LAP-BAND®

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Laparoscopic gastric banding is both adjustable and reversible. In this procedure, the band, a belt-like device, is placed around the upper part of the stomach. Around the inside of the band, there is a balloon that can be inflated by injecting fluid into a small access port located under the skin. As the balloon inflates, the gastric band tightens, creating a narrow passage between the small upper stomach pouch and the lower stomach. This limits the amount of food that is able to pass through and maintains the feeling of fullness.

Because the pouch can hold only about one to two ounces of food at one time, you’ll eat less and feel full faster. Frequent band adjustments, performed in the office, lead to a slow and steady weight loss of one to two pounds per week. Maximum weight loss is achieved at two to three years after surgery.

Serious complications are rare, but problems may develop after surgery. As discussed at the seminar, complications include but are not limited to: device infection or malfunction, band slippage, band erosion, esophageal obstruction or dilatation, bleeding, injury to other organs, blood clots, pulmonary embolism, anesthetic complications, and the need for further surgery. Typical weight loss is 60% of excess body weight, but minimal weight loss may occur in up to 10% of patients.

An adjustable device can be implanted around the top portion of the stomach to assist in weight loss in the morbidly obese. Over 250,000 of these devices have been implanted worldwide. Two such devices are approved by the Food and Drug Administration (FDA) for use in this country.

The LAP-BAND® was approved by the FDA in 2001. Only surgeons successfully completing the authorized training course are permitted to insert this device. The surgeons at Advanced Laparoscopic Associates have the largest experience with LAP-BAND® in the state and inserted our first LAP-BAND® in October 2001.

The Realize® Adjustable Gastric Band was FDA-approved in 2007.

Both of these devices are placed surgically around the top portion of the stomach. A small stomach pouch is created above the band, with the larger part of the stomach below. This reduces the food storage area of the stomach to only a small egg-sized pouch. The opening into the rest of the stomach is limited by the band, and this opening is easily adjusted depending on appetite.

Adjusting the band is accomplished in the office by injecting saline solution into a reservoir port embedded beneath the skin during surgery. The fluid fills a balloon along the inside of the band thereby tightening it. If the band is too loose and weight loss too small, adding more fluid will reduce the size of the opening. If the band is too tight, fluid can be removed. The ability to adjust the band as often as necessary is a unique feature of these devices, not available in other operations.