How exactly does the band work?

[Bruce120 19]

As you can see I'm getting banded on Monday, so it's a little odd to be asking this question now, but it's really something that I could never wrap my head around. I never clearly understood how exactly the band will work. I've heard and read hundred times how it works, but I could never really understand the next point.

I know that a small pouch is created, and it can only hold around 1/4 to 1/2 cup of food depending on the fill level of the band. But other than that I'm not quite sure how it works. Will all my meals from now on consist from only a quarter to a half a cup of food, and then I'll feel full? If so, why all the emphasis on eating slow and chewing well? I might as well gobble up half a cup of food, get full and finished. If I have to eat slow in order to give food from inside the pouch time to go into the larger stomach (as one doctor put it to me), then what did I accomplish with the band? Hypothetically I can eat the same amounts as before simply by eating slower and giving the food time to move out of the pouch.

Again, my question is, will my meals only be as large as my pouch is, and in that case I wonder why I must eat slow and chew well, or will my meals be bigger than the size of the pouch, and in that case I wonder how exactly the band will make me eat less, if I can simply eat slower and give the food time to move out of the pouch and continue to eat?

[2muchfun 8,927]

Nope, that's not how it works. It's late here so to save time I'm going to post 4 videos for you to watch. Dr. O'Brien explains how the band works perfectly. However, some of his comments may conflict with your own doctors guidelines. Follow your own surgeons guidelines. Dr O'Brien will explain how this works. I'll be back tomorrow morning to add more of my own comments!

http://www.youtube.com/watch?v=Qa3Lwt6ElIs&list=UL Part 1

http://www.youtube.com/watch?v=K4jYJipQ7vc part 2

http://www.youtube.com/watch?v=Wbdhf44ZweI&feature=relmfu Part 3

http://www.youtube.com/watch?v=KF3TCKUn3YI Part 4

[plopez 77]

Nope, that's not how it works. It's late here so to save time I'm going to post 4 videos for you to watch. Dr. O'Brien explains how the band works perfectly. However, some of his comments may conflict with your own doctors guidelines. Follow your own surgeons guidelines. Dr O'Brien will explain how this works. I'll be back tomorrow morning to add more of my own comments! http://www.youtube.com/watch?v=Qa3Lwt6ElIs&list=UL Part 1 http://www.youtube.com/watch?v=K4jYJipQ7vc part 2 http://www.youtube.com/watch?v=Wbdhf44ZweI&feature=relmfu Part 3 http://www.youtube.com/watch?v=KF3TCKUn3YI Part 4

I just wanted to say thank you. You always take the time to show support and even though this is not my post...THANK YOU!!!

[Bruce120 19]

Nope, that's not how it works. It's late here so to save time I'm going to post 4 videos for you to watch. Dr. O'Brien explains how the band works perfectly. However, some of his comments may conflict with your own doctors guidelines. Follow your own surgeons guidelines. Dr O'Brien will explain how this works. I'll be back tomorrow morning to add more of my own comments!

http://www.youtube.com/watch?v=Qa3Lwt6ElIs&list=UL Part 1

http://www.youtube.com/watch?v=K4jYJipQ7vc part 2

http://www.youtube.com/watch?v=Wbdhf44ZweI&feature=relmfu Part 3

http://www.youtube.com/watch?v=KF3TCKUn3YI Part 4

Thanks much for the reply.

What he says in the video, is unlike anything I've heard about the band till now. He doesn't mention anything about the pouch, or about it getting full. From his words it seems like food slips right through the band without going through the pouch, and the essence of food going through the band makes you feel full. That is something I've never heard before, and is totally new to me.

[kayleena_journey2014 37]

Hope all goes well Beijing banded.

I was banded june 28th and doing great.

Keep in touch

[Lite'N'Sweet 60]

@@2muchfun Thanks for supplying these videos. In all honesty, I didn't get that much detail from my doctor (i'm 2 days post op). I did a lot of the research on my own and watched actual surgery videos online to get familiar with the process. But hearing a doctor detail it out has put me at ease greatly.

I might have to show my doctor this stuff......... have him step his game up

Thanks again!

