Procedures

Adjustable Gastric Banding

Adjustable gastric banding (AGB) is a weight loss surgery performed by bariatric surgeons at the Massachusetts General Hospital Weight Center in which a band is placed around the upper portion of the stomach, reducing food intake.

Adjustable gastric banding

Adjustable gastric banding

What is Adjustable Gastric Banding and Why is it Performed?Adjustable gastric banding (AGB) is a weight loss surgery where an adjustable silicone band is placed around the upper portion of the stomach, reducing food intake. Bariatric surgeons at Massachusetts General Hospital Weight Center perform adjustable gastric banding as a minimally invasive procedure or a standard procedure, depending on the needs of the patient.

AGB is recommended for patients based on the following benefits:

  • Average loss of 45% of excess weight
  • Improves conditions such as type 2 diabetes and hypertension
  • Increased life expectancy
  • Positive effects on insulin resistance

To qualify for this procedure, patients must have a Body Mass Index (BMI) of 40 or greater, or a BMI of 35 or greater plus a medical condition such as type 2 diabetes, high blood pressure or sleep apnea. Patients must also have tried other weight loss approaches that did not lead to significant and sustainable weight loss.

How is AGB Performed?AGB compartmentalizes the stomach into two sections. Your surgeon places the band around the upper part of the stomach. This band restricts the amount of food you can consume. The smaller section of the stomach, located above the band, has a capacity of about one tablespoon in volume.

A plastic tube connects the band to a port located under your abdominal muscles. Your surgeon accesses the port using a needle filled with saline, or sterile salt water. When saline is injected into the port, the band tightens, restricting your food intake. When saline is removed, the band expands, increasing your food intake. Your surgeon will adjust the amount of saline deposited or removed depending on your weight loss goals.

The duration of this procedure ranges from 30 to 60 minutes. After the procedure, you will stay at the hospital for one night. We recommend taking off two to three weeks from work.

What Preparation is Required Before AGB?You may be required to enroll in the Mass General Weight Center’s pre-surgery nutrition program before you can undergo adjustable gastric banding. All patients scheduled for weight loss surgery are required to lose some weight prior to surgery. Weight loss before bariatric surgery results in a decrease of the size of the liver, commonly known as “shrink the liver” diet. This size decrease in the liver makes the surgery less difficult and faster, reducing postoperative complications. Your Mass General dietitian will create a meal plan specifically tailored to your weight loss goals. Learn more about preparation for bariatric and metabolic surgery
What Happens After AGB is Performed?At the Mass General Weight Center, your care team develops an individualized postoperative program to monitor, guide and support you after the adjustable gastric banding. The program is divided into two phases— Postoperative Adjustment and Lifestyle Modification— each lasting three months.  Learn more about postop treatment for bariatric and metabolic surgery

You will require saline adjustments every one to two months for the first few years after surgery and then every year or two for life.

How Safe is AGB?Your Mass General Weight Center care team will discuss the benefits (see above) and risks of this procedure including the possibility of re-operation (revisional surgery) due to complications such as:

  • Band erosion
  • Band slippage
  • Inadequate weight loss
  • Infection
  • Intolerance of band
  • Scar formation

Why Mass General?Mass General is consistently ranked among the best hospitals in the country by U.S. News & World Report. As part of the Mass General Digestive Healthcare Center, the Mass General Weight Center is unique for its expert, multidisciplinary approach to AGB. Our surgeons, among the most experienced in the region, are accustomed to seeing both local and international patients with multiple medical conditions.

At the Mass General Weight Center, your care team comprises your surgeon, dietitian and psychologist, who meet weekly to coordinate your care. Before and after your surgery, your care team designs an individualized treatment plan for you that promotes long-term weight loss. Mass General experts are available for counseling on nutrition, exercise and behavior modification along with medical management of related diseases. Learn more about our approach to bariatric and metabolic surgery

Bariatric surgery for people with type 2 diabetes and prediabetes

Massachusetts General Hospital Weight Center surgeon Ozanan Meireles, MD, answers common questions about the effect of bariatric surgery on individuals with type 2 diabetes and prediabetes.

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