Adjustable Gastric Lap-Band: An Update
The Lap-band was introduced to the US in 2001 from Australia where it had been used with great success. However, here in the US we have not had the same success. Approximately 30% of the patients that have a Lap-band placed do really well. They lose 55-60% of their excess weight. They seem to find the sweet-spot in their band adjustment and get comfortable, and require infrequent fills.
However, the remaining 70% of Lap-Band patients struggle with adequate weight loss and frequently are not comfortable with their band and their fills. In addition, nausea, vomiting, and dehydration are common. This has been the experience of bariatric centers around the country, and it has been our experience as well at the Colorado Bariatric Surgery Institute.
With such a majority of Lap-Band patients not having a good outcome, it is important to point out that good alternatives are available. The sleeve gastrectomy is one good alternative. The average weight loss is about 70% of excess weight and the weight comes off quickly. The sleeve also resolves most of the co-morbidities or medical problems associated with obesity. Nutritional deficiencies are uncommon. And finally, the cost is not that much more for the sleeve than the cost for the Lap-Band.
If you have a Lap-band in place and are doing well and are comfortable with good weight loss, keep up the good work. However, if you have a Lap-band and are not comfortable, and you are experiencing nausea, vomiting, GERD, awake during the night coughing, or are consistently gaining weight, make an appointment and get evaluated. You may need to have the band removed and consider converting to another weight-loss operation.
The Laparoscopic Adjustable Band was approved by the FDA in 2001, and since that time has become a popular alternative to the gastric bypass surgery in this country. Attractive attributes of the Lap Band System are:
- Less invasive surgical option
- Safe – no stomach stapling, cutting or intestinal re-routing
- Effective weight-loss and resolution of co-morbidities over time
- Minimal side effects
- Easily reproducible
- Adjustable – customized by our surgeons to meet each individual’s unique needs
- Reversible if necessary
- Low malnutrition risk
- Satiety-inducing procedure
- Outpatient procedure
- Early return to work
Weight loss occurs slower with the adjustable gastric lap-band as compared to the gastric bypass with most patients reaching their maximum weight loss at 3 years. The expected long-term weight loss with the adjustable gastric lap-band ranges from 50-60% of the excess body weight. Multiple studies have documented resolution of a majority of the weight-related co-morbidities. Follow up with your surgeon or physician assistant for adjustments, especially in the first year, is vital to the success of the Band.
Brief Description of the Lap-Band Procedure
The Lap Band is a hollow silicone tube that is wrapped around the upper portion of the stomach and then attached to a small port buried beneath the skin and adipose tissue on the abdominal wall. To perform the procedure requires five small incisions through which we place our laparoscopic instruments. We then create a small tunnel around the upper portion of the stomach through which we pass the Band and lock it into place. Several sutures are also placed on the stomach to hold the Band in the correct position.
Once the Band is secured in the correct position, the amount of food that you can eat is diminished considerably. By adding or removing saline through the port, we can adjust the size of the Band to allow you to eat more or less food. The actual adjustment of the Band takes place in our office. It is a quick and simple procedure that is performed by placing a needle into the access port and adding or removing a small amount of saline. During your first year after surgery, you will meet with your surgeon or physician assistant several times to make sure the adjustment is perfect for you. A well adjusted Band will provide a sense of satiety (satisfaction) with small portions and allow you to lose 1.5-2.0 pounds per week.
Lap-Band Clinic – Aftercare and Fill Clinic
The Colorado Bariatric Surgery Institute (CBSI) provides a comprehensive aftercare and fill clinic for all patients with the Lap-Band. If you are a Lap-Band patient in need of routine adjustments or fills, or if you are new to the Denver area seeking an experienced bariatric surgery practice, we can provide immediate and long-term care to support your overall success with the Lap-Band System.
Our experienced and compassionate healthcare team, headed by bariatric surgeon Dr. Tom Brown, has demonstrated a high standard of care in bariatrics with highly favorable patient outcomes, as well as a low incidence of complications. Please contact us if you are a Lap-Band patient in need of assistance in meeting your weight loss goals.