What is Adjustable Gastric Banding?
LAP-BAND® and the REALIZE® band are brand names for the generic “gastric banding” procedure.  The name comes from the “laparoscope” (a small fiber-optic camera the surgeon uses to perform the procedure) and the gastric “band” that is placed around the stomach.  

Gastric banding is the only adjustable and reversible obesity surgery that does not require cutting and stapling of the stomach, or gastrointestinal re-routing to bypass normal digestion.   Patients experience reduced surgical trauma, complications, pain and scarring, as well as shorter hospitalization and recovery time compared to other obesity surgeries.  

With this procedure, 75% of patients are expected to lose 75 – 80% of their excess body weight.  As weight decreases and lifestyle habits improve, most patients realize drastic improvement in other areas of their health as well, including hypertension, diabetes, pulmonary disease and more.


The Procedure
Gastric banding (either through LAP-BAND or the REALIZE band) is a restrictive procedure which helps patients lose weight by limiting how much they can eat, reducing appetite and slowing digestion.  During the procedure, the surgeon places an inflatable silicone band around the upper part of the stomach. This divides the stomach into two sections.  The smaller upper section limits the amount of food that can be consumed at one time, making patients feel fuller quicker.  The band also controls the size of the “stoma,” which is the outlet between the two parts of the stomach.  The narrower the stoma, the longer it takes for the stomach to empty, making patents feel fuller longer and helping prevent hunger between meals.       


The physician can adjust the size of the band to fit the needs of the individual patient. It has an inner balloon that is connected by tubing to an access port, which is placed deep under the skin on the left-hand side of the abdomen.  To tighten the band, saline is injected into the port and makes its way to the inner balloon.  The tighter the band, the fuller patients will feel throughout the day.

The procedure is performed laparoscopically, under general anesthesia.  The surgeon makes a few small incisions in the abdominal wall for the insertion of long, thin surgical instruments as well as the laparoscope, which he uses to view the procedure on a nearby video monitor.  LAP-BAND® surgery is reversible.


What to Expect After the Procedure
THE FIRST FEW WEEKS
Most people who undergo LAP-BAND® surgery spend one to three days in the hospital and are able to return to work within a week.  The band is usually left empty or only partially inflated for the first four to six weeks.  Patients will start on a liquid diet for the first few weeks and gradually progress to soft foods and then solids.  They are given an ongoing dietary plan, including vitamin supplements, and an exercise program.  Some patients are advised to seek behavioral modification therapy as well.

ONE TO EIGHTEEN MONTHS
LAP-BAND® patients must visit the doctor's office several times for band adjustments. The simple procedure (described above) is painless and takes approximately 15 minutes. The average patient needs six to eight adjustments over the first 18 months after surgery.

LONG TERM
Most patient settle at their final weight at approximately two years.

REMOVAL
If there is a problem with the band, if patients can’t lose enough weight or can’t adjust to the new eating habits, the surgeon may suggest it be removed. The stomach should revert to its original form and the digestive tract should function normally.  However, weight will likely increase.


Risks and Benefits of the LAP-BAND® Procedure
The benefits of LAP-BAND® far outweigh the risks. However, it should be considered only after you have tried unsuccessfully to lose weight on diet and exercise programs and are not likely to be successful without surgical intervention.  

Once you and your physician have decided on surgery, you should ask questions, understand your role in the procedure, recognize that surgery has its limitations and commit yourself to a long-term follow up program in order to maximize your results.  It is also important to understand that the higher your Body Mass Index (BMI) and/or age, the greater your risk and that reactions to the stress of surgery and drugs used can be unpredictable.  Before surgery, you will be asked to sign a Consent Form stating you understand the risks involved.  

Benefits of LAP-BAND®	Risks of LAP-BAND®
Reduced risk of shortened lifespan due to morbid obesity Overall sense of well being Improved quality of life Improvement in conditions related to morbid obesity, including: Sleep apnea Asthma Joint pain Arthritis Reflux Fatigue Shortness of breath	Standard risk of surgery (bleeding, infection, adverse risk of anesthesia) Band could slip or erode, reducing effectiveness or requiring minor revision surgery Access port may leak, requiring minor correction surgery Possible nutritional deficiency due to decreased intake1
1These risks can be significantly reduced by following your dietitian’s guidelines very carefully, especially during the first two months after surgery.

     
Disclaimer:  As with any surgery, there are certain risks and complications associated with these procedures.  Please talk to your doctor about your individual risk and candidacy for bariatric surgery.


Maximizing Your Outcome
LAP-BAND®  is not a magic bullet.  It is a tool for weight loss and maintenance, but the overall results are up to you.  Committing to a follow-up program is key, and we’ll be with you every step of the way with tools and resources to help you maximize your success.