[2muchfun 8,927]

You may want to talk to your surgeon about band placement? If the band is placed as O'Brien places the band, this is how it works. And this method is the standard now as far as I know. I believe they call it the Pars Flacida technique and all new studies address this method.

It's possible your surgeon places the band lower on the stomach to create a pouch? But if you look at all the examples and videos, the band is placed 2-3 cm below the lower esophageal sphincter.

I've tried to discuss this with my own surgeon and he dodges the questions. My band does not operate as my own surgeon believes it does? My band works just like O'Brien states. My nutritionist still believes that my pouch fills with food and this is what gives me satiety. I've never been able to eat more than 2 bites of food quickly without feeling that stuck feeling so I know I have no "pouch". I have a staging area in front of my band/stoma where food is massaged through.

I'm no doctor so take everything I've said with caution. Consult your own surgeon for a more specific explanation(good luck).

Sorry, from all the posts I've read on this forum, I think there are a lot of surgeons who just slap a band on a patient and hope for the best. I'm a little cynical about the bariatrics profession.

[Bandista 7,466]

These videos really helped me understand about the esophageal signals to the brain through -- the squeezes. I sort of picture that now when I'm eating and that helps me "listen" in to my body. And also I find I am chewing and savoring a lot longer in my mouth and I know that this is an important part of digestive health that I've probably been missing since I was such a fast eater there was never time for anything to mix with saliva.

And TMF I just want to echo what others have said -- I'm so glad you're here!

[Bruce120 19]

Nope, that's not how it works. It's late here so to save time I'm going to post 4 videos for you to watch. Dr. O'Brien explains how the band works perfectly. However, some of his comments may conflict with your own doctors guidelines. Follow your own surgeons guidelines. Dr O'Brien will explain how this works. I'll be back tomorrow morning to add more of my own comments!

http://www.youtube.com/watch?v=Qa3Lwt6ElIs&list=UL Part 1

http://www.youtube.com/watch?v=K4jYJipQ7vc part 2

http://www.youtube.com/watch?v=Wbdhf44ZweI&feature=relmfu Part 3

http://www.youtube.com/watch?v=KF3TCKUn3YI Part 4

I asked my surgeon prior to surgery how he does it, and how the band will work on me, and he distinctly told me that the band will create a small 4-6 oz. pouch, and once that pouch fills up, my meal is done. In essence this means that I can only eat in one meal, the amount of food that fits in to the pouch. This is obviously completely different than what the doctor here says in the videos. My surgeon added, that there's only one way to do it and everybody does it this way, so now I'm really, really confused.

[KateP 359]

Nope, that's not how it works. It's late here so to save time I'm going to post 4 videos for you to watch. Dr. O'Brien explains how the band works perfectly. However, some of his comments may conflict with your own doctors guidelines. Follow your own surgeons guidelines. Dr O'Brien will explain how this works. I'll be back tomorrow morning to add more of my own comments!

http://www.youtube.com/watch?v=Qa3Lwt6ElIs&list=UL Part 1

http://www.youtube.com/watch?v=K4jYJipQ7vc part 2

http://www.youtube.com/watch?v=Wbdhf44ZweI&feature=relmfu Part 3

http://www.youtube.com/watch?v=KF3TCKUn3YI Part 4

I asked my surgeon prior to surgery how he does it, and how the band will work on me, and he distinctly told me that the band will create a small 4-6 oz. pouch, and once that pouch fills up, my meal is done. In essence this means that I can only eat in one meal, the amount of food that fits in to the pouch. This is obviously completely different than what the doctor here says in the videos. My surgeon added, that there's only one way to do it and everybody does it this way, so now I'm really, really confused.

When I was banded in 2006, that is what we were taught - that food was retained in the pouch and exerted pressure on the vagus nerve. Research (for example by Monash University, Australia) carried out then and subsequently demonstrated that a well-adjusted band allows food to pass through within a minute. Retaining food above the band risks damage to the vagus nerve and the diaphragm. A band should not be tight enough to keep food above it for long.

As a long term banded person, I have an annual barium swallow to check all is well and one of the main checks is that food moves through quickly and never pools above the band.

[Bruce120 19]

I find it very interesting that my own surgeon would tell me something that is obsolete and not used anymore. Could it possibly be that he's still doing it the old fashioned way, and I'm actually going to have more risks than all of you here? I mean, this stuff just baffles me!

