Laparoscopic Adjustable Gastric Band: the LAP-BAND® or the REALIZE® Band

Like the gastric bypass operation, the adjustable gastric band procedure reduces the effective size of the stomach. With gastric bypass, this is accomplished by stapling and dividing the stomach. With the adjustable gastric band, this is accomplished using a plastic band that fits around the top part of the stomach like a belt. The band is hollow and is filled with fluid. By adding or removing fluid from the band, the band can be tightened or loosened.

As with gastric bypass, the stomach pouch fills with food rapidly and empties slowly. When the pouch gets full, the brain responds with a feeling of fullness even though the person has only consumed a very small amount of food. Unlike gastric bypass, there is no re-routing of the intestines.

One of the advantages of the adjustable gastric band procedure is that it is a less complex operation than most other weight loss operations. There is no stapling, cutting, or rerouting of the stomach or intestines. This generally leads to a shorter length of time in the operating room under anesthesia, and a shorter length of stay in the hospital. Since there are no staple lines, there is a lower risk of leaking. The band is also adjustable – it can be tightened or loosened depending on the needs of the patient. This procedure is also more easily reversible than other weight loss operations.

The disadvantages of the adjustable gastric band procedure includes a generally slower initial weight loss than with gastric bypass surgery. Some patients may take up to three years to acheive their final weight loss results. Also, overall long-term weight loss results may not be as good with the adjustable gastric band as with gastric bypass.

Laparoscopic surgery

As with gastric bypass, the adjustable gastric band operation can be performed laparoscopically in almost all cases. This means that instead of a large incision, several small puncture holes are made in the abdomen. Through these holes, long and slender instruments are used to perform the operation. The surgeon can see inside with a small television camera, which shows the operation on a television screen next to the patient in the operating room.

Risks of Surgery

As with any operation, there are risks associated with weight loss surgical procedures. Possible risks include, but are not limited to:

› Complications due to anesthesia and medications
› Blood clots (deep vein thrombosis)
› Pulmonary embolus
› Intestinal leak
› Bleeding
› Possible need for an open operation
› Death

Long-term complications may also arise, particularly in patients who are not able or willing to follow the postoperative diet instructions and maintain lifelong followup with their doctor. Some possible long-term problems include:

› Inadequate weight loss
› Band slippage
› Band erosion into the stomach
› Infection of the band or port
› The port or plastic tubing may break
› Vitamin and mineral deficiencies
› Possible need for other procedures in the future

For more information about morbid obesity and the adjustable gastric band procedure, please visit the Lap-Band info site from Allergan, or the Realize Band web site from Ethicon Endosurgery.

The adjustable gastric band surgery should be considered a “tool” to allow a person more control over the consumption of food.