Lap Band Surgery: Complete Guide of Gastric Banding

Introduction to Lap-Band

Lap Band, commonly known as Gastric Banding or Adjustable Gastric banding, is a very popular weight-loss surgery. With hundreds of thousands of people already “banded”, gastric banding is the most well-known weight-loss procedure.

What is Gastric Banding?

Gastric Banding Surgery is the most common form of bariatric procedure that utilizes a band that wraps the upper portion of the stomach to reduce the amount of food that you consume. This is a restrictive type of bariatric procedure that restricts food intake, thus helping the patient consume less food.

The adjustable part comes in when patients can adjust the band that affects the amount of restriction that is necessary. The physician usually changes the band based on your current weight loss, food cravings, and other physical reactions.

Gastric Banding uses a proprietary device that restricts the stomach; the two FDA approved “bands,” or implants are the: Lap-Band system and the Realize Band. The Lap-Band system is the most popular, with over 550,000 people undergoing it and over 100,000 people undergoing the Realize procedure.

What is the Lap-Band?

The LAP-BAND is a specific type of gastric band, which places a Lap-Band device around the upper portion of the stomach, physicians can adjust the tightness around the stomach, thereby effectively managing weight-loss.

Who is a Candidate?

Unlike RNY gastric bypass and sleeve gastrectomy which typically require high BMIs, Mexico Lap-Band is least invasive and provides a short-term to mid-term tool for weight loss. Patients with body mass indexes of over 40 are good candidates, but patients with as low as 30 BMIs can also be a candidate.

Based on the manufacturer’s website, the Lap-Band system is acceptable for patients with between 30 and 40 BMIs if they have a co-morbidity such as hypertension, diabetes, or high cholesterol. Realize Band is approved for patients who have BMIs of 35 to 45 and also with a co-morbidity.

The LAP-BAND System may be right for you if:

• You are an adult (at least 18 years old).
• Your BMI is 40 or higher or you weigh at least twice your ideal weight or you weigh at least 100 pounds (45 kilos) more than your ideal weight.
• You have been overweight for more than 5 years.
• Your serious attempts to lose weight have had only short-term success.
• You do not have any other disease that may have caused you to be overweight.
• You are prepared to make major changes in your eating habits and lifestyle.
• You are willing to continue working with the specialist who is treating you.
• You do not drink alcohol in excess.

If your BMI is less than 40, this may not be right for you. On the other hand, your surgeon may consider it if you have health problems that are related to obesity. Your surgeon may also have other criteria he or she uses. Ask him or her to discuss the criteria with you. See also the LAP-BAND Contraindications.

How Does Gastric Banding Operation Work?

Before your surgery, you should talk about the procedure in detail with your surgeon. Your doctor may also want you to meet with other experts. They can help you understand what will happen during and after the operation. These experts might include the process.

This will create a small stomach pouch. Part of the lower stomach will then be sutured to the band. The rest of the lower stomach will stay in its usual position. The reservoir for adjusting the band will be placed on your skin. To do this, the surgeon will slightly enlarge one of the incisions that he or she made for the laparoscopic tubes.

• A dietitian
• A physiotherapist
• A psychologist
• Other specialists

Preparing for the Surgery

Some examinations have to be carried out before a patient can undergo surgery, The patient also needs to visit a dietitian, he or she may give them a food diary to obtain a comprehensive picture. The aim is that the patient should keep a detailed diary of what he or she eats for a week.

After the operation, the patient may find it less comfortable to breathe deeply, and it may be painful to cough up mucus. So before the operation, the physiotherapist gives the patient instructions on the correct way to breathe and cough, so that postoperative treatment can be carried out efficiently and well.” (LAP-BAND System surgeon)

Gastric Banding Recovery

Once the anesthesia has worn off, you may feel some pain. This pain can usually be relieved with ordinary painkillers. The hospital staff will help you get out of bed and start moving as soon as possible. This will help prevent blood clots, respiratory problems, and bedsores.

On the day after the surgery, you will likely be given an X-ray. This is so your health team can see that the Lap-Band is in the right place. It is also to see that the new stomach outlet is open. You may be asked to swallow a liquid that can be seen on an X-ray.

