Gastric banding and Gastric bypass surgery

Dear Ask The Doctor: Is it possible to have the banding surgery years after having the bypass surgery?

Dear Preston:Gastric banding is a procedure performed to restrict food ingested to facilitate weight loss. An inflatable adjustable silicone band is placed around the top portion of the stomach, by laparoscopic surgery (key-hole surgery). Gastric banding is reversal and has a much lower mortality rate 1:2000 compared to gastric bypass surgery 1:250. Gastric bypass surgery is a procedure that has a restrictive and a malabsorptive component to facilitate weight loss. The gastric bypass provides a substantial amount of dietary restriction. In addition the malabsorptive element is a result of bypassing the distal stomach, the entire duodenum, and a varying length of the jejunum. It is theoretically possible to have gastric banding after gastric bypass surgery, but this is dependent on the amount of stomach bypassed and whether a band would fit around the remaining functioning stomach. This may be technically challenging because the normal anatomy has been disturbed during the previous bypass surgery and there may be adhesions secondary to the surgery. I would advise discussing potential gastric banding with your gastroenterology surgeon.