What is a Lap-Band®?
LAP-BAND® is an adjustable gastric banding system used to facilitate gradual weight loss in morbidly obese patients. This laparoscopic obesity surgery involves the placement of a hollow doughnut-shaped tube around the upper part of the stomach, which is then filled with saline (salt water) to restrict the amount of food the stomach can hold. The name of the procedure signifies the laparoscopic techniques and gastric band used in this minimally invasive surgery.
The LAP-BAND® works in two ways: it reduces the size of the stomach to hold less food, and it limits the amount of food that can enter the stomach. This means you feel full faster, so you eat less and lose weight. This system is the only laparoscopic obesity surgery approved by the FDA and the only adjustable and reversible procedure for long-term weight loss available in the U.S. The LAP-BAND® procedure is generally considered to be the safest, least invasive, and least traumatic of all weight loss surgeries.
Patients who undergo LAP-BAND® surgery typically lose about one to two pounds a week, and lose up to 50 percent of their excess weight within the first year of surgery. It is important to maintain a healthy life after surgery in order to maximize and fully enjoy the results of the procedure. This includes a diet that is low in fat and calories, as well as regular daily exercise.
Who is a Candidate for the Lap-Band Procedure?
LAP-BAND® is designed to help morbidly obese patients gradually lose weight and control the results by restricting the size of the stomach and adhering to a healthy life. While many overweight patients can benefit from LAP-BAND® surgery, there are certain guidelines to help determine who is a good candidate for this procedure. The LAP-BAND® procedure is most effective for patients who:
- Are at least 18 years old
- Have a BMI of 40 or higher OR are at least 100 pounds overweight
- Have been overweight for at least five years
- Are committed to losing weight and making the necessary life changes
The LAP-BAND® system is not recommended for people who have disorders of the gastrointestinal tract (such as ulcers, esophagitis or Crohn’s disease), heart or lung disease, or are pregnant.
If you are considering weight loss surgery, you can discuss your options with your doctor to find out if you can benefit from this safe, effective and minimally invasive procedure.
How is the Lap-Band® Procedure Performed?
During the LAP-BAND® procedure, several tiny incisions are made in the abdominal wall to insert the surgical instruments and a camera to accurately visualize the area. There is no cutting or stapling of the stomach involved with this procedure, as there is with other bariatric procedures.
The surgeon then positions the gastric band around the stomach and fastens it with a lock to hold it in place. This procedure is performed under general anesthesia and is considered to be minimally invasive, as it requires only tiny incisions and has a short recovery time.
Adjustments can be made as needed by adding or removing saline to the convenient access port that is placed during this procedure. This process is known as inflating or deflating and can be adjusted throughout the patient’s life after the LAP-BAND® procedure.
What is the Recovery from the LAP-BAND Procedure?
After LAP-BAND® surgery, patients can return home within 24 hours. You may experience some soreness around the incision site and access port, but this usually subsides on its own within a few days. Patients are encouraged to get up and walk around as soon and as often as they feel comfortable to help recover strength and prevent blood clots. Most patients can return to work after one week, and may begin an exercise program after four to six weeks.
Patients must follow certain dietary guidelines after LAP-BAND® surgery in order to help the stomach heal and adjust to its new size. Only small amounts of clear liquid should be consumed for the first few days, before then incorporating other liquids such as clear broth or soup, skim milk or fruit juice during the next one to two weeks. Three to four weeks after surgery, patients can begin consuming pureed foods and then soft foods. Your doctor will advise you as to which foods are best to eat throughout the healing process. If you experience nausea or vomiting at any point, you should return to the liquid diet. Vomiting can stretch the new stomach pouch and should be avoided at all costs.
Your doctor may request that you come in for follow-up visits every week or every other week during the first month after LAP-BAND® surgery. Your first gastric band adjustment is usually made after six weeks, after a thorough evaluation of your pouch and stomach size, as well as your rate of weight loss.
What are the Benefits of the Lap-Band Procedure?
The LAP-BAND® can be tightened or loosened over time to let more or less food pass through and to regulate each patient’s rate of weight loss. As part of the LAP-BAND® surgery, an access port is placed under the skin in the abdomen. Saline can then be injected into or removed from the LAP-BAND® through the access port at any time in order to prevent or allow food to pass through. Adjustments can also be made to accommodate pregnancy or illness. Thus patients can optimize their weight loss over a period of months or years with no additional surgery, as well as control their weight and maintain long-lasting results.
Although it is intended to be a permanent weight loss solution, the LAP-BAND® can be removed, as it does not involve any serious alterations to intestinal organs. Removal can often be performed using the same laparoscopic techniques used to place the band. The stomach usually regains its previous shape and function afterwards. Patients who wish to remove the LAP-BAND® should be aware that they may regain some or all of the weight they have lost.
Minimal Trauma and Fewer Risks
The LAP-BAND® procedure involves no stomach cutting or stapling and no gastrointestinal rerouting, as opposed to gastric bypass surgeries such as the Roux-en-Y technique. This significantly lowers the mortality risk during surgery. LAP-BAND® patients also experience little to no risk of the nutritional deficiencies, hair loss or “dumping syndrome” associated with other weight loss surgeries. In fact, the LAP-BAND® procedure has the lowest complication and mortality rate of any weight loss surgery.
Because the LAP-BAND® procedure is minimally invasive, patients generally have:
- Smaller incisions and scars
- Shorter hospital stay
- Faster recovery
- Less post-operative pain
Are There Risks to the Lap-Band Procedure?
While the LAP-BAND® procedure is considered safer than other weight loss surgeries, there are certain risks associated with any type of surgical procedure. Some of these risks may include:
- Gastric perforation
- Hiatal hernia
- Gastroesophageal reflux
- Stomach obstruction
- Nausea and vomiting
These risks are considered rare and only occur in a very small number of patients. Patients can minimize these risks by choosing an experienced surgeon to perform their procedure and by strictly adhering to the surgeon’s instructions after the LAP-BAND® procedure.
How To Maintain Weight After Your Lap-Band Procedure
Once the post-op liquid and pureed diet has been completed, patients can begin eating regular foods once again. While the LAP-BAND® will help control how much you eat, it is important for patients to make smart choices regarding the type of food they eat. Your doctor may recommend certain foods, such as:
- Fruits and vegetables
- Whole grain breads and cereals
- Dairy products
- Low-fat proteins
Most patients lose one to two pounds a week after this procedure, which is considered a safe amount for healthy weight loss. Depending on each patient’s individual conditions, the LAP-BAND® may be adjusted to increase or decrease the rate of weight loss.
In addition to the significant weight loss achieved with the LAP-BAND®procedure, many patients also experience improvement or elimination of obesity-related conditions such as high blood pressure, type 2 diabetes, obstructive sleep apnea and more.
Long-term weight loss with LAP-BAND® is comparable to the results of other weight loss surgeries, including gastric bypass. Although gastric bypass patients may lose weight faster in the beginning, the overall percentage of weight loss is about the same after five years, while LAP-BAND® patients were able to benefit from a minimally invasive procedure.
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