After the laparoscopic process, you will stay in the hospital for 1 to 3 days. The hospital stay may be long after the open procedure or if there are complications. If there are no complications, you should be able to resume normal activities within a week or two.

Overall, this is the safest bariatric surgery today. It’s the most common procedure in the world and is offered in many different countries. Most notably, the United States, India, and Mexico.

Cost of Gastric Banding (Lap-Band)

The average cost of gastric banding depends on where you have the surgery, hospital, and surgeons. The cost can range from $5,500 to $20,000. When people choose to have this abroad they can save themselves thousands (Mexico Bariatric Surgery costs about 1/5 to 1/3 the cost of the United States).

Costs can decrease with Medical Tourism, one study found that bariatric procedures in Mexico saved patients 70%, from what they would have spent in the U.S.

Lap-Band Side Effects and Complications:

Patients can experience complications after surgery. Most complications are not serious but some may require hospitalization and/or re-operation. Adverse events that were considered to be non-serious, and which occurred in less than 1% of the patients, included:

• Esophagitis (inflammation of the esophagus)
• Gastritis (inflammation of the stomach)
• Hiatal hernia (some stomach above the diaphragm)
• Pancreatitis (inflammation of the pancreas)
• Abdominal pain
• Hernia,
• Incisional hernia
• Infection
• Redundant skin
• Dehydration
• Diarrhea (frequent semi-solid bowel movements)
• Abnormal stools
• Constipation
• Flatulence (gas)
• Dyspepsia (upset stomach)
• Eructation (belching)
• Cardiospasm (an obstruction of the passage of food through the bottom of the esophagus)
• Hematemesis (vomiting of blood)
• Asthenia (fatigue)
• Fever
• Chest pain
• Incision pain
• Contact dermatitis (rash)
• Abnormal healing
• Edema (swelling)
• Paresthesia (abnormal sensation of burning, prickly, or tingling)
• Dysmenorrhea (difficult periods)
• Hypochromic anemia (low oxygen-carrying part of the blood)
• Band system leak, cholecystitis (gall stones)
• Esophageal ulcer (sore)
• Port displacement
• Port site pain
• Spleen injury
• Wound infection

Be sure to ask your surgeon about these possible complications and any of these medical terms that you don’t understand.

Lap Band Surgery Risks

One of the benefits of choosing gastric banding verse another procedure is because risks and complications are a lot lower. There is also the fact that since this surgery has been around a lot longer than the gastric sleeve, there are more known problems. Surgeons know what to expect 5, 10, or 15 years post-surgery.

Lap-Band comes with many risks and possible complications, but so does any serious operation. One of the benefits is that since it’s less invasive than other bariatric surgeries, it holds fewer risks than, for example, gastric bypass. But that still doesn’t mean there are no risks.

There is always the likelihood of death during or after gastric banding – as with all surgeries – but it occurs once about every 2,000 surgeries.

Specific risks from the implant itself include eroding implant, the implant can deflate, the band can make the stomach blocked, and more. There is also infection risks with Lap-Band, as well as bleeding.

Side effects can include vomiting, nausea, and diarrhea. Your bariatric physician will tell you all the possible risks, and complications that can occur – it’s important to ask a lot of questions with your doctor before doing the procedure.

Using the LAP-BAND System induces the same risks that come with all major surgeries. There are also added risks in any operation for patients who are seriously overweight.

Important

You should know that death is one of the risks. It can occur any time during the operation. It can also occur as a result of the operation. Death can occur despite all the precautions that are taken. There is a risk of gastric perforation (a tear in the stomach wall) during or after the procedure that might lead to the need for another surgery.

In the U.S. clinical study, this happened in 1% of the patients. There were no deaths during or immediately after surgery in the U.S. study. Your age can increase your risk. So can excess weight. Certain diseases, whether they were caused by obesity or not, can increase your risk from surgery.

There are also risks that come with the medications and the methods used in the surgical procedure. You also have risks that come from how your body responds to any foreign object implanted in it.

Published results from past surgeries, however, do show that LAP-BAND System may have fewer risks than other surgical treatments for obesity.

Why Bariatric Surgery is an Investment in Your Future

Having LAP-BAND will change your life for the better. Though it’s one where you should consult a trained physician before deciding the risks and complications. This procedure provides people a way of losing weight and handling obesity.

