LAGB – Laparoscopic Adjustable Gastric Band
Laparoscopic adjustable gastric band (LAGB) is one of the restrictive surgical methods applied in the treatment of morbid obesity. In the LAGB procedure, which is a restrictive surgery, a band is placed around the stomach approximately 20 mm below the junction of the esophagus and stomach. LAGB inflation is started 1 month after surgery. Sterile serum is injected through the port under the skin and inflated step by step. The most important advantage of this application is that it can be adjusted after the surgery. The band is made of silicone. When inflated, it divides the stomach into two chambers like an hourglass. The filling of the upper small stomach pouch with food provides the feeling of early satiety. Thus, since the feeling of satiety occurs, food intake is directly reduced.
The basic principle in the gastric band method is to change the behavioral habits and eating style of the patient, as in other surgical methods.
How is it placed?
Adjustable gastric band is currently applied using the laparoscopic method. The advantage of laparoscopic surgery is that the patient returns to his daily life in a short time. The patient loses approximately 60-80% of their excess weight within 12-24 months following the operation. If there is no problem with the gastric band itself or the patient’s band tolerance, these patients do not have the risk of gaining weight.
Are There Any Changes In The Digestive System?
The most important advantage of gastric band surgery is that the anatomy of the stomach is absolutely intact. Since the lumen is not opened in the stomach or intestines, complications such as leakage, bleeding and infection are minimized. This surgery is the simplest type of bariatric surgery. At any time, the restrictive feature of the band can be temporarily disabled by aspirating serum from the port. It is also a permanently reversible process by removing it completely.
The risk rate in LAGB surgery is approximately 3 – 4 per thousand. Possible complications may be related to the technique, such as band perforation, or to the patient, such as the patient’s non-compliance with the diet program after the surgery.
Possible complications of gastric band surgery are as follows:
- Infection: In some cases, infection is observed. It’s sometimes severe enough to require removal of the gastric band. In order to avoid these complications, maximum attention should be paid to sterility during injection.
- Band Problems: Nowadays, the technological development of bands has minimized problems such as perforation. If the band is perforated, patients suddenly begin to gain weight. In this case, the patient should be operated again and the band should be replaced with a new one.
- Band Migration: Band migration is the situation where the band erodes the stomach wall and passes into the stomach lumen. In this case, patients quickly return to their pre-operative weight.
- Port Problems: Subcutaneous port problems, usually seen in 4 percent of cases. These are slip of the port and a perforation of the connecting tube.
8 Golden Rules
- You should definitely eat your food very slowly.
- You should consume your meals by chewing very well.
- You should definitely stay away from carbonated drinks such as soda and cola.
- You should drink water between meals.
- You should eat food in small bites.
- You should have your teeth checked so that your chewing is sufficient.
- When you get the first signs of satiety, you should stop eating.
- You should participate in various exercises twice a week in accordance with your abilities and preferences.
After gastric band surgery, patients should be careful to consume small amounts of healthy foods. These foods should be rich in protein and in solid form. Its amount should be half a glass.
Protein is the most important macronutrient for gastric band patients. For this reason, protein-rich foods should be preferred and approximately 50 g of protein should be consumed per day. The daily protein intake of the patients should be followed and the protein blood levels should be measured regularly. Average energy intake should not exceed 1500 calories.
The best source of protein is meat. However, red meat can be difficult to chew and shred. Therefore, the fish is easier to chew and many types of fish are much richer in protein. White meat is a relatively easy food to chew. Eggs, yogurt and cheese are excellent sources of protein. Apart from animal sources, protein can also be obtained from legumes. Half of the food taken at the meal should be protein, and the other half should be fruit or vegetables.
Unprocessed, natural foods should always be consumed. There is no harm in using spices to flavor foods.
When to Eat?
After gastric surgery, a patient should consume three or fewer meals a day. If the patient is in the green zone – which means that the band is adjusted correctly – he will not feel the need to eat between meals. Therefore, patients should be warned not to snack between meals. If they feel hungry in the afternoon, they can take small quantities of high quality food. This could be a piece of vegetable or fruit. If the patient is not in the green zone, he should definitely visit his doctor.
How to Eat?
Food should be eaten in small bites and well chewed. Half a glass of food should be placed on a small plate. Small forks and spoons should be used. Each bite should be chewed for at least 20 seconds. This will ensure that the food is adequately broken down. Patients should be motivated to enjoy eating. Food should only be swallowed after it has been sufficiently chewed.
Patients should wait for the first bite to pass completely through the gastric band before taking another bite. This takes about 1 minute. Therefore, the patient should be warned to chew well, swallow and wait at least 1 minute.
A meal should not take more than 20 minutes. This means 20 small bites per minute for each bite. The patient will probably not be able to finish half a glass of food during this time. In this case, the remaining food on the plate should be thrown away. Every patient who has a gastric band should know that he can throw away the food left in his plate.
With optimal band filling and good eating habits, patients do not feel hunger after 20 or less bites. When the feeling of hunger disappears, the act of eating should definitely be stopped. After gastric band surgery, patients should not expect to feel bloated after eating. feeling bloated; It means that the food is stalling on the band and the most important part of the LES (lower esophageal sphincter) is stretching. If this condition becomes chronic, it destroys the LES mechanism.
If the patient still feels hungry after eating half a glass, it most likely means that he is not in the green zone and the gastric band needs filling.