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LAP-BAND® System
This is the simplest and the least invasive of all of the bariatric procedures.
It works by imposing portion size restrictions on the patient by placing an adjustable
band, like a belt, around the top part of the stomach. The tightness of the band
is adjusted by injecting saline water into a reservoir placed under the skin under
the left rib cage.
This procedure is viewed as the most “patient friendly” approach as our patients
can determine how fast or how much weight they desire to lose on an on-going basis.
During conditions where our patient would need to eat more (for example, during
a pregnancy, or after an unforeseeable surgical procedure or illness) the band can
be deflated and the restriction for food intake can be suspended.
The Installation Procedure:
 
The Lap-Band procedure is performed under general anesthesia where 5 small incisions
are made in the upper abdomen above the umbilicus. The largest one is about 1 inch
wide for the placement of the port. Sutures are placed around the band to secure
it to the stomach to prevent slippage.
This minimally invasive procedure takes about one hour to perform, and most patients
are ready to go home the same day or within 24 hours after admission. They are offered
clear fluids for oral consumption after surgery and are encouraged to walk the same
day as tolerated. Pain medications are given intravenously or orally and most patients
usually recover after a few days to 2 weeks and can return to work.
The One Month Post-Surgery Inflation Procedure:
The band is not filled until 1 month after surgery. Adjustments are performed in
our offices, where the skin is cleansed and a local anesthetic is administered.
A special needle is inserted through the port and saline water is injected into
the reservoir. We ask our patients to drink small amounts of water after each adjustment
to make sure that the reservoir is not filled too tightly. Occasionally, if the
port is difficult to locate, an ultrasound or X-ray may be needed to aid in locating
the port.
Our patients are asked to return monthly for adjustments until they have achieved
the tightness that they feel comfortable with or have achieved their desired weight
loss. After some weight has been lost, the band will loosen, so it will need to
be tightened again.
Advantages & Disadvantages:
With this procedure, since food will pass through the natural route, and the Lap-Band
will not interfere with the natural absorption of nutrients and vitamins from food,
blood tests are performed less frequently and vitamin supplements are not as important
and not mandatory. However, multi-vitamin and fish oil supplements are still recommended
to enjoy a healthier life.
Generally, the Lap-Band procedure will require the most post-surgery follow-up relative
to the other bariatric procedures.
Potential Complications from the Lap-Band Procedure can include:
• Port and tubing related problems: Leaks, flips, kinks, and infections.
These problems are usually corrected under local anesthetic and on an outpatient
basis.
• Band related problems: Slippage, leaks, erosion, reflux and infections.
Slippage means that the portion of the stomach below the band slides upwards into
the band and enlarges the top part of the stomach or the “pouch”. This slow and
gradual process can cause a blockage where the patient will experience food and
liquid intolerance. This can be corrected laparoscopically by moving the band higher
and re-suturing the stomach around the band.
The occurrence of slippage in our practice is currently about 2.2%.
Other Complications:
Other clinics have reported erosions and infections in their practices, but we have
not seen these issues in our practice after performing over 650 Lap-Band procedures.
Band intolerance, including reflux and pains, can also occur, and may require removal
of the band.
Corrections:
In our study of 600 patients, approximately 13% of our patients required surgical
intervention. More than half of these corrections were performed under local anesthesia,
and the remainder were performed under general anesthesia.
Lifestyle Choices:
Although this procedure usually produces satisfactory results, unsatisfactory weight
loss is still a possible outcome when patients choose to regularly eat inappropriate
foods, continually take in too many calories on a daily basis, and restrict their
lifestyles to an inadequate level of physical activities.
The Lap-Band procedure is not a miracle cure -- it does require some level of patient
cooperation for a successful outcome.
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Related Links:
www.BariatricEdge.com
www.ObesityHelp.com
www.LapBand.com
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