I frequently get asked, “what has happened to the adjustable gastric band (Lap-band)”? 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.
The next 30-35% of patients have some, but frankly limited weight loss. They tend to lose 30-40 lbs which is much less than they had anticipated. They tend to have difficulties finding the sweet-spot on their adjustments, getting filled followed by a few days to a week when they require an infill. In addition, nausea, vomiting, and dehydration are common to this group of Lap-band patients.
The final 30-35% of Lap-band patients fail to lose significant weight and are not comfortable with their fills. This group of patients often get lost to follow-up because they get frustrated and quit. This has been the experience at bariatric centers across the country, and I’m sorry to say it has been our experience as well. As a result, I have stopped placing Lap-bands in patients. With 60% of patients not having good results with the Lap-band, and having good alternatives, it seems like the right thing to do.
The sleeve gastrectomy is a very good alternative to the Lap-band. The average weight lost is about 70% of excess weight and the weight comes off quickly. The sleeve also resolves most of the co-morbidites or medical problems associated with obesity. Nutritional deficiencies are uncommon with the sleeve. 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; come for band fills when you need them. However, if you have a Lap-band, are not comfortable, and 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. This is common protocol and you will find yourself achieving your weight-loss goals once again.
Please feel to contact us if we can help (303-861-4505), or visit us on our website (www.coloradobariatric.com).
Tom Brown, MD
Colorado Bariatric Surgery Institute