Adjustable Gastric Band (AGB)
What is an AGB?
An AGB is a medical device used in weight-loss surgery. It consists of a silicone ring that is placed around the upper part of the stomach, creating a small pouch above the band and a larger pouch below the band. This reduces the amount of food than can be consumed, leading to weight loss. The band is connected to a small port that is placed under the skin of the abdomen. The port can be accessed with a needle, and saline solution can be added or removed to adjust the tightness of the band. This procedure can be performed either robotically or laparoscopically (keyhole surgery), leaving you with approximately five small incisions (cuts) in your abdomen.
How does an AGB help you?
The smaller pouch above the AGB becomes the new ‘working’ stomach. It limits the amount of food a person can eat at one time, which helps to reduce overall calorie intake. The band also slows down the passage of food from the pouch to the rest of the stomach, which helps a person feel full sooner and for longer. Inflating the band creates pressure around the outside of the stomach, that further narrows the passage way between the pouch, and the rest of the stomach, restricting the movement of food even more. The band may be inflated or deflated as often as required to achieve optimal restriction.
Advantages of the AGB
- Minimally invasive: the AGB is a minimally invasive procedure that does not involve cutting or stapling the stomach, leading to fewer complications and a faster recovery time compared to other weight-loss procedures.
- Reversible: the AGB can be adjusted, or removed if necessary, making it a good option for patients who are not wanting the permanency of other surgical options.
- Lower risk of complications: compared to other weight loss procedures, the AGB has a lower risk of complications such as infections, blood clots, and bowel obstructions.
Disadvantages of the AGB
- Limited weight loss: typically, the AGB results in less weight loss that other weight-loss procedures and patients may not achieve their desired goals.
- Slower initial weight loss: the initial weight loss with the AGB is slower compared to other weight loss surgeries, which can be frustrating for some patients.
- Requires regular adjustments: the AGB requires regular adjustments to achieve optimal weight loss, which can be an inconvenience.
- Side effects: the AGB can cause unpleasant side effects such as nausea, vomiting, acid reflux, and difficulty swallowing.
Risks and Complications of the AGB
Risks in the Short-Term
- Infection: any surgical procedure carries a risk of infection, and the insertion of an AGB is no exception. Infections can occur at the incision site, around the port where the band is adjusted, or inside the abdomen.
- Bleeding: the surgery involves making incisions in the abdomen, which can lead to bleeding.
- Damage to organs: this can occur during placement of the band.
- Band slippage or migrations: the gastric band can slip out of place or migrate to another part of the stomach, causing complications such as nausea, vomiting, and difficulty swallowing.
- Obstruction: the small pouch created by the AGB can become obstructed, making it difficult to eat, or causing food to become stuck in the stomach.
- Perforation: the band can perforate the stomach which can lead to serious complications such as infection, bleeding and sepsis.
Risks in the Long-Term
- Discomfort or pain: some patients may experienced discomfort or pain from the band, or long-term difficulties with eating without discomfort.
- Oesophageal dilation: the small pouch created by the AGB can cause the oesophagus to dilate, leading to reflux, heartburn, and other digestive issues.
- Band erosion: over time, the AGB can erode into the stomach tissue, which can cause pain, infection, and bleeding.
- Nutritional deficiencies: restricting the amount of food that can be eaten can lead to nutritional deficiencies if the patient does not eat a balanced diet and take regular vitamin/mineral supplements.