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Gastric Banding (Lap Band) Surgery
INFORMATION
ON COST, INSURANCE, BENEFITS AND RISKS
The LAP-BAND System is designed to help you lose excess
body weight for resolution of obesity-related health
conditions and enhancement of life. In partnership with
leading bariatric surgeons around the world, a new surgical
approach has been developed that eliminates many of the
known associated operative risks and provides unique
benefits compared to other obesity surgeries.
This effort has resulted in the LAP-BAND System, 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.
Patient benefits include reduced surgical trauma,
complications, pain, and scarring, as well as shorter
hospitalization and recovery time compared to other obesity
surgeries. The name "LAP-BAND®" comes from the surgical
technique used (laparoscopic) and the name of the implanted
medical device (gastric band).
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.
Advantages
- Lowest mortality rate
- Least invasive surgical approach
- No stomach stapling or cutting, or intestinal
re-routing
- Adjustable
- Reversible
- Lowest operative complication rate
- Low malnutrition risk
Disadvantages
- Slower initial weight loss than Gastric Bypass
or BPD
- 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
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.
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