Swedish Adjustable Gastric Banding (SAGB)
The SAGB is a device placed around the highest part of the stomach to create a small pouch of stomach which fills quickly and empties slowly. It works by removing the feeling of hunger, and also by making you feel full after only a small meal. You therefore eat smaller amounts less often and lose weight. The tightness of the device is easily adjustable so that as time goes by adjustments can be made to ensure maximum life long effectiveness of the procedure.
The SAGB can usually be inserted laparoscopically (keyhole surgery). This avoids a large abdominal incision, which assists recovery and avoids the pain associated with a big cut. It also reduces the complication rate for the surgery. Most people can expect to go home 2 days following surgery.
Another advantage of the SAGB is that the normal anatomy is not altered in any way. Therefore gut function and absorption remain normal. If for some reason the SAGB needs to be removed, this can be done easily with no permanent side effects.
The operation is performed under a general anaesthetic. Usually 5 keyhole incisions (5-10mm) are made and the SAGB is placed in position. A small reservoir is then placed under your skin and connected to the SAGB by a small tube. This is to allow easy adjustments to the SAGB later. The operation takes about an hour to perform. You will then spend a short time in the recovery ward before returning to your hospital bed. You will be allowed to drink liquids shortly after returning to the ward. You should be able to get out of bed and walk around later that day. You will have a special X-ray the following day to ensure that the SAGB is in the perfect position and working properly. Most people are back at work or back to normal activities within 2 weeks of surgery.
Treatment does not begin and end with surgery. The success of the procedure depends on a permanent commitment to careful follow up. This includes a multidisciplinary team approach to medical health, diet, exercise and psychological well being, as well as adjustments to the SAGB as required. The restriction of the SAGB is easily adjusted by adding or removing fluid from the reservoir. This will usually be done by your surgeon using a special needle, and can be performed in the surgeons office. It only takes a few minutes. Sometimes it may be necessary to use X-rays to help make the adjustments and if necessary this will be done in the radiology department. Over time, adjustments will be less frequent and follow up appointments may only be required as little as once per year.
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