Laparoscopic adjustable gastric banding is often called gastric banding, lap banding, or LAP-BAND(TM) surgery. Laparoscopic gastric banding is the second most common weight loss surgery, after gastric bypass. More than 250,000 LAP-BAND procedures have been performed worldwide.
Lap banding surgery involves the following:
- Using laparoscopic tools, the surgeon places an adjustable silicone band around the upper part of the stomach.
- Squeezed by the silicone band, the stomach becomes a pouch with about an inch-wide outlet. After banding, the stomach can only hold about an ounce of food.
- A plastic tube runs from the silicone band to a device just under the skin. Saline (sterile salt water) can be injected or removed through the skin, flowing into or out of the silicone band.
- In this way, the band can be tightened or loosened as needed. This can reduce side effects and improve weight loss.
Laparoscopic adjustable gastric banding leads to loss of about 40% of excess weight, on average. Someone people who are 200 pounds overweight could expect to lose an average of 80 pounds after gastric banding. However, these results vary widely.
Gastric banding is considered the least invasive weight loss surgery. It is also the safest. The procedure can be reversed if necessary, and in time, the stomach generally returns to its normal size.
Lap banding surgery has a low complication rate. The most common problems after lap banding surgery include:
- Nausea and vomiting. These can often be reduced by adjusting the tightness of the LAP-BAND.
- Minor surgical complications occur less than 10% of the time. These include problems with the adjustment device, wound infections, or minor bleeding.
- The risk of death due to lap banding surgery is about 1 in 2,000.
Unlike gastric
bypass surgery,
lap banding does
not interfere
with food
absorption. For
this reason,
vitamin
deficiencies are
rare after lap
banding.
LAP-BAND Gastric Banding System
The LAP-BAND Adjustable Gastric Banding (LAGB®) System is designed to induce weight loss in severely obese patients by limiting food consumption. The slip-through buckle design band eases laparoscopic placement around the stomach. The band forms a small gastric pouch and stoma. No cutting or stapling of the stomach is required and there is no by-passing of portions of the stomach or intestines.
The initial pouch and stoma sizes are controlled through the use of the calibration tube. An inflation of the calibration tube balloon with 15-25 cc of air or saline provides an acceptable size range of the proximal pouch. The precise size may vary among patients depending on dissection points, individual patient physiology, and balloon and placement procedures.
The inner surface of the band is inflatable and connected by kink-resistant tubing to the access port, which is included in the LAGB System. This permits postoperative percutaneous stoma size adjustment. Dietary and behavior modification counseling, and frequent and long term follow-up are required for all patients after weight-loss surgery.
The LAP-BAND Adjustable Gastric Band is a 13 mm-wide band which, when fastened, forms a circular ring with an inside circumference of 9.75 cm or 10 cm and transitions to a 50 cm-long silicone tube. The band is made of silicone elastomer, chosen for its biocompatibility. The inner surface of the band is inflatable. The radiopaque kink-resistant tube is used to connect the inflatable section to the access port. An end plug is provided to seal the system while the band is being passed around the stomach.The access port is for percutaneous adjustment of the stoma diameter and is self-sealing when penetrated by the access-port needle. Other features include: high compression septum; tested to over 1,000 punctures with a 20 gauge non-coring needle. Titanium reservoir: designed for long-term durability and positive tactile feedback when accessing needle makes contact; resists gouging from repeated needle contact for long-term reservoir integrity.
