The LAP-BAND System is an adjustable gastric band designed to help you lose excess body weight, improve weight-related health conditions and enhance quality of life. The surgical procedure to place the Lap-Band involves laparoscopically fastening the device around the upper section of the stomach to create a small stomach pouch. The Lap-Band itself is a silicone ring containing an inner band that can be filled with saline to controls the “stoma” (stomach outlet) between the new small stomach pouch and the lower part of the stomach. As the band is filled, the stoma is made smaller creating the sensation of being full, or satiated.

Tubing connects the silicone ring to an access port placed beneath the skin of your abdomen. This port allows the physician to change this size of the stoma by adding or removing saline from the band around the stomach which affects the amount of food a patient can consume.

At the initial placement of the device during surgery, the band is empty. During the following weeks and months the band is adjusted on an outpatient basis to accomplish a weight loss rate of about one to three pounds per week. Further adjustments to the band are driven by several factors including:

1. Amount of patient's weight loss
2. The quantity of food that can be comfortably consumed
3. Other health issues (pregnancy or other medical condition requiring increased caloric/nutritional intake)

Lap-Band advantages

The primary factors that attract most patients to choose this procedure are that the band is removable, adjustable, does not change or divide the anatomy, and is laparoscopically placed. Because the procedure is laparoscopically completed, the stress on vital organs is lessened and the risks encountered during surgery are greatly reduced, resulting in faster recovery periods. In addition, because no parts of the stomach are cut or repositioned, risks of obstructions or leakage are very low.

Although the Lap-Band would only be removed if medically necessary, it is referred to as a removable device and/or a reversible procedure because there is little or no effect on the stomach if removed. Even in rare occurrences when the band has eroded, slipped or caused an infection, removal of the device results in no residual problems. The reason for the lack of effect is that the band is made from a silastic substance that has virtually no tissue reaction. If the device is removed and not replaced by another weight loss solution, the patient risks significant weight regain.

The most exciting key to the success of the Lap-Band is its adjustability that promotes long-term, significant weight loss. However, this long-term success is only maintained as long as the patient works with their physician to monitor progress and adjust the Band to fit the individual’s needs.

Slower weight loss

This procedure is different than other weight loss surgeries because it targets slow, steady weight loss over a longer period of time. Patients start their post-surgical weight loss journey with a relatively loose band that gives them the flexibility to adjust the device as needed to account for what progress is made and the patient’s reports of satiation.

Nutrient Absorption

Gastric Bypass surgery and other procedures that require rearrangement of the abdominal organs change the way the body absorbs iron, calcium and B12, which often results in a deficiency of these elements. Because the Lap-Band does not bypass any part within the digestive system, theoretically, there should not be any problem with absorption of iron, calcium or B12. However, patients must use caution because it may be that the reduction of food intake in the role of malabsorption is more important than the specific bowel anatomy. Therefore, we recommend Lap-Band patients use the same supplements as gastric bypass patients.

Lap-Band as a new technology

There is little data indicating the lifetime success of the Lap-Band system because it has only been in use since the early to mid 1990's. Additional questions about this new technology have surfaced, which are addressed below:

Weight loss results and maintenance

Early and current studies indicate the system is a successful long-term solution for weight loss and maintenance although official long-term results are not in existence. Initial comparative studies conducted in Europe and the U.S. showed results that were less notable than those of the gastric bypass procedure. But, newer studies between patients who undergo the Lap-Band procedure versus those who have Gastric Bypass reliably indicate similar final weight loss results between the two groups.

Lap-Band risks

Band erosion

There is a small percentage of patients who experience erosion of the Lap-Band into their stomach which causes the loss of the device’s restriction or infection due to stomach liquids leaking onto the Band. Erosion can occur at any time, but is most frequently experienced within the first year after surgery. Although erosion does not usually cause serious illness or an emergency, it does mean the system must be surgically removed and the patient must convert their weight loss plan.

Band slippage or shifting

For the Band to properly function, it must remain in position on the upper stomach. The stomach can be obstructed if the band moves out of place or twists, in which case it will need to be surgically repositioned.

Esophageal function

The Band works by restricting the flow of food into the stomach, which may cause the normal function of the esophagus to be disrupted, fatigued or to fail. Recent reports indicate aggressive tightening of the Band can cause these problems with normal swallowing function, also known as esophageal peristalsis. Indicators of this problem include painful swallowing, reflux or regurgitation and the system must be either deflated or removed.

Silastic reaction

The Lap-Band is made with a non-reactive material called silicone elastomer which has not been shown to react to body tissues and is used in numerous medical devices that are implanted within the body. Although it is rare, it may occur that the material can cause the patient’s immune system to react negatively, triggering problems such as arthritis or Systemic Lupus Erythematosis (SLE).

Hardware problems

The device itself and all of its components are designed to last a lifetime. If a patient experiences a problem with the hardware, which is rare, it most commonly involves the connecting tube becoming twisted or kinked. In this case, a minor surgical repair or repositioning is needed to fix the problem.

Abdominal injury during surgery

Sometimes even the most experienced surgeons can make mistake and injure the stomach, spleen, esophagus, liver or other abdominal tissues while conducting the Lap-Band procedure which requires intricate movements to place the device. In this uncommon case, if the issue can be addressed during surgery, it is solved and the Band is still placed. Although on occasion, the manner of the injury requires the intended placement of the Lap-Band to be stopped.

If you have any additional questions or concerns, you surgeon can help by providing answers more specific to your individual case.