The LAP-BAND ® Surgery system is the most commonly used band in the country. The procedure is done laparoscopically (through little holes, “laser surgery”) under general anesthesia and it usually takes less than an hour to perform. Most of the times, patients go home the same day after surgery. Sometimes the patient may have to stay in the hospital overnight. The pre-operative workup is identical to the work-up done for the laparoscopic gastric bypass procedure.

It involves implanting a device around your stomach that is connected with a thin tube to a reservoir or “port” that is placed under the skin. The device around your stomach is inflatable and adjustable and we call it the band. The Band is adjusted once a month and the first adjustment is done 4 to 6 weeks after surgery. The adjustment can be done in the office without x-rays or in the hospital under x-ray guidance. It involves accessing the reservoir with a needle and injecting fluid to inflate the band.

The fluid can also be withdrawn to deflate the band. Without adjustments no weight loss can be achieved. It takes an average of 5 to 6 adjustments before you can start to lose weight in a steady fashion. The goal is for you to lose 1-2 pounds per week. Weight loss is much slower than with the gastric bypass and it usually takes between two to three years to achieve the results seen with the Roux Y Gastric Bypass. The Lap Band ® is a restrictive procedure. It makes you lose weight by restricting or limiting the amount of solid food that you can eat. It does not restrict liquid calories. Therefore some specialists do not recommend it for “sweet eaters”, people who like sweet high calorie containing liquids or dissolvable foods.

Advantages of the procedure are that it is fully reversible and that the stomach returns to normal after the band is removed. There is no cutting or stapling of the stomach with no possibility of leaks. The hospital stay is short and recovery is quick. Most people are back to work the same week of surgery. There are no malabsorption issues because there is no re-routing (bypass) of the intestines but multivitamins are still recommended to be taken daily. Life threatening complications are less common than the Gastric Bypass and the mortality rate is only 1 in 2000 versus 1 in 200 for the Gastric Bypass.

With the lap band the rate of re-operation is higher than the gastric bypass. Complications include obstruction if the band is adjusted too tight which can be solved by deflating the band. Slippage is when the band slides up or down and it can no longer be adjusted and the restrictive effect is lost. It is solved by removing the band. Erosion of the wall of the stomach has also been described but it is very rare. There can be problems with the port or the tubing system. They can break or they can get infected requiring replacement.

Advantages

• Fully reversible, stomach returns to normal if the band is removed
• No cutting or stapling of the stomach
• Short hospital stay
• Quick recovery
• Adjustable without additional surgery
• No malabsorption issues (because no intestines are bypassed)
• Fewer life threatening complications
• Laparoscopic
• Outpatient or Overnight stay
• Less than one hour procedure
• 1st adjustment after 6 weeks
• 4-5 adjustments are needed on average
• Weight loss is 1-2 lbs/week

• Involves placing device
• Risk of re-operation
• Slippage
• Obstruction
• Erosion
• Need for monthly follow-up
• Does not restrict intake of liquid or dissolvable food