Gastric Banding Fights Obesity

Arthur Brandon was so depressed, he rarely left home. Morbidly obese since childhood, he found refuge in food. The more he ate, the bigger he became and the added weight made him even more depressed.

It was a vicious cycle he could not break until 3.5 months ago when he learned about a procedure used at San Jacinto Methodist Hospital called laparoscopic adjustable gastric banding.

Brandon is one of several hundred patients across the country who is participating in a U.S. clinical trial to test adjustable gastric banding as a surgical option for the treatment of severe obesity. The procedure aids in weight loss by limiting the intake of food and slowing down the process of emptying into the intestine.

Unlike traditional surgical approaches, such as stomach stapling, adjustable gastric banding is a minimally invasive procedure that is completely reversible, and it is the only method that can be modified for each patient's individual needs months after surgery. The procedure, which has been approved for widespread use in Europe, accounts for 70 percent of the obesity surgeries performed there.

In a 45-minute procedure, the surgeon makes five small incisions in the patient's abdomen. A small silicone band, 1.5 inches in diameter, is placed around the upper part of the stomach, creating a pouch and adjustable opening called a stoma.

By creating a smaller gastric pouch, the band limits the amount of food the stomach will hold and controls the flow of food to the rest of the digestive tract. The patient feels full with a small amount of food and because of the slow emptying, the patient will continue to feel full for several hours, reducing the urge to eat between meals.

Dr. Hadar Spivak, the only surgeon in Texas participating in the trial, has performed more than 100 such procedures. He said banding is an attractive treatment because it has a higher success rate than many other weight-loss surgeries, causes less surgical trauma and pain, requires a shorter hospital stay, and patients can return to work within a week.

Dr. Spivak said patients can expect to lose approximately five to 10 percent of their body weight in the first month and four to six pounds per month for the first 1.5 years. If the patient does not lose the desired amount of weight, the stoma size can be adjusted without additional surgery.

Brandon, who weighed 312 pounds on the day of his surgery, lost 60 pounds in three months. Five days after the surgery he felt great. He said if not for the small incisions on his abdomen, he would not have known he had undergone surgery just days before.The surgery has given Brandon a new lease on life. He said he eats the same things he ate before having the surgery, but in smaller amounts. When asked to describe his self-image, the 55-year-old stated simply, "I'm hot and I love to go shopping."

Patients who weigh no more than 350 pounds, are between 18 and 65 years of age, obese for more than five years, have no dependency on alcohol or drugs and no glandular problems, such as hyperthyroidism, are potential candidates. Participants must pay standard treatment costs, including surgery. For more information call (713) 790-3333.

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©2006 Texas Medical Center

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