Since the first laparoscopic adjustable bands for weight loss were used on patients in Europe and Australia in 1993, lap-band surgery has grown in scope and popularity. Lap-band surgery was initially used only to treat morbidly obese patients, however, it is currently made available to patients with smaller amounts of weight to lose in order to treat or prevent the health risks associated with obesity.
How it Works
With the lap band in place, the amount of food you eat is reduced and the metabolic process of digestion is slowed. Consuming smaller amounts of food and the slowing down of digestion as food takes longer to pass through the narrow opening created by the band gives you an extended feeling of fullness.
The Procedure
If you have tried diets, exercise, and behavior modification, and are still unable to lose weight and keep it off, discus the lap-band procedure with your doctor and ask for a recommendation to a surgeon who performs laparoscopic adjustable gastric banding. The surgeon will ascertain if you are a candidate for this procedure with medical screening including blood tests, urinalysis, image studies including chest x-ray, electrocardiogram, ultrasound, GI evaluation (gastrointestinal evaluation), a gastroscopy to look inside the esophagus, stomach, and duodenum, and additional testing, if required by your doctor.
If it is determined that you are a good candidate for the surgery, the procedure will be performed under general anesthesia and takes approximately 30 minutes to one hour. The lap-band procedure establishes a small pouch in the upper portion of the stomach controlled by an adjustable band at the base of the pouch. The band is made of silicone and titanium. During the procedure, small hollow tubes will be inserted through a 1-centimeter incision in your abdomen. The instruments used for this procedure, including cameras designed to enable your doctor to see the surgical area, are inserted through the tubes. The lap-band will be placed around the upper portion of your stomach and locked securely in place. This will create a small pouch that will serve as your stomach. Your hospital stay for this procedure will be approximately 48 hours.
Lap-band adjustments are made via a tube extending from the band to an access port fastened inside your abdominal wall. All adjustments are made as determined by your doctor to control the amount of comfort and weight loss. A saline filled balloon located inside the band is inflated or deflated by inserting a syringe into the access port to add or remove saline from the balloon. The band remains in place for life, however, the procedure is reversible allowing the band to be removed at any time. No external parts are required.
Pros
Lap band surgery can enable the loss of up to 90 percent of your excess body weight. In addition, it can resolve many health issues. Patients suffering from high blood pressure and diabetes, for example, have been able to come off their medications. Compared with other bariatric surgical procedures, lap band surgery is the least invasive and does not require cutting into the stomach.
Cons
Any weight loss strategy requires adherence to diet. Patients who have lap band surgery and believe they can continue eating as usual, only in smaller amounts, fail to lose weight. It is imperative to follow the advice of your doctor and dietician who will continue to work with you to aid in the transition to a new and healthier way of eating. Attempting to go it on your own, will result in failure to lose weight and can pose a health risk.
Continual follow up visits are an absolute requirement as adjustments may be needed on your lap band. Band slippage and leakage at the access port can occur, but these problems can usually be laparoscopically repaired. Though it represents a small fraction (less than one percent) of the number of people having this procedure performed, one in 300 people who have lap band surgery die.