Edited July 17, 2014 by Bruce120

[want2besleeved 21]

I find it very interesting that my own surgeon would tell me something that is obsolete and not used anymore. Could it possibly be that he's still doing it the old fashioned way, and I'm actually going to have more risks than all of you here? I mean, this stuff just baffles me!

Hi good morning, I'm a newbie

Here. Starting option class in September.

I'm sill having a hard time on deciding band or sleeve.

It seems the band is less invasive while the sleeve removes 85% of your stomach.

But I read the band has a higher rate of long term

complications.?

Pls anyone there who did decide on the band and not the sleeve for whatever reason.? I'd really like your input to help me make a decision.!

Thx-Debbie

[KateP 359]

I find it very interesting that my own surgeon would tell me something that is obsolete and not used anymore. Could it possibly be that he's still doing it the old fashioned way, and I'm actually going to have more risks than all of you here? I mean, this stuff just baffles me!

Bruce, I am very sure that the modern view is the one quoted by me and by others. But none of us are surgeons (I assume) or qualified as bariatric experts. Your doctor is both!

But my understanding is that the pars flaccida technique has been in use since about 2005. The implantation method does not change the way the band works. The idea that food needed to stay above the band was the orthodoxy until about 2008/9. After that, it was not the method of implantation that changed but the understanding of how the band worked.

[lisacaron 5,075]

From my perspective it seems that many doctors have their usual "schtick" that gives the basic description of the band and how it works to the patients. I realize we are not doctors, but I really do think it's essential for a patient who is banded to understand how their bands work.

There are subtle differences in manufacturer and the guidelines for installation by a doctor, and there have been some new understandings in the way the band functions since the days of early banding.

There is a bit of a pouch that is created since the band cinches in around part of your stomach though this pouch is not a container in and of itself, it is still part of the whole stomach. Think of the way an hour glass is pinched at the center. If that pinch or narrowing was not there the sand would flow straight from one side to the other as you flip it.

Once you add that cinch into the middle it slows the rate or amount of time that it takes for the sand to move from one side of the hour glass to the other.

Your band functions in pretty much a similar way. You put food in and it slowly filters from the smaller end of your stomach through the band stoma into the larger stomach at the other side of the band.

This slowing down and exerting of pressure on the food particles being pushed through the stoma by the muscles in the esophagus are what stimulate the vagus nerve to signal the brain that you are no longer hungry and have had enough to eat.

Now should you start "stacking" bites of food one after another without giving the previous bite of food time to filter through the stoma you are going to get extremely full and perhaps feel sick and want to purge some of that food back up and out.

In this case think of a funnel placed into a larger container, you are filling that funnel quickly and to the max, at the other end it can only empty into the larger container at a certain pace and the more you push in from the top the more pressure you exert on the narrow opening at the bottom.

If the funnel is flexible and pliable like our organs are, you are going to stretch that bit out to where it no longer fits correctly into the lower container and if you bend it out of shape it's just not going to work the way it was meant to. Continued pressure is going to cause a reverse to the flow and push back out the larger end rather then slowly through the smaller end as intended.

For someone who is banded eating mechanics is very important. You want and need to take your time, at least 20 minutes to finish your meals. You want to take a bite, and then chew chew chew, wait for that bite to pass through your stoma and then begin to take the next bite. Put your fork and knife down between bites and pace yourself.

Many doctors will tell a new patient not eat and drink together. A good explanation for this is that as you are learning to use and live in tandem with your band and working on your eating mechanics adding the pressure of Fluid on top of food particles that have not yet cleared the band can exert pressure on the stoma which when newly banded or newly filled is often swollen and tender though we do not feel the swelling since it's happening internally unless we are unfortunate enough to get something stuck in the stoma opening.

I know much of this was long winded and I hope it makes sense to you. The reason that I chose to be banded was for the fact that it is adjustable to my life style and because of the fact that there was no mal-absorption component and none of my internal organs needed to be removed or re-routed.

Edited July 18, 2014 by lisacaron

[Bruce120 19]

Thanks Lisa. This is the best explanation of how the band works that I've read to date! Great job!