Lap Band Surgery

Laparoscopic adjustable gastric banding (LAGB) is one of the most frequently performed types of weight loss surgery for the treatment of obesity. This bariatric procedure has proven to be a safe and effective method of surgical weight loss since its worldwide debut in the mid 1990's.

LAGB has been available in the United States since June 2001, when the LAP-BAND® System of adjustable gastric banding system was approved for safety by the FDA. It is currently the top selling adjustable gastric band system, with over 500,000 LAP-BAND® Systems sold worldwide.

The goal of the LAP-BAND® procedure is to help severely overweight people achieve long-term weight loss.

About The LAP-BAND® System

The LAP-BAND® System is a medical device designed to help severely overweight people achieve long-term weight loss. It is placed into the body during a relatively simple operation which has a low rate of surgical complications. Recovery is quicker and the hospital stay is shorter than with gastric bypass surgery. The band is adjustable to a patients needs and can be reversed if medically necessary.

The LAP-BAND® System consists of an adjustable gastric band, tubing, and an access port. The design has undergone several revisions over the years, a result of integrating technological advances with functional improvements. It is now in the third generation, which is identified as the LAP-BAND AP System, "designed for Advanced Performance."

The three generations of LAP-BAND® adjustable gastric band are:

• The 9.75/10 LAP-BAND System
• The LAP-BAND VG System
• THE LAP-BAND AP System

The first generation, LAP-BAND 9.75/10, was released in 2001. It featured one single inner balloon with a 260-280 degree fill radius and a 4cc fill volume.

The second generation, LAP-BAND VG, was released in 2004. It featured an inner balloon comprised of 6 baffles (mini reservoirs) with a 280-300 degree fill radius and a 10cc fill volume.

The current version, LAP BAND AP, was released in 2007 and is the most advanced adjustable gastric band system. It features a low pressure inner ring that is soft and pre-curved with 7 baffles (mini reservoirs) and a 360 fill radius. There are two band sizes (AP Standard, 10cc and AP Large, 14cc) and two port sizes (11.9mm or 14.7mm profile) enabling placement to be tailored to an individuals anatomy.


What is LAP-BAND® Surgery?

The Lap-Band procedure involves placing an adjustable silicone band around the upper part of the stomach which reduces the opening to the stomach and creates a smaller food pouch at the top of the stomach. The larger portion of the stomach is left below the band. The inner liner of the gastric band is a hollow ring filled with saline that can be adjusted with more or less saline to create a smaller or larger opening.


How is the LAP-BAND® placed into the body?

Lap-Band surgery is usually performed laparoscopically, a modern and minimally invasive method of surgery. General anesthesia is required with laparoscopic surgery.

With laparoscopic surgery, small incisions are made in the abdominal wall, then narrow and hollow tubes are inserted thru the incisions to the surgical area. Specially designed instruments and cameras are inserted thru the tubes to perform the surgery. The camera takes pictures and shows then on a monitor which allows the surgeon to see inside the abdomen.

The surgeon inserts the Lap-Band into the body and positions the gastric band around the stomach to form a ring and then fastens the lock which holds the band in place. The access port, which is connected to the gastric band via tubing, is fastened to the inside of the abdominal wall.

The advantages of laparoscopic surgery are less pain, fewer wound complications, and a quicker recovery than traditional open surgery.


How does the LAP-BAND® promote weight loss?

Lap-Band Surgery, or laparoscopic adjustable gastric banding, helps with weight loss by restricting food consumption and slowing digestion. By limiting how much food can be eaten at any one time and reducing hunger sensations it can help an individual eat less and thus lose weight.

The smaller gastric pouch that is created by the gastric band limits the amount of food that can be eaten and slows the emptying process from the stomach into the intestines. The smaller stomach pouch and slower digestion rate lets you feel full sooner and feel full longer. The band can be adjusted to let in more or less food as needed.

How is the LAP-BAND® adjusted?

During surgery, an access port is placed beneath the skin that is connected to the gastric band via tubing. Saline can be easily added or removed by the surgeon thru the access port using a thin needle. This process is called inflating or deflating. If weight loss is too small and the band is too loose, saline is added to reduce the opening. If the opening is too tight, saline can be removed. The ability to adjust the opening is a unique feature of the Lap-Band procedure and a normal part of follow-up care.

Lap-Band Surgery is a promising new weight loss procedure with many advantages over other obesity surgical options. Since it's approval by the FDA in 2001 it has become the fastest growing bariatric (weight loss) procedure in the United States.

The LAP-BAND® is Adjustable

One big advantage of the LAP-BAND® is that the band's size can be adjusted to meet a patient's needs. Not only does the band create a smaller upper stomach pouch, it also controls the stoma (stomach outlet) between the two stomach areas. The size of the opening determines the flow rate of food from the upper part of the stomach to the lower part. Once the band is put in place, it can be tightened or loosened by your surgeon. The adjustments are made by either adding or removing saline from the reservoir port using a fine needle. The ability to adjust the LAP-BAND® makes it possible to customize the rate of weight loss for each patient. Adjustments are a normal part of follow-up care. Reasons for adjustments include weight loss progress, pregnancy, and illness.

The LAP-BAND® Procedure is Reversible

Another advantage of the LAP-BAND® is that the procedure is reversible because there has been no stomach cutting or stapling, or intestinal cutting and rerouting. The LAP-BAND® is meant to be a long-term implant, but it can be removed at any time if necessary. It may need to be removed if you have any adverse reactions or if you and your doctor feel you aren't losing as much weight as you should be losing. After the band is removed, the stomach generally returns to it's original form and the digestive tract will function normally again.

