Gastric banding (stapling) is a restrictive type of surgery. It is easy to place, and it has a very short operation duration. The basic mechanism is to restrict the amount of food that can be eaten. (Please visit our video gallery to see how a stomach stapling is placed). Strict patient compliance is the most important factor in this procedure. Inappropriate selection of patients may result in failure. Certification is required for centers that will be performing this procedure in the United States and Europe. It helps to improve quality and success of the procedure.
Stomach stapling is not appropriate for those patients with psychological eating disorders, addiction to sweet foods/sugar and also incompliant patients. Each patient should be preoperatively evaluated by endoscopy for presence of such problems. Psychological assessment is essential in success of the surgery.
This procedure allows a loss of 40 to 60% in excess weight. This loss may be less in patients who consume high-calorie liquid foods (soda, ice-cream, chips, chocolate etc.). Active patients with exercise/ diet may achieve better rates.
The potential damages of the stapling are determined by the quality and softness of the silicone used in the production of stomach stapling, a good surgical technique and presence or absence of infections. Stomach staplings may lead to some damages in tissues. Even tough none of the above negative effects are observed, stapling adheres to stomach and surrounding tissues. It is very common to see postoperative complications following stapling surgeries performed in other centers, particularly referred to units which are involved in complication surgery such as in our center. Stapling adheres to both stomach and hepatic tissue. Removal of the stapling is not that simple and uncomplicated as it is expected. Manifestations following infection may include formation of adhesions between stapling and surrounding tissues that can be very difficult to detach.
Bands may differ in quality of the silicone, connection systems, material of the subcutaenous access ports, softness and hardness. A qualified band should be soft. It should have a reliable and simple locking mechanism. It should also be easily applicable. In some bands, the cutaneous access ports include plastic elements while some others are made of metal only. Unfortunately, use of cheaper versions which are produced in countries other than Europe and the United States is common.
Staplings are mainly produced in Europe where they were first introduced. It was only in 2000 that they became available for use in the US. There are a few FDA approved bands available, but many bands manufactured in Europe have similar or better quality. Therefore, absence of any FDA approval does not necessarily mean that the band is not good in quality. The most important task of the patient is to get detailed information about the band to be placed.