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The Adjustable Gastric Band

Approved by the FDA in June 2001, the LAP-BAND® Adjustable Gastric Banding System is a minimally invasive and adjustable surgical treatment for morbid obesity. The LAP-BAND® System induces weight loss by reducing the capacity of the stomach, which restricts the amount of food that can be consumed.

The average weight loss is 1 to 2lb per week and then slows down to a plateau by three years. It can help achieve and maintain significant weight loss, improve health and enhance quality of life.

Adjustable Gastric Band

The band is wrapped around the upper part of the stomach creating a small pouch.

Lap Band     Lap Band

The lap band consists of a silicone band with a balloon that is connected by tubing to an access port. The port is buried under the skin so that it remains accessible for adjustments.

Like gastric bypass, the lap band is placed using laparoscopic techniques leaving small scars. The access port is placed just above and to the right of the umbilicus (belly button).

The Laparoscopic Approach

The laparoscopic approach results in a few small scars and less pain and is applicable to both lap band and gastric bypass.

The band is fastened around the upper stomach to create a new, small stomach pouch that limits and controls the amount of food you eat. It also creates a small outlet that slows the emptying process into the stomach and the intestines. As a result, patients experience an earlier sensation of fullness and are satisfied with smaller amounts of food. In turn, this results in weight loss.

Lap Band Model

There is no cutting or division of stomach or bowel in the bap band procedure. The band is therefore easily removed and reversed. However, removal of the lap band, unless replaced by another bariatric procedure, will result in weight regain in most patients.

Lap Band Adjustment
Success with the lap band requires adjustment of the tightness of the band. The surgeon can control the amount of saline in the band by entering the port with a fine needle through the skin. This is called a ‘band adjustment’ and is done in the office in most circumstances. Occasionally, one may have to use x-rays to locate and enter the port.

Adjustments are done on average monthly for the first 6 months and thereafter 2 to 3 times a year until effective weight loss is achieved. It is important to realize that failure to come for adjustments could result in failure to loose any weight.

The ability to adjust the tightness of the band gives it the advantage of meeting the individual patient’s needs. In pregnancy, for example, the band may be loosened to ensure the baby’s growth is normal.

Lap Band Adjustment
Lap Band adjustment is done in the office using a small needle.

Unfilled Band     Filled Band
Filling the band makes it tighter around the stomach causing earlier fullness.

Cautions: The LAP-BAND® System is not recommended in patients with conditions that may make them poor surgical candidates or increase the risk of poor results, who are unwilling or unable to comply with the required dietary restrictions or come for follow up adjustments.

Removal of the band and replacement surgery may be required in between 10 to 15% of patients, usually on account of a complication. Patients who become pregnant or severely ill, or who require more extensive nutrition may require deflation of their bands with consequent weight regain. Patients should not expect to lose weight as fast as gastric bypass patients. Anti-inflammatory agents, such as aspirin, should be used with caution and may contribute to an increased risk of band erosion.

Complications and side effects: Placement of the LAP-BAND® System is major surgery and, like any surgery, death can occur. Possible complications include the risks associated with the medications and methods used during surgery, the risks associated with any surgical procedure, and the patient’s ability to tolerate a foreign object implanted in the body.

Band slippage, erosion and deflation, obstruction of the stomach, dilation of the esophagus, infection or leaks from the tubing or port may occur. Reoperation may be required.

Band slip (prolapse) or pouch enlargement may result in reflux, including night time wheezing, cough and aspiration which if treated could damage the lungs. Too tight a band may cause long term damage to the esophagus (food pipe) resulting in its dilatation.