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Adjustable gastric band

What is adjustable gastric banding?

Adjustable gastric banding, also known as the Lap-Band®, is a weight loss procedure that involves placing a soft silicone ring with an expandable cushion along its inner surface, around the top portion of the stomach. The ability to adjust the lap band helps to restrict the passage of food from the top portion of the stomach, and reduces the amount you need to eat in order to feel full.  Over time, food is able to pass through the narrowing of the band into the rest of the stomach for normal digestion to occur.

Why it's done

The adjustable gastric band is used to help you lose excess weight and reduce your risk of potentially life-threatening obesity-related health problems including; diabetes, heart disease, high blood pressure, gastroesophageal reflux disease, obstructive sleep apnea, high cholesterol and infertility. A main goal in treating obesity is to decrease these risks and improve quality of life.

Benefits of the band include:

  • Minimally invasive approach
  • Nutritional deficiencies are less likely because absorption is not altered
  • More gradual weight loss than with other procedures
  • No cutting or stapling of the stomach, and intestines are not re-routed
  • The Band is reversible if necessary – though intended to be permanent
  • Can be done as a first-stage procedure in high-risk patients
  • Slightly lower overall complication rate

Disadvantages of the band include:

  • Average weight loss lower than more involved procedures
  • Slightly higher incidence of nausea and vomiting
  • Slightly higher weight loss failure rate

Risk factors

There are various factors to consider when exploring weight loss surgery—all of which should be discussed with your bariatric surgeon. These risks are both patient and procedure specific. Risks associated with the adjustable gastric band are different for everyone. Possible risks include:

  • Injury to the stomach at the time of surgery
  • Infection of the band
  • Band slippage
  • Band erosion
  • Band intolerance

The adjustable gastric band is not recommended for people who have an autoimmune disease, due to risks associated with the insertion of a foreign body.

What to expect 

The band is a silicone elastic ring that is placed around the upper part of the stomach filled with saline on the inner surface. It is connected to an access port with a tube that is placed beneath the skin during surgery. This procedure is performed laparoscopically sometimes utilizing the robot. The specific method chosen for the procedure depends on each individual case.

After the procedure, the band will require occasional in-office adjustments. Your surgeon is able to adjust the band by adding or removing saline inside the inner cushion via the access port. This ability to adjust the band helps drive the rate of weight loss. If weight loss is inadequate as a result of a loose band, the surgeon will add more saline to reduce the size of the opening and further restrict the amount of food that can move through it. If the band is too tight, the surgeon will loosen it by removing some saline, thus reducing the amount of restriction. If for any reason the band needs to be removed, the stomach generally returns to its original form.

Recovery

Those who undergo adjustable gastric band surgery typically go home the same day and are back to work within 24 to 48 hours. How quickly you return home and back to work will vary according to your physical condition and the nature of the work you do.

Although hospital stay is rare, nearly 100 percent of patients who are admitted to our hospital for this procedure are released after one night, with a return to hospital rate of around just one percent (one fifth of the national five percent average).

Initially, you will be restricted to small frequent liquid “meals.” Over the ensuing days to a few weeks you will advance your diet slowly though soft food ultimately to regular food. It is important to remember after adjustable gastric band surgery to always chew your food well. 

Results

People who have the band enjoy modest weight loss assuming that they are compliant with regularly scheduled follow ups and band adjustments.

If your initial weight-loss procedure is no longer working, revisional surgery may be an option for you to achieve continued weight loss and improved health. While revisional surgery is generally more complex than the original procedure, our collaborative team of weight loss specialists have the knowledge and expertise to perform these procedures successfully.

The approach chosen for the revisional procedure varies on the patient’s individual needs and is tailored to the goals you are trying to achieve. Speak with one of our experts to determine if you are a candidate for revisional surgery and the best option for you.

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