Laparoscopic gastric banding or “Lapband”

Laparoscopic gastric banding (gastric banding) commonly referred to as Lap Band is another form of restrictive weight loss surgery that helps patients to slowly decrease their weight by decreasing the amount of food that the stomach can hold at a given time. Gastric banding involves the surgeon placing a silicone band around the upper portion of the stomach creating a small 15-22 cc gastric pouch above the lap band. The band which is accessed through a port placed over the abdominal wall muscle is filled or emptied with saline solution to allow for greater restriction or less restriction as necessary. Patients who undergo gastric banding surgery generally experience slower initial weight loss than those who undergo gastric bypass or sleeve gastrectomy. However, long term weight loss results in some studies have shown similar results. The advantage of this surgery is that there is no cutting or stapling of the stomach or the small bowel and it can completely be reversed by removing the band.

Over time, your surgeon adjusts the tightness of the band to help you continually meet your weight loss goals. During an adjustment, saline is delivered through the port into the band balloon, making the band fit more snugly around your stomach. After an adjustment, you'll feel full sooner, stay satisfied longer, and maintain gradual weight loss. Fast and easy band adjustments take place at your surgeon's office. Your adjustment will probably be scheduled 4 to 6 weeks after your surgery. Your weight, the physical symptoms you report, and other factors help your surgeon decide if a band adjustment is necessary. The timing and number of band adjustments are different for everyone and can only be determined by each patient's surgeon.

The gastric banding surgery is usually very effective for younger patients (18 to 36) since their basal metabolic rate is faster than older patients. Women do better with Lap Band than men according to recent studies. And patients who need to lose approximately 50 to 75 pounds are good candidates for the Lap Band. Patients who are older and have a higher BMI who need to lose 75 to 300 pounds will do better with sleeve or gastric bypass. The lap band patient, requires regular physician visits the first few month after surgery for adjustments. Adjustments are done in the office setting and are when the surgeon will add or remove saline from the band. Adjustments do not require surgery and are simple injections. However, remember that Lap band patients have to work harder to lose the excess weight compared to patients undergoing lap sleeve and lap gastric bypass. Patients with the gastric banding lose approximately 35% to 45% of their excess body weight.

Important Safety Information

The gastric band is for adult patients 18 years of age or older, who have obesity and have failed more conservative weight loss alternatives. The gastric band is not for patients with medical conditions that may put them at increased risk during or after surgery, or for patients who are unwilling to make significant changes in eating and behavior patterns. If you have a hiatal hernia, it may need to be repaired before or during gastric banding surgery.