How does the bandage work?
A silicone ring with an inflatable cuff is placed laparoscopically around the upper stomach, just below the esophagogastric junction. It divides the stomach into a small upper reservoir with a volume of about 15–20 milliliters and the rest. A small portion of food fills the upper section and creates a feeling of fullness, and it slowly moves on through the narrow opening.
The key feature of the method is adjustability. The cuff is connected by a tube to a subcutaneous port, which is installed under the skin of the anterior abdominal wall. By introducing or removing saline solution through it, the doctor changes the diameter of the hole: if weight loss has slowed down, the bandage is tightened, and in case of pregnancy or excessive weight loss, it is loosened.
The second important property is reversibility. The anatomy of the stomach does not change, nothing is removed or crossed, so if necessary, the band can be removed and the stomach will return to its original state. The price for this is slower weight loss compared to sleeve and bypass surgery and the need for strict discipline: the band does not work without changing eating behavior, and the consumption of high-calorie liquids and soft foods completely devalues the operation.
Advantages of laparoscopic approach
Instead of a 10–20 centimeter long incision, 3–4 punctures ranging in size from 5 to 12 millimeters are made. This reduces pain after surgery, reduces the need for painkillers, speeds up the recovery of bowel function and allows you to be discharged much earlier.
The cosmetic result is no less important: puncture marks become almost invisible over time. The incidence of postoperative hernias and adhesions is also reduced, since the abdominal wall and internal organs are less injured.
When laparoscopy is not possible
Limitations include a pronounced adhesive process after previous operations, severe heart and lung diseases in which the injection of gas into the abdominal cavity is poorly tolerated, blood clotting disorders and extreme obesity.
Sometimes the decision is made already during the operation: if the anatomy does not allow working safely, the surgeon switches to an open approach. This is not a complication, but a provided option, about which the patient is warned in advance.
What happens after discharge
In the first weeks, fractional meals, sufficient amounts of fluid and a gradual expansion of the motor regime are recommended. Heavy loads, saunas and swimming pools are avoided until healing.
Reasons to immediately consult a doctor include fever, increasing abdominal pain, redness and discharge from punctures, nausea and vomiting, retention of stool and gas.