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            <td><img style="border-bottom: 1px solid; border-left: 1px solid; margin-top: 5px; margin-bottom: 5px; border-top: 1px solid; margin-right: 10px; border-right: 1px solid" border="0" alt="Gastric Band Illustration" src="https://www.consultingroom.com/uploads/Image_Directory/Treatment_FAQs/gastric_band.jpg" width="325" height="238" /><br />
            <span style="font-size: 8pt">Picture Source: The British Obesity Surgery Patient Association </span></td>
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<p>Restrictive procedures, using gastric bands or rings are based on the concept of dividing the stomach into two sections. The top part of the stomach is turned into a small pouch that fills up with food quickly, giving a feeling of fullness. It then empties slowly through the small space (called the stoma), formed by the band, into the rest of the stomach or lower part, before passing normally through the rest of the digestive system. </p>
<p>These kinds of surgery restrict the amount of food a person can intake, and it becomes uncomfortable to eat anything more than small meals, with excessive eating tending to cause vomiting and pain. As digestion is not affected these procedures also don’t generally cause vitamin or nutrient deficiencies in the individual.</p>
<h4>Adjustable Gastric Banding</h4>
<p>The Laparoscopic Adjustable Gastric Banding (LAGB) procedure is also commonly known by the main brand name for the device utilised in the procedure, the LAP-BAND®. Although, this is the most popular brand, other devices (such as MIDband®) are available which all work in basically the same way. </p>
<p align="center"><img style="border-bottom: 1px solid; border-left: 1px solid; margin-top: 5px; margin-bottom: 5px; margin-left: 10px; border-top: 1px solid; border-right: 1px solid" alt="Adjustable Gastric Band Operation" align="right" src="https://www.consultingroom.com/uploads/Image_Directory/Treatment_FAQs/gastricbanding.gif" width="298" height="203" /></p>
<p>A silicone band lined with an adjustable balloon is secured into a ring shape around the top of the stomach with a locking device at each end of it; this produces the small pouch at the top part of the stomach and the new stoma entrance into the main part of the stomach. The band then has a thin tube attached to it with a reservoir or access port at the end (secured under the skin in the lower chest or abdomen), through which the balloon on the band can be inflated with fluid and therefore tightened to reduce the size of the stoma (gateway to the main stomach) as required.</p>
<p>Inflation of the band is usually done a few weeks after the initial operation to fit the device as this gives time for the swelling caused by surgery to subside so a clearer picture of how ‘tight’ the band should be is available. In order to get the amount of inflation needed correctly set, the patient must swallow a liquid called barium which shows up on x-rays, that way a series of x-ray pictures can be taken over time to monitor how quickly the barium flows through the stoma from the created pouch; too fast and you will feel hungry again too quickly when eating food, so the band will need inflating (tightening) and too slow could cause vomiting even when eating small meals, so the band needs deflating.</p>
<p>The key advantages of this gastric banding technique are the ability to perform it laparoscopically (by keyhole surgery), and the fact that the band can be adjusted depending on the individual’s weight loss progress post-surgery. If medically necessary, it can also be reversed, with the band being removed and the stomach returning to its original size, as the stomach will not have been surgically altered as with bypass surgery. This type of procedure is best suited to individuals with a BMI below 45. Average weight loss is typically 20-25% of original weight.</p>
<h4>Vertical Gastric Banding</h4>
<p align="center"><img style="border-bottom: 1px solid; border-left: 1px solid; margin-top: 5px; margin-bottom: 5px; border-top: 1px solid; margin-right: 10px; border-right: 1px solid" alt="Vertical Gastric Band Operation" align="left" src="https://www.consultingroom.com/uploads/Image_Directory/Treatment_FAQs/vertical_gastric_banded.gif" width="166" height="118" /></p>
<p>Vertical gastric banding or vertical banded gastroplasty is sometimes commonly referred to as “stomach stapling”. The size of the stomach is reduced by placing a vertical line of staples along it, creating a small pouch at the top for food intake, whilst a fixed width band or ring is placed at the bottom of this pouch (through a small window hole made in the stomach), to allow the food to slowly move down into the main stomach and be digested. </p>
<p>Since the advent of adjustable gastric bands, as described above, and with the side effects often noted from this procedure, such as tearing along the staples, this procedure is rarely performed these days.</p>

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