LAP-BAND Surgery

Lap Band Diagram

The LAP-BAND System is a surgically implanted weight loss device that helps a person lose weight by restricting food intake and controlling hunger. It is prescribed as a treatment for morbid obesity and obesity-related health conditions, when non-surgical methods of weight loss have been unsuccessful. The LAP-BAND system offers bariatric patients a safer, healthier, and less extensive surgical option compared to the gastric bypass procedures.

During LAP-BAND surgery, an adjustable silicone band is placed around the top part of the stomach to create a smaller stomach pouch. The procedure does not involve cutting, stapling, or rerouting of the stomach and intestines. Since the digestive system is not altered, the body continues to digest food normally and nutritional deficiencies are unlikely to occur. Weight loss occurs at a safe and steady rate.

Overview

The LAP-BAND System was the first adjustable gastric band approved for use for use in the United States. It consists of an adjustable gastric band, connective tubing, and an access port. The product has continued to evolve and improve over the years, providing patients with the most up-to-date medical care possible.

The LAP-BAND is currently manufactured and marketed by Allergan, Inc., a multi-specialty health care company. The product was originally developed by an American company, INAMED Health, and patented as the BioEnterics LAP-BAND Adjustable Gastric Banding System. The LAP-BAND was first used in Belgium in 1993 and began being marketed outside the United States in 1994. It entered clinical trials in the United States in 1995 and then received FDA approval in 2001. The LAP-BAND was acquired by Allergan, Inc. in 2005.

  • The 9.75/10 LAP-BAND System was released in 2001
  • The LAP-BAND VG System was released in 2004
  • The LAP-BAND AP System was released in 2007

LAP-BAND AP™ System Specifications

  • Product Material: Silicone
  • Band Sizes: AP Standard and AP Large
  • Gastric Liner: 7 soft and pre-curved baffles (mini reservoirs), low-pressure, 360 fill capacity
  • Fill Volume: AP Standard is 10cc, AP Large is 14cc

LAP-BAND Surgery

Surgery to place the LAP-BAND into the patient is a relatively safe and quick procedure. In most cases, the operation is performed laparoscopically on an out-patient basis, taking less than one hour to complete. During surgery, the gastric band is put into position around the upper part of the stomach and the access port is stitched to the abdominal wall.

The average patient can expect:

  • Operating time: One hour
  • Hospital stay: Less than 24 hours
  • Time off work: 1 week
  • Recovery time: 6 weeks

LAP-BAND Fills

The LAP-BAND is usually placed into the body unfilled, allowing the body to recover from surgery and adjust to the initial restriction of the gastric band. The first fill is scheduled approximately 4 to 6 weeks after surgery. During the first two years, which is the period of maximal weight loss, most patients will receive from 5 to 8 band adjustments.

The ability to adjust the amount of restriction is one of the benefits of the LAP-BAND. The band can be filled (tightened) to increase restriction and rate of weight loss, or loosened to decrease restriction. Finding just the right balance between the amount of restriction and rate of weight loss is often known as finding the “sweet spot.” If the gastric band is too tight, it can cause eating problems. If it is too loose, weight loss will not be sufficient. Also, the band can be unfilled for health reasons or pregnancy, when increased food and nutrient intake is needed.

Patient Support

The success of bariatric surgery is greatly determined by the level of support and follow-up care a patient receives, including participation in exercise programs, nutritional counseling, and bariatric support groups. The patient support program available to LAP-BAND patients is called My LAP-BAND ® Journey, which supplements the bariatric program offered by your bariatric surgeon. The resources available with this program can help keep you motivated and successful with weight loss and long-term weight maintenance.

Weight Loss Results

LAP-BAND surgery helps a person lose excess weight by restrictive measures; it limits the amount of food that can be eaten at any one time, slows digestion, and increases satiety (feeling of fullness). Weight is lost at a safe and steady rate, about 1-1/2 to 2 pounds per week, with the body settling at a final weight 3 to 4 years after surgery. When measured five years after surgery, the average LAP-BAND patient has reached and maintained a 55% loss of excess weight.

Weight loss results will vary from patient to patient, with some losing more and some less than the average. Actual weight loss is affected by a combination of factors, including starting weight, diet after surgery, and exercise habits.

Substantial weight loss following lap band surgery will also improve or resolve other health conditions associated with obesity, including type 2 diabetes, high blood pressure, and sleep apnea.

Lap Band Surgery vs. Gastric Bypass Surgery

The long-term weight loss is very comparable between patients of Lap Band Surgery and Gastric Bypass Surgery, although the rate and method of weight loss is very different.

Method of Weight Loss:

  • Lap Band: purely restrictive, thus low malnutrition risk
  • Gastric Bypass: combination restrictive and malabsorptive, thus risk of nutritional deficiencies

Rate of Weight Loss:

  • Lap Band: slow and steady, settles at final weight 3 to 4 years after surgery
  • Gastric Bypass: rapid weight loss first six months, settles at final weight 18 to 24 months after surgery

Weight loss results at one year:

  • Lap Band: 40 to 50% excess weight loss
  • Gastric Bypass: 70% excess weight loss

Weight loss results at five years:

  • Lap Band: 55% excess weight loss
  • Gastric Bypass: 60% excess weight loss (weight regain usually occurs after first year results)

Overall, lap band surgery offers patients a safer, healthier, and less extensive treatment for morbid obesity than gastric bypass surgery. The surgery does not involve removing or altering any part of the stomach or intestines, thus recovery is quicker, there is a lower rate of surgical complications, and a lower risk of nutritional deficiencies over time. While the initial weight loss results are less, the long-term results are very favorable for lap band surgery. Also, the slower rate of weight loss reduces the side effects of hair loss, gallstones, and excess hanging skin that can occur with rapid weight loss.

LAP-BAND vs. REALIZE Band

The LAP-BAND and REALIZE Band are the only two types of adjustable gastric bands approved for use in the United States. The LAP-BAND was approved in 2001 and the REALIZE Band in 2007, but both have been available worldwide since the mid 1990's. Bariatric patients are often interested in finding out which band is better, but generally bariatric surgeons consider them equal choices. There are some differences in the way the bands are constructed, but this affects comfort and fit more than use and results. The primary benefit of having two choices is that the bariatric surgeon can choose which product is the best fit for a patient based on the patient’s anatomy.

Bariatric Surgeons
The main reasons that patients chose lap band surgery were low risk of surgery, quicker recovery, and felt it was better for them.