The LAP-BAND® Adjustable Gastric Banding System Procedure
The LAP-BAND® System is usually placed laparoscopically while you are under general anesthesia. While you may be in the operating room for two to three hours, the surgery itself typically takes about an hour. First, the surgeon makes a few very small incisions in the abdominal wall and secures "ports" in these incisions to accommodate long, thin surgical instruments. A narrow camera is also passed through one of these ports so that the surgeon can view the operative site on a nearby video monitor. A small tunnel is made behind the top of the stomach to let the LAP-BAND® System device through and allow it to be wrapped around the upper part of the stomach, like a wristwatch. The LAP-BAND® System is then locked securely in a ring around the stomach. This creates your new, smaller stomach pouch. Also, to help hold the LAP-BAND® System in place, stomach tissue is folded over it and stitched together. The rest of the lower stomach will stay in its normal position. Then, the small access port, which is used for LAP-BAND® System adjustments, is fixed just underneath the skin. The access port is used by the surgeon to inject saline (sterile salt water) into the LAP-BAND® when you have an adjustment. The LAP-BAND® System is usually left empty for the first 4 to 6 weeks after surgery
How It Works
The LAP-BAND® Adjustable Gastric Banding System is a simple yet advanced gastric banding system that helps you gradually lose and control your weight by reducing the amount of food that your stomach can hold at one time. Allergan is the pioneer of adjustable gastric banding in the United States - this is a constantly evolving technology, involving a great deal of research and development.
The name "LAP-BAND" comes from the minimally invasive surgical technique used (laparoscopy) and the silicone gastric band placed around the top of the upper part of your stomach. The LAP-BAND® System works by helping you control your food intake and supporting long term, sustainable weight loss.
The LAP-BAND AP® System
The latest generation of the LAP-BAND® System - the LAP-BAND AP® System - is the most advanced adjustable gastric banding system approved by the FDA and was built on a proven heritage of effective laparoscopic adjustable gastric banding technology.
The LAP-BAND AP® System uses patented Omniform™ technology—soft, precurved, individual sections—and introduces a 360 degree inflation area. Omniform™ technology is designed to minimize the potential for leaks due to unwanted creases or folds (crease-fold failure). At the same time, the 360 degree inflation area evenly distributes pressure for complete coverage of stomach anatomy. The
LAP-BAND AP® System also has the highest available fill volume so your surgeon has the flexibility to offer more precise adjustments.
The LAP-BAND AP® System was designed to extend the proven performance of the LAP-BAND® System.
The LAP-BAND® System Advantages at a Glance
Minimally Invasive Surgery
- Minimally invasive surgical approach
- No intestinal re-routing, cutting or stapling of the stomach wall or bowel as with gastric bypass
- Small incisions and minimal scarring
- Reduced post-surgical pain, shorter hospital stay and recovery time
- Return to work/normal activities typically within a week
Fewer Risks and Side Effects
- Low risk of post-surgical nutritional deficiencies
- Reduced risk of hair loss
- No "dumping syndrome" (food passes through the system too fast resulting in severe cramping/digestive disruption) related to dietary intake restrictions
- Allows for personalized steady, healthy rate of weight loss
- No additional surgery for adjustments
- Supports pregnancy by allowing for increased nutritional needs
Effective Long Term Weight Loss
- More than 350,000 LAP-BAND® System devices distributed worldwide
- #1 selling adjustable gastric band for weight loss worldwide
- Over ten years of medical studies and academic publications follow-up
- While it is intended to be a long-term treatment, the LAP-BAND® System can be removed at any time, in some cases laparoscopically
- Stomach and other anatomy typically return to their original state/functions
All surgical procedures have risks. When you decide on a procedure, you should know what those risks are. Talk with your surgeon in detail about all the risks and complications that might arise. Then you will have the information you need to make the right decision for you.
