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Lap Band

As a device whose purpose is to help obese patients lose weight and turn to a healthier lifestyle, the LAP-BAND® system consists of a flexible band that is placed around the upper area of the stomach and a thin tube that connects it to a port under the abdominal skin.

Following the positioning of the adjustable band, a small pouch will be created above it, which will prevent the individual from ingesting large amounts of food at once. With the aid of the port, the medical professional will be able to adjust the band by inflating or deflating it so as to control weight loss without additional surgery.

The procedure, also known as adjustable gastric band surgery or AGB, is minimally invasive and is performed via laparoscopy. It is ultimately a means of promoting safe weight loss and a transition to beneficial eating habits.

The LAP-BAND® system received approval from the FDA for the treatment of morbid obesity in 2001 and it has become the second most commonly performed bariatric surgery.

Before recommending lap band surgery, your doctor will take into account several factors which might make you a suitable candidate for this procedure, including:

• a BMI (body mass index) of over 40 or a BMI of over 35 accompanied by serious health problems such as diabetes, high blood pressure, heart disease, or sleep apnea
• multiple failed attempts to lose weight
• having been overweight or obese for more than 5 years
• determination to radically change your lifestyle and eating habits

If you qualify for the procedure and decide to follow through with it, you will first undergo a series of medical tests, such as EKG and blood work, to assess your current health and ascertain whether it is safe to have lap band surgery in the near future. Supposing you are eligible, you will be scheduled for surgery and instructed by a bariatric specialist with regard to what to do and avoid in the meantime. You must not consume any food or liquid the night before the lap band surgery. In certain cases, the patient will be advised to begin having 5 or 6 small meals a day several weeks before the surgery to be able to adjust more easily to the lifestyle they will lead afterward. When the risk involved by lap band surgery is too great, a weight loss of 5% to 10% will reduce it significantly. 

On the day of the procedure, you should arrive at the hospital at least two hours before your appointment. You will be administered general anesthesia and a nurse, along with a specialized anesthesiologist, will constantly monitor your vital signs while you are unconscious. The bariatric surgeon will make 3 to 5 small incisions in your abdomen, each of approximately one inch, through which they will place the adjustable band around the superior area of your stomach with the aid of a fiber-optic camera and various other instruments. Sutures will be used to attach the band to your stomach, which will be followed by the positioning of the port under the skin of your abdomen. It will also be attached to the area in question with stitches. When the procedure is completed, the surgeon will carefully close your incisions and cover each of them with a sterile dressing, which should be worn until the wounds are entirely healed.

Lap band surgery is generally carried out within one to two hours. It is worthy of note that, while the procedure is reversible, you should be truly committed to making a lifelong change in your eating patterns before considering it. The band is usually adjusted 2 weeks after the surgery by filling it with saline solution to achieve the compression of the upper part of the stomach. Thereby, after the patient eats, food will remain in the newly created pouch for a while before further traveling down the digestive system, making the individual feel full for a longer period of time. You will have to go to multiple appointments every year for the surgeon to adjust your lap band.

Following lap band surgery, the average patient will lose approximately 87% of their excess weight. Within the first year, a 40% decrease in weight should occur if they comply with the advice of their bariatric surgeon, namely paying close attention to their diet and eating no more than the daily recommended amount of food. Additionally, lap band surgery entails the following benefits:

• improves or cures health problems and diseases associated with obesity, such as diabetes, hypertension, and sleep apnea
• prolongs life expectation
• increases mobility
• reduces the risk of developing colon, breast, endometrial, as well as pancreatic cancer by 33%
• alleviates respiratory issues such as asthma, which was noted in 82% of patients
• improves depression, which was observed in 57% of patients
• increases fertility
• alleviates gastroesophageal reflux disease (GERD), which was noted in nearly 90% of patients
• is completely reversible, as it does not permanently alter the anatomy of the stomach
• implies low postoperative risks, as it is minimally invasive
• allows adjustments without additional surgery
• short recovery time

However, in order to experience as many benefits as possible after undergoing lap band surgery, you need to periodically check with your bariatric surgeon and strictly follow their advice concerning your eating habits. Otherwise, the procedure will prove ineffective.

Considering that lap band surgery is performed using a minimally invasive technique, you will only have to spend one day in the hospital. It is recommended to take 1 to 3 weeks off work afterward, whereas full recovery is achieved within 4 to 6 weeks. Once the effect of the anesthesia wears off, you will be given pain medication and will be encouraged to walk as soon as you wake up, as this will reduce the risk of blood clots. When you are able to urinate without the help of a catheter and drink sufficient water to keep yourself hydrated, the medical team will release you.

If you experience one or more of the symptoms below shortly after lap band surgery, please seek medical attention immediately:

• fever
• difficulty swallowing
• nausea and/or vomiting
• infection of the incisions
• worsening pain

For the first few days, you will only be allowed to consume liquids, as you need to slowly transition to a normal diet. Noticing a decrease in your energy levels is to be expected during this period since you will be eating considerably less. You will be gradually able to include solid foods in your diet and after several weeks, you will no longer need to take pain relievers. Bathing and swimming are forbidden until your incisions are completely healed. Lifting heavy weights and intense exercise are also ill-advised for one to two months. The majority of lap band surgery patients need approximately 10 adjustments during the first year. Nevertheless, as time goes on, you will have to visit your bariatric surgeon less and less – 2 or 3 times a year, in general.

While the risks and complications of lap band surgery are minimal, they refer to:

• bleeding
• infection inside the abdomen
• perforation of the esophagus or stomach during surgery
• spleen or liver damage
• band slip, which occurs in 5% to 10% of patients
• the band eroding into the lining of the stomach (in less than 2% of cases)
• infection of the band or port
• food trapping
• gastroesophageal reflux disease (GERD)
• bowel function changes
• pouch dilation
• death (lap band surgery is actually the safest bariatric procedure, with a mortality rate lower than 0.5%)

When a complication takes place, a second surgery might be necessary to remediate it.