Laparoscopic Adjustable Gastric Banding (Lap-Band®)
Gastric Banding with the Lap-Band® is a variation on the banded gastroplasty, in which the stomach is neither opened nor stapled—a band is placed around the outside of the upper stomach, and creates an hourglass-shaped stomach. It also produces a narrow, controlled and adjustable outlet that allows for management of the rate at which food travels from the upper to the lower stomach. Patients are satisfied with smaller meals that easily fill the small upper stomach. The Lap-Band® constriction causes food to slowly pass through the outlet and maintain stretch on the upper pouch – leading to a prolonged sense of fullness and lack of hunger. The Lap-Band® is made of a non-reactive, durable elastomer that can be surgically implanted during a relatively short laparoscopic procedure (less than an hour, on average). The inflation port, which is placed under the skin near but below the patient’s ribs, allows for periodic adjustments to the volume of the outlet; making it tighter, if weight loss is too slow, or looser, if weight loss is too fast. These adjustments can usually be done without hospitalization and always with the utmost of safety.
True advantages to the Lap-Band® are:
- It can almost always be inserted laparoscopically, without the usual large incision.
- It does not require any opening in the gastrointestinal tract, so infection risk is reduced.
- There is no staple line to come apart.
- It is adjustable.
- If necessary, it is reversible (Band can be removed).
- This device has now been approved by the Food and Drug Administration (FDA) for use in the United States. One-hundred thousand have been implanted here and abroad, and the track record of safety is well-established.
This procedure may be particularly suited to persons of lower BMI (35-48), who may wish to have a quicker recovery, less risk, and the ability to undergo a surgical procedure without the obvious outward evidence of surgery. Most can return to work quickly, and dietary changes are less obvious. Although its effects may not be as profound or rapid as the gastric bypass, the risks of the procedure are less, and the recovery time is the shortest.
The Lap-Band® is also an excellent tool in the treatment of morbid obesity. In the latest study out of the journal of Obesity Surgery (Rubenstein, 2002), the average weight loss at three years was approximately 54%, range: 21-94%. The resolution of comorbidities (weight-related illness and injury) in the same interval, was similar to the Gastric Bypass procedure.
Gastric Banding is not recommended for everyone. You should review your specific case with your surgeon to determine the right option for you. Gastric Banding is FDA approved for adults only.
There are potential risks and complications with gastric banding surgery. Although these problems rarely occur, we want you to know the facts. After gastric banding surgery, potential risks include band slippage, erosion and deflation, port-site infection, reflux, obstruction of the stomach, dilation of the esophagus, infection or nausea and vomiting may occur. Surgery complications may result in reoperations.
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