by placing a prior intragastric balloon.

How is the operation?
The intervention comes to last 60 to 90 minutes but can be extended exceptionally, is done by "Laparoscopic Surgery", without having to open the abdomen.

The adjustable gastric band is placed through small holes in the abdomen (4 of 10 mm and 1 18 mm) with general anesthesia. Is placed around the stomach, resulting sectioning without stapling or tissues, a stomach of small size (less than 50 cc capacity), which has the function of limiting the amount of food that can be ingested by the patient.

Then the food passes progressively to the rest of the stomach, where nutrients are absorbed normally, since in this intervention does not alter gastrointestinal physiology.

How does the adjustable gastric band?
The adjustable gastric band system is adaptable to each patient and their therapeutic needs. It contains a camera inside, which is connected to a small tank in the wall of the abdomen - without it being annoying then, even when you lose weight.

Puncture of the reservoir by adding or removing serum, allows to decrease or increase the size of the hole within the ring and therefore the passage or flow of the stomach.

Inflation of the band is performed on the X-ray room:

• In a few minutes.
• Without income.
• Without anesthesia.
• Undisturbed.

By this simple method can be modified satiety of the patient and tailor treatment to each case.

Usually the patient will require from 2 to 5 swollen band, along the entire treatment.

The banda is designed to remain in place for life. It is a reversible method and can be removed if so desired patient with a surgical technique analogous to the placement.

Will I have a lot of trouble after the operation?
After surgery, the patient:

• He gets up and gives short walks around the room at 3-4 hours.
• Eat cold liquids from the 4 hours after the intervention.
• Is discharged home the day after surgery. It stitches removed after 10 days.
• Relative rest to be retained for 7 days, although it is advisable to get out there and perform some activity.
• You should avoid heavy physical exertion for at least 4 weeks.
• The return to its normal working life or life will depend on the characteristics of their work, and must be between 1 and 4 weeks.
• Intervention is therefore a very rapid recovery with little impact on daily life.

What risk is the operation?
This is an operation that can be considered "low risk" or "minimal risk". Still, in every operation the patient should take minimal risk. The intervention of adjustable gastric band has a lower mortality of 1.5 per 1000 patients, the same as if it were operated on for appendicitis or gallstones. This is because the main risk of the intervention is due to increased anesthetic risk of obesity itself, not the surgical technique.

The key to this low-risk, compared to gastric bypass with a mortality of 3%, is due to:

• Its relative technical simplicity.
• The anesthetic and surgical time shorter.
• So little time bed rest and income.
• The rapid transition to a normal life.

What can I eat with the adjustable gastric band?
During the first 4-6 weeks will have to take a liquid diet and soft. From here you can enjoy a normal diet with certain limitations.

In general, we recommend 5 meals a day while eating, chewing and drinking very little fluid during the meal. Finally, the patient can eat food prepared and cooked normally, and no impairment in social relationships.

Occasionally it may be necessary without any food, like undercooked meat or little tender.

Will I be able to live normally with the adjustable gastric band?
The patient can make normal life a few weeks of operation.

In our program of support, the patient receives the first visit by the physician practice specializing in sports medicine, 6 weeks after surgery. You should perform regular physical exercise appropriate to their weight, age and possible musculoskeletal limitations.

You must also follow the recommendations seek to change dietary habits and lifestyle.

The patient must make a real change of mentality that allows a true "cure" for obesity.

How much weight will I lose with lap band?
55 to 60% of overweight suffering, but you may lose more, depending on the patient.

Half of this weight is lost during the first 6 months, and the remainder over the next 12 to 18 months.

The weight loss is forever, when the patient maintains the changes in their dietary habits.

How does the Clinic Silhouette patients involving gastric banding?
Silhouette Clinic, supportive treatment performed by the whole team, consisting of:

• Treatment and dietary education.
• Changes in lifestyle-appropriate exercise limitations and needs of each patient.
• Psychological treatment-behavioral therapy.

To do this, Silhouette Clinic provides a consultation protocol for intervention and patient follow up.