Laparoscopic adjustable gastric banding (LAGB), also known as gastric banding or lap band surgery, is a type of bariatric surgery that promotes weight loss by restricting the amount of food that can enter the stomach at any one time. By slowing digestion, it also helps to control feelings of hunger and increase the feeling of fullness after eating a meal. Gastric banding is an alternative that is less invasive and safer than gastric bypass surgery or sleeve gastrectomy.
Laparoscopic adjustable gastric banding does not involve changing the body's natural digestion or cause nutritional deficiencies as with gastric bypass procedures. While the amount of food that can be eaten is restricted, the stomach and intestines are left intact to digest food and nutrients completely and naturally.
The gastric band is a medical device that is implanted into the body during a relatively quick and minimally invasive operation. It consists of a silicone band lined with inflatable sacs, an injection port, and tubing. The band is placed around the upper stomach and is connected with tubing to an injection port that is attached to the abdominal wall.
There are two gastric bands approved for use in the United States:
The inflatable sacs that line the gastric band are usually left empty when first placed into the body. Over time, they are filled with a saline solution to further reduce the opening to the stomach and make it difficult to eat a large amount of food at any one time.
The gastric band fills are performed by a bariatric surgeon on a periodic basis. The saline solution is added to the gastric band using a thin needle that is inserted into the access port. When the saline solution is injected into the port, it travels to the inflatable sacs through the connective tubing and the band tightens around the stomach opening. This shrinks the stomach opening and increases food restriction.
The first fill is often performed about 4 to 6 weeks after surgery. Periodic fills are scheduled over the next couple of years to find the optimal amount of restriction that balances eating comfort with satisfactory weight loss.
The gastric band is a specific treatment for obesity and not a general method of weight loss for anyone who is overweight. Certain indications are used as guidelines by bariatric surgeons in determining whether or not an individual is a good candidate for gastric band surgery.
In general, the following guidelines outline patient criteria for gastric banding:
Individuals with the following conditions are not good candidates for gastric banding:
Individuals who are interested in gastric banding should talk to their doctor in order to determine if they are acceptable patients for this bariatric procedure.
Although gastric banding is considered a relatively safe procedure, especially compared to other bariatric surgeries, all surgical procedures involve some degree of risk and possible complications which should be considered before proceeding with surgery. During surgery, complications include: hemorrhage; injury to the spleen, stomach, or esophagus; conversion to open surgery. After surgery, complications include: band slippage, band or tubing leakage; port or band infection; obstruction; nausea and vomiting. Long-term complications include: band erosion into stomach; esophageal dilatation (stretching).
Gastric banding promotes a safe and steady rate of weight loss and long-term weight loss maintenance. The average weight loss in gastric band patients is:
The weight loss also leads to an improvement or resolution of obesity related health conditions, such as type 2 diabetes, high blood pressure, and severe sleep apnea.