The Safety of LAP-BAND® Surgery

LAP-BAND® surgery is the least invasive weight loss surgery available and has both the lowest complication rate and lowest mortality rate of any weight loss surgery procedure. LAP-BAND® patients usually have less pain, less scarring, a shorter hospital stay, and quicker recovery than patients of other forms of weight loss surgery. It is important, however, to talk to your doctor about the possible risks and complications that may occur with any surgical procedure, including weight loss surgery of any kind.

No Dumping Syndrome with the LAP-BAND®

Rapid gastric emptying, or dumping syndrome, often occurs with gastric bypass surgery but not with LAP-BAND® Surgery. Dumping syndrome, an intolerance of sugars and some carbohydrates, happens when concentrated and undigested foods such as sweets enter the lower intestine (jejunum) too quickly. Symptoms of dumping include nausea, vomiting, cramping, dizziness, and weakness. Dumping syndrome does not occur with LAP-BAND®, but it is still best to avoid sweets in order to maximize weight loss and the nutritional value of your diet.

The advantages of LAP-BAND® Surgery include:

• A minimally invasive surgery
• No stomach stapling or cutting
• No intestinal re-rerouting
• The band is adjustable
• The procedure is reversible
• No Dumping syndrome
• Low malnutrition risk
• Shorter hospital stay
• Quicker recovery
• Lowest complication rate
• Lowest mortality rate

The LAP-BAND procedure is a safe and effective weight loss solution, but weight loss surgery is not for everyone who is overweight. Whether or not you are a good candidate for weight loss surgery is a decision that you and your doctor will make together. One of the most important measures of eligibility that your doctor will use is your Body Mass Index (BMI), a calculation based on your height and weight. Your BMI classifies you as either overweight, obese, or morbidly obese and determines if you fall in the range to be considered for Lap-Band Surgery.

What is the Body Mass Index (BMI)?

The Body Mass Index (BMI) is used as a measurement of body fat based on height and weight. The formula for determining your BMI is (weight in pounds) divided by (height in inches squared).

The BMI measurement categorizes weight as follows:

• Healthy Weight: BMI between 19 and 25
• Overweight: BMI between 25 and 30
• Obese: BMI over 30
• Severely (Morbidly) Obese: BMI is 40 or more

• Your BMI is more than 40 or more than 30 with obesity related health conditions
• You weigh twice your ideal weight or are at least 100 pounds overweight
• You are between the ages of 18 and 60
• You have been overweight for 5 years or more
• You have been unable to lose weight thru diet and exercise
• You do not have an illness that has caused you to be overweight
• You do not drink too much alcohol
• You are committed to making changes in your diet and lifestyle
• You are willing to continue working with and be monitored by your LAP-BAND doctor
• If you are interested in Lap-Band Surgery and want to see if it is right for you, take a step for your health and talk to your doctor about weight loss surgery.

The purpose of Lap-Band surgery is to help you lose weight safely and steadily and improve your overall health and quality of life. Many Lap-Band patients have already experienced weight loss success and improved health because of the Lap-Band procedure. If you are committed to losing weight, the Lap-Band procedure will help you have positive results and successful weight loss as well.

During the initial consultation with a Lap-Band surgeon, you will be able to discuss your weight loss hopes and expectations. As you learn about Lap-Band weight loss surgery, from research on the internet, consultations with your surgeon, and knowing about success stories from other Lap-Band patients, the information will help you decide if Lap-Band Surgery is the best choice for your health as well.


How much weight and how fast can I expect to lose weight with Lap-Band Surgery?

Based on the average weight loss seen in other Lap-Band patients, you can expect to lose about 1-1/2 to 2 pounds per week and about 50% of your excess weight within the first year of surgery. Your individual results may be more or less than the average because weight loss is dependent on a combination of factors including your starting weight, your diet after surgery, and the amount of exercise you do.


Is the rate of weight loss with the Lap-Band safe?

The Lap-Band device helps you lose weight safely and steadily. In general, if you lose weight too quickly it can be a health risk. With Lap-Band it may be possible to lose 2 to 3 pounds per week, but it is more likely that you will lose about 1-1/2 to 2 pounds per week. The rate of weight loss experienced with Lap-Band Surgery is considered a safe amount.


What health conditions show improvement with Lap-Band Surgery?

Most Lap-Band patients find that their obesity related health conditions either improve or disappear completely as they lose weight. If you have medical conditions such as type 2 diabetes, high blood pressure (hypertension), obstructive sleep apnea, and knee pain, it is likely that you too will see your health improve as you lose weight.


What is the importance of follow-up medical appointments with Lap-Band Surgery?

After your Lap-Band Surgery, follow-up medical appointments are an important part of achieving a safe and significant long-term weight loss. During your appointments, your doctor will work with you to develop a personalized diet and exercise plan, monitor your weight, eating habits, and various symptoms and make any necessary band adjustments. Working with your doctor and keeping your follow-up appointments will help you achieve the healthiest weight loss possible.


How do weight loss results with Lap-Band compare to those of Gastric Bypass (RNY) Surgery?

At the five year mark, there is no difference in weight loss results between Lap-Band patients and Gastric Bypass (RNY) patients. Patients of the gastric bypass surgery tend to drop weight faster in the beginning, but the percentage of weight loss and the ability to keep the weight off after a couple of years is comparable.