Lap Band Treatment

The Facts about Lap Band Procedure

The laparoscopic adjustable gastric banding procedure, also known as lap band treatment, Lap-Band® System or gastric banding is an invasive weight loss surgery that bands the stomach with an implanted prosthetic device. The device "divides" the stomach into two pouches connected by a narrow passage, which slows digestion and limits food-intake capacity. It helps patients reduce their appetite and feel full sooner after eating less.

Lap band treatment was approved by the FDA in June 2001 for use in weight loss surgery. The lap band procedure is comprised of three parts:

• Silicone or silastic (pliable soft plastic) band
• Reservoir or "port"
• Tube connecting the band to the port

After performing a series of incisions, the surgeon will insert a small video camera to view the area where the lap band device is to be placed. The lap band is then inserted and placed around the upper part of the stomach. A small stomach pouch is formed just above the band, and the larger stomach pouch remains below the band. The reservoir or port is placed just below the patient's surface fatty tissue and skin. The port and the band remain inside the patient's body and are connected by the tube.

• Injecting saline into the port inflates the band, which makes the passage to the stomach smaller, further restricting food intake.
• Draining saline through the port deflates the band, widening the passage into the stomach, allowing greater food intake.

The surgical portion of the lap band procedure is sixty to ninety minutes and an overnight hospital stay is typically required.

Lap Band Recovery and Aftercare

In the months after your lap band treatment, periodic office visits are necessary to adjust the band. Your doctor or nurse will pierce the skin with a needle, into the reservoir or port just beneath the skin, and inject or drain saline. Periodic lap band adjustments are part of the ongoing post-surgical treatment customized for each patient. Patients typically return to work in a week or so, and fully recover in one to three weeks. Your doctor will give you post-surgical instructions, which may include waiting at least an hour between eating, chewing food thoroughly, and a specific diet and exercise regimen. As with gastric bypass surgery, additional plastic surgery may be necessary to remove excess skin and to lift sagging body areas. Follow-up procedures may be performed two to three years after your lap band treatment.

As with any surgery, and with implanted medical devices, there is a risk of infection. Side effects of a lap band procedure may include slippage of the band, abdominal pain, nausea, or heartburn. More serious side effects may require another operation or hospitalization. Patients who are morbidly obese are at greater risk of complications.

Lap band treatment has certain advantages over gastric bypass procedure.

• Lap banding is reversible: the device can be removed.
• Anatomy is not permanently altered.
• There is no effect on your body's nutrient absorption (In some cases gastric bypass may cause nutritional deficiencies).
• Lap band surgery is less invasive: the stomach and intestines are not cut or rerouted.
• There is less scarring since the procedure requres only small incisions.

Disadvantages of lap band treatment over gastric bypass procedure include:

• The procedure requires that a foreign object be left in the patient's body, which increases risk of infection.
• Patients typically experience a more gradual weight loss.
• Nearby internal organs may be injured during the surgical placement of the band.
• Slippage of the band is rare but possible.