What is LAP-BAND Surgery?
LAP-Band surgery (or Laparoscopic Adjustable Gastric Banding) is the least invasive and safest of all the weight loss surgery procedures done for weight loss. The procedure works by limiting the amount of food the stomach can hold after eating, erasing hunger and allowing the patient to be full eating only a small amount of food. This is why it works better than any diet you’ve ever tried. It involves placing an inflatable silicone band around the upper part of the stomach. The band is connected by tubing to an access port. The access port sits on the rectus muscles (six-pack muscles), but below the skin and fat. Using the access port, saline can be injected into the inflatable inner ring within the band to narrow the upper portion of the stomach.
The new, small upper stomach pouch limits the amount of food that can be consumed at one time, and a narrowed stomach outlet increases the time it takes for the stomach to empty. When properly adjusted, you will be full eating a small amount of food and your hunger will be gone. The subsequent reduction in food intake results in weight loss. Band fills are usually done in the office, and are a necessary part for success. We use an ultrasound machine to easily locate the port and guide the fills, so they are quick and relatively painless. It’s way easier and less painful than getting your blood drawn.
The fills allow the band to be adjusted to meet your needs. If food is going too quickly through the band, you feel hungry between meals, or you are eating more than a small plate of food to get full – you need a fill. You should lose a minimum of 1-2 pounds a week when properly adjusted. If you feel the band is too tight, feel like food is sticking, or are have reflux symptoms – it’s too tight and you simply remove some fluid. The band should never be uncomfortable, it’s totally adjustable!
LAP-BAND surgery is a tool to help you achieve sustained weight loss by limiting how much you can eat, reducing your appetite, and slowing digestion. Remember, though, that the LAP-BAND by itself (like other weight loss procedures) will not solve morbid obesity. The amount of weight you lose depends both on the band and on your motivation and commitment to a new lifestyle and eating habits. The weight loss is slower with the band than other surgeries – some people view this is an advantage and some as a disadvantage. Over time, most studies show the weight loss achieved with the band is fairly equivalent to the other quicker weight loss surgeries.
What you eat goes through the band and is absorbed, so compliance to healthy foods is still required for optimal results. What you eat is up to you, but we’ll make it so you can’t eat very much. The better you do with the diet, the more weight you will lose. Average weight loss is around 60% of your excess weight. Lap-Band surgery is a very safe and quick procedure that usually takes only 30-45 minutes to perform. The complications that could occur with the band are generally taken care of easily and safely. It generally carries no more risk than having your gallbladder removed or some other straightforward surgery. It is usually done as outpatient surgery, so you are home the same day. Certain medical conditions may require an overnight stay. Most patients are back to work in about a week or less.
Advantages of the LAP-BAND:
- Least invasive surgical approach – No stomach stapling or cutting, or intestinal re-routing. Most patients go home the same day of surgery
- Adjustable – It can be tailored to the patient’s need.
- Reversible – Lowest mortality/operative complication rates
- Low malnutrition risk. All vitamins and minerals are absorbed normally
Disadvantages of the LAP-BAND:
- Slower weight loss than gastric bypass surgery
- Requires an implanted medical device – potential for band slippage, port flip or leak
- Regular follow-up is critical for optimal results
Comparing Weight loss Results – over time, the weight loss results are very similar
LAGB – Laparoscopic Adjustable Gastric Band (Lap Band)
RYGB – Roux-En-Y Gastric Bypass
Source: O’Brien et al. Obesity is a Surgical Disease: Overview of Obesity and Bariatric Surgery, ANZ J Surg, 2004; 74: 200-204.
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