While the cost of the surgery is an important factor, it shouldn’t be paramount. If you’re an ideal candidate for this process, then there are more pressing issues to consider. If you are significantly overweight there are health issues that may increase your chance of getting or developing a serious disease or condition.

FAQs on Gastric Banding

Q: Will I be sick a lot after the operation?

A: The LAP-BAND System limits food intake. If you feel nauseous or sick on a regular basis, it may mean you are not chewing your food well. It could also mean you are not following the diet rules properly. Another reason you would feel sick maybe that there is a problem with the placement of the band. So you should contact your doctor. Vomiting should be avoided as much as possible. It can cause the small stomach pouch to stretch. It can also lead to slippage of part of the stomach through the band. That would reduce the success of the operation. In some cases, it would also require another operation.

Q: Will I suffer from constipation?

A: There may be some reduction in the volume of your stools. That’s normal after a decrease in food intake because you eat less fiber. This should not cause severe problems. If difficulties do arise, check with your doctor. He or she may suggest you take a mild laxative and drink plenty of water for a while. Drinking plenty of water is a good idea, anyway. Your needs will vary, but you should drink at least 6-8 glasses of water a day.

Q: Will I need to take vitamin supplements?

A: You may. It’s possible you may not get enough vitamins from three small meals a day. At your regular check-ups, your specialist will evaluate whether you are getting enough vitamin B12, folic acid, and iron. Your surgeon may advise you to take supplements.

Q: What about other medications?

A: You should be able to take prescribed medication. You may need to use capsules or break big tablets in half or dissolve them in water so they do not get stuck in the stoma and make you sick. You should always ask the doctor who prescribes the drugs about this. Your surgeon may tell you to avoid taking aspirin or other non-steroidal anti-inflammatory pain relievers. That’s because they may irritate the stomach. The problems these drugs may cause could mean the band would need to be removed.

Q: What about pregnancy?

A: Becoming pregnant can be easier as you lose weight. Your menstrual cycle may become more regular. If you need to eat more while you are pregnant, the band can be loosened. After the pregnancy, the band may be made tighter again. Then you can go back to losing weight.

Q: Can the band be removed?

A: Although the LAP-BAND System is not meant to be removed, it can be. In some cases, this can be done laparoscopically. Surgeons report that the stomach generally returns to its original shape once the band is removed. After the removal, though, you may soon go back up to your original weight. You may also gain more.

Q: What if I go out to eat?

A: Order only a small amount of food, such as an appetizer. Eat slowly. Finish at the same time as your table companions. You might want to let your host or hostess know in advance that you cannot eat very much.

Q: What about alcohol?

A: Alcohol has a high number of calories. It also breaks down vitamins. An occasional glass of wine or other alcoholic beverages, though, is not considered harmful to weight loss.

Q: Will I need plastic surgery for the surplus skin when I have lost a lot of weight?

A: That is not always the case. As a rule, plastic surgery will not be considered for at least a year or two after the operation. Sometimes the skin will mold itself around the new body tissue. You should give the skin the time it needs to adjust before you decide to have more surgery.

Q: What will happen if I become ill?

A: One of the major advantages of the LAP-BAND System is that it can be adjusted. If your illness requires you to eat more, the band can be loosened. This can be done by removing saline from it. When you have recovered from your illness and want to lose weight again, the band can be tightened. This can be done by increasing the amount of saline. If the band cannot be loosened enough, it may have to be removed.

Q: How is the band adjusted?

A: Adjustments are often carried out in the X-ray department. They are done there so the reservoir can be clearly seen. When X-rays are used, your reproductive organs should be shielded. Sometimes adjustments can be done in an outpatient clinic or office. Local anesthesia may or may not be needed. A fine needle is passed through the skin into the reservoir to add or subtract saline. This process most often takes only a few minutes. Most patients say it is nearly painless.

Q: How much weight will I lose?

A: The amount of weight you may lose depends on several things. The band needs to be in the right position. And you need to be committed to your new lifestyle and eating habits. In the U.S. clinical trial, 2% of patients gained some weight. 5% neither gained nor lost weight (t5%). 61% of the patients lost at least 25% of their excess weight. 52% of the patients lