Lap-Band

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Overview

Lap-Band surgery was considered a breakthrough in bariatric weight loss surgery when it was introduced in the early to mid 1990s. The procedure caught on with surgeons who wanted to offer their patients a less-invasive procedure than the Gastric Bypass, and a nonpermanent option for those apprehensive of receiving a lifelong surgical procedure. The Lap-Band is a good choice for patients whom desire weight loss through a minimally-invasive procedure and don’t mind the frequent follow-up doctor visits and procedures associated with the Lap-Band.

How Does the Lap-Band Work?

Like the Gastric Sleeve, the Lap-Band surgery helps patients lose weight by restricting the amount of food the patient can take in at one time. The Lap-Band reduces the patient’s stomach to about the size of a golf ball by implanting an inflatable silicone belt or collar device on the upper-part of the stomach.  The band has little pillow-like chambers lined around the inside that is adjusted throughout the patient’s next couple of years, or more. The adjustments are made through tubing and an “access port” that is attached to the band, which is implanted beneath the patient’s skin near the abdomen. Saline is injected into the access port through a needle to inflate the band, compressing the upper-stomach like a tightening belt. Later, saline can be dejected out to deflate, allowing more food. The restriction slows down the passage of food, which helps signal to the patient’s brain that they are full.

The Surgical Procedure

The entire surgery is performed while the patient is asleep and is always performed laparoscopically. The surgeon creates 4 to 5 small incisions in the abdomen so that tiny surgical tools and a small camera can be inserted to carry out the procedure. The band and fill port is implanted through the incisions as well, and the entire procedure takes about 30 minutes to an hour to complete. Note that the band will not be inflated during the surgical procedure and the patient will need to get their first saline fill at least 6 weeks after surgery. Also, no cutting or stapling of the patient’s intestines or stomach occurs during the procedure.

Advantages

Since the Lap-Band is always performed laparoscopically, the procedure has fewer surgical risks than bariatric weight loss surgeries that may require an open procedure. Unless the patient is not careful about eating a regular balanced diet, there is no real risk of nutrient or vitamin deficiencies to the body. Patients generally do not suffer from dumping syndrome since the pylorus is not affected, and the chance of complications such as ulcers, intestinal obstruction, osteoporosis, and anemia is minimized. The Lap-Band is also the only bariatric weight loss procedure that can be suited for a patient’s precise needs, is removable, and completely nonpermanent.

Disadvantages

The biggest disadvantage to the Lap-Band procedure is the risk of band complications after surgery. Since the Lap-Band is an implanted device, each patient’s bodies can react differently. The band can erode, in which it migrates into the stomach, it can reject, in which the patient’s body rejects the band itself, it can leak, where the restriction loses its effect over time, and it can slip, when a portion of the lower stomach moves above the band. Some patients experience nausea, vomiting, dehydration, and acid reflux as a result of these potential complications. Lastly, the Lap-Band requires frequent follow-up doctor visits and procedures to fill and deflate the band.

Recovery and Results after the Procedure

The usual recovery time for patients is 2 to 3 days, and depending on the patient’s profession, they can return to work and normal activity within a week. The band is not inflated during the surgery, and after recovery from the initial surgery, usually 4 to 6 weeks afterward, the patient then goes to a doctor for their first saline fill. Weight loss is usually more gradual and slower than most other forms of bariatric weight loss procedures, however if weight loss stalls, the patient can get more saline filled to tighten the band. Health complications associated with excess weight is either eliminated or drastically reduced. These complications commonly include type 2 diabetes, sleep apnea, high cholesterol, and high blood pressure.

Diet and Lifestyle after the Lap-Band

Patients who have a Lap-Band need to make sure they eat and drink very slowly and to not swallow until food is completely chewed. Also, patients should take at least 20 minutes to eat their meals, eat smaller and frequent meals throughout the day, and to not snack between meals. This consistent flow of food will deter overeating, which can cause some of the band complications. The Lap-Band is not a solution for weight loss, so patients should consider lifestyle changes such as regular exercise and diet modification as part of their permanent aftercare.

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Procedure Details