LAP-BAND® Adjustable Gastric Banding
System
The LAP-BAND® System
adjustable gastric banding procedure restricts the amount of
food the stomach can hold by placing an inflatable silicone band
around the upper part of the stomach. The new, small upper
stomach pouch limits the amount of food that can be consumed at
one time, and a narrowed stomach outlet increases the time it
takes for the stomach to empty. The subsequent reduction in food
intake results in weight loss.
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Advantages
Least invasive
surgical approach
No stomach
stapling or cutting, or intestinal re-routing
Adjustable
Reversible
Lowest
operative complication rate
Low
malnutrition risk
|
Disadvantages
Regular
follow-up critical for optimal results
Requires an
implanted medical device
In some cases,
effectiveness can be reduced due to band slippage
In some cases,
the access port may leak and require minor revisional
surgery
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LAP-BAND® System
- Overview
The body gets
energy from food while it
passes through the alimentary canal, which consists of
the mouth, esophagus,
stomach, and small and large intestines.
Digestion starts in the
mouth with chewing
and the addition of saliva. After food passes through the
esophagus, this process continues in the stomach. The stomach
then provides temporary storage for food. Gastric juices, which
contain enzymes,
break down the food so that energy
can be
carried through the body by the blood.
The LAP-BAND® System
is a silicone elastomer ring designed to be placed around the
upper part of the stomach and filled with saline on the inner
surface. This creates a new small stomach pouch and leaves the
larger part of the stomach
below the band so the food storage area in the stomach is
reduced, and the pouch above the band can hold only a small
amount of food. The band
also controls the stoma (stomach outlet) between the two
parts of the stomach. The size of the stoma regulates the flow
of the food from the upper
to the lower part of the stomach. When the stoma is
smaller, you feel full
sooner and have a feeling of satiety so you are not
hungry between meals.
The band is
connected by tubing to an
access port that is placed beneath the skin during
surgery. Later, the surgeon can change the stoma size by adding
or subtracting saline inside the inner balloon through the
access port. This adjustment
process helps drive the
rate of weight loss. If the band is too loose and weight
loss inadequate, adding
more saline can reduce the size of the stoma to further
restrict the amount of food
that can move through it. If the band is too tight, the
surgeon will remove some saline to loosen the band and reduce
the amount of restriction.
LAP-BAND
®
System - Placement
The LAP-BAND® System
is usually placed
laparoscopically under general anesthesia. First the
surgeon makes a few small incisions (or “ports”) in the
abdominal wall for the insertion of long, thin surgical
instruments. A narrow camera is also passed through a port so
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 band through and allow it to be wrapped around the upper
part of the stomach, almost like a wristwatch. The band is then
locked securely in a ring around the stomach. The LAP-BAND® is
usually left empty or only partially inflated for the first 4 to
6 weeks after surgery.
LAP-BAND
®
System - Weight-Loss Results
The LAP-BAND® System
is a tool to help you achieve sustained weight loss by limiting
how much you can eat, reducing your appetite, and slowing
digestion. Remember, though, that the LAP-BAND® System by itself
will not solve morbid obesity, nor will it ensure that you reach
your goal weight or even that you lose weight at all. The amount
of weight you lose depends both on the band and on your
motivation and commitment to a new lifestyle and eating habits.
Some people lose more than others, and though you may never
reach your ideal weight, chances are good that with weight loss
your health and self-image will improve.
LAP-BAND
®
System - Removal
If there is a
problem with the band, if you can’t lose enough weight or can’t
adjust to the new eating habits, your surgeon may suggest
removal of the band. This decision will come after your surgeon
consults with you. Generally, after LAP-BAND® System removal your
stomach will be restored to its original form, and the digestive
tract should function normally. Please
keep in mind that when the band is removed, your weight will
likely increase.
