Lap Band*

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How the Lap Band Operation Works*

The Lap Band operation works by restricting the amount of food that can be eaten at a single meal, while also producing a feeling of fullness that lasts in between meals.* The band is a silastic cuff that fits around the upper stomach producing a small upper gastric pouch. Like the Gastric Bypass the upper pouch varies somewhere between 15 and 30 ccs in size. Once the band it tightened it will only hold a few ounces of solid food at a meal. Food filling and distending the small upper gastric pouch produces a sensation of being full.*

In actuality, the Lap Band does not control the size of the upper gastric pouch – the pouch size is fixed. The Lap Band only controls the rate of emptying of that pouch. By  restricting the passage of food out of the pouch the LapBand prolongs the feeling of fullness. This is called INTRAMEAL SATIETY and is the key to making the Lap Band surgery effective.*

Of course, the other variable that has an impact on function of the Lap Band is the consistency of the food that fills the pouch. SOLID food achieves the best result because it effectively fills the pouch and slowly passes on to the distal stomach. Soft foods and liquids are less likely to achieve a good effect because they empty from the pouch quickly and cannot produce prolonged satiety.

A guideline for effective eating with the Lap Band would include the following:

  1. Meals should consist of solid food, preferably both low in fat and sugars.
  2. Food should be eaten slowly, with attention to the impending feeling of fullness so as not to overstuff the pouch.
  3. Liquids with calories such as juice, whole milk and soups should be avoided. They contain concentrated calories and do not distend the pouch or produce a feeling of fullness. The Lap Band does not work with liquid calories.
  4. Liquids should be low calorie or no calorie.
  5. Liquids should be consumed prior to eating any solid food and not taken again for an hour after the meal.

Laparoscopic Adjustable Gastric Banding (LapBand)

Fact Sheet

Main Features

Laparoscopic surgery – not open
Several (5) small scars
Less pain than open surgery
Quick recovery

  • Immediate activities of daily living
  • Return to work 7-10 days
  • No lifting > 20 lbs or strenuous activity 3 weeks

Place a plastic cuff around the upper stomach to create a small pouch of proximal stomach above a channel that can be narrowed (or widened) by adjusting the cuff.

Who is a Candidate?

BMI 35-40 with comorbidities

  • Diabetes
  • High blood pressure
  • High cholesterol or triglycerides
  • Obstructive sleep apnea
  • Family history of heart disease or stroke

BMI > 40 with or without comorbidities
BMI 30-35 if favorable surgical candidates and acknowledge that he/she does not meet the 1991 NIH criteria for weight loss surgery and that the benefit to risk ratio is unknown

Contraindications

Deformity or pathology of the esophagus or stomach – e.g. esophageal stricture
Previous Bariatric Surgery – e.g. gastric sleeve
Previous gastric surgery – e.g. Nissen fundoplication

Downside

Cumulative long-term risk with late problems requiring explantation > 25%
Variable weight loss – unpredictable outcome
Loss of therapeutic window over time
Weight regain is common
Requires needle adjustments in the office

  • Sometimes adjustments are difficult or require fluoroscopy
  • Measurements very inconsistent
  • Over adjustment requiring early unfill

Diet after procedure

Low sugar clear liquids 4 hours -7 days
Low sugar low fat soft diet 7-21 days
Low sugar low fat high protein diet after 21 days

Is it reversible?

Reversible but scaring and proximal gastric deformity can occur
Revision to other procedure is possible – gastric sleeve, gastric bypass

Risks

Lowest peri-operative risk of any laparoscopic procedure

  • Bleeding very rare
  • Leak with peritonitis (re-operation) very rare

Eventual Explantation > 25%

  • Cuff Prolapse
  • Cuff erosion
  • Esophageal dilation

Band system leak – requires reoperation to repair or replace

Exercise

Patients start an exercise program before LAGB
Interruption approx. 3 weeks by procedure

Procedure

General Anesthesia in Operating Room
20-30 min
Outpatient: recovery with same day discharge

What to Expect

Eat low calorie density solid food – create full feeling*
Eat less*
Weight loss *

* Results will vary by person and are based upon the patient, the surgery type and the compliance with the aftercare program. As with any medical procedure or surgery, there are specific risks and possible complications. The testimonials, statements, and opinions presented on our website are applicable to the individuals depicted. Results may not be representative of the experience of others. Testimonials are voluntarily provided and are not paid, nor were they provided with free products, services, or any benefits in exchange for said statements. The testimonials are representative of patient experience but the exact number of pounds lost and experience will be unique and individual to each patient.

Contact Us

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