Using the LAP-BAND® System includes the same risks that come with all major surgeries. There are also added risks in any operation for patients who are seriously overweight. You should know that death is one of the risks. It can occur any time during the operation. It can also occur as a result of the operation. Death can occur despite all the precautions that are taken. There is a risk of gastric perforation (a tear in the stomach wall) during or after the procedure that might lead to the need for another surgery. In a U.S. clinical study this happened in 1% of the patients. There were no deaths during or immediately after surgery in the U.S. study. Your age can increase your risk from surgery. So can excess weight. Certain diseases, whether they were caused by obesity or not, can increase your risk from surgery. There are also risks that come with the medications and the methods used in the surgical procedure. You also have risks that come from how your body responds to any foreign object implanted in it. Published results from past surgeries, however, indicate that LAP-BAND® System surgery may have fewer risks than other surgical treatments for obesity.
Patients can experience complications after surgery. They may include but not limited to: nausea and vomiting, regurgitation, band slippage, stomach-band outlet blockage, infection, port leakage, band erosion. Surgical techniques have evolved to reduce slippage. Surgeons with more laparoscopic experience and more experience with these procedures report fewer complications.
Talk to your doctor about all of the following risks and complications:
- Gastritis (irritated stomach tissue)
- Gastroesophageal reflux (regurgitation)
- Gas bloat
- Dysphasia (difficulty swallowing)
- Weight regain
- Infection (requires removal of band)
The LAP-BAND® System is a long-term implant, but it may have to be removed or replaced at any time. For instance, the device may need to be removed to manage any adverse reactions you might have. The device may also need to be removed, repositioned or replaced if you aren't losing as much weight as you and your doctor feel you should be losing.
It is It is possible you may not lose much weight or any weight at all. You could also have complications related to obesity.
If an If any complications occur, you may need to stay in the hospital longer. You may also need to return to the hospital later. A number of less serious complications can also occur. These may have little effect on how long it takes you to recover from surgery.
Anti Anti-inflammatory drugs that may irritate the stomach, such as aspirin and NSAIDs, should be used with caution.
Frequently Asked Questions:
Q: How is the band adjusted?
A: Your Lap-Band system consists of a band with an inflatable (balloon-like) inner surface. The band is connected by a thin tube to an access port under your skin. The doctor or another health care professional adjusts the band by injecting fluid (saline) into the port or removing fluid from it. A special needle is used.
Q: Where are band adjustments performed?
A: Band adjustments are done in the doctor’s office. If the doctor feels that an x-ray would be needed for accessing your port, you would go to the hospital to the radiology department.
Q: Do I need to be on a special diet after an adjustment?
A: It’s recommended you follow a clear liquid diet for 48 hours after your adjustment. Each day following, progress to thin liquids, pureed, soft, then solids.
Q: Who is allowed to adjust my band?
A: Only a trained health care professional authorized by Allergan can adjust your band. This person usually will be your surgeon or physician’s assistant. Never let an untrained clinician or non-medical person adjust your band—and never adjust it yourself. Doing so could cause you serious problems. It could also damage your band.
Q: When should I expect my first band adjustment?
A: It is likely your first band adjustment will occur 4 to 6 weeks after surgery. The exact time, though, can differ for each person. You and your surgeon will decide when the right time is for you.
Q: How will I know when I need a band adjustment?
A: The most common reasons for adjustments are:
- You are not able to eat much of anything without feeling uncomfortable or vomiting. Your band may be too tight.
- You are able to eat without restriction. Your band may be too loose.
- You are not losing weight. Your band is possibly too loose. It could also be too tight, causing you to choose a liquid diet.
Fluid may be added to the band to “tighten” it. This will decrease your stoma size (the band outlet). Sometimes a patient may notice symptoms such as reflux or vomiting. Or a patient may have a hard time with many foods. It this happens, fluid may be removed to “loosen” the band. This will increase your stoma size.
There is no set formula to know how much fluid you need. Your doctor needs to evaluate you. Your doctor will consider:
- The size of your small upper pouch
- The size of the opening (stoma) to the lower pouch
- Your weight loss progress
- How and what you eat
Q: How many band adjustments will I need?
A: This varies with each patient.
Q: How much weight will I lose?
A: The amount of weight you may lose depends on several things: the band placement, your new lifestyle and new eating habits. A weight loss of 2 to 3 pounds a week in the first year after the operation is possible, but one pound a week is more likely. Twelve to eighteen months after the operation, weekly weight loss is usually less. Remember that your main goal is to have a weight loss that prevents, improves, or resolves health problems connected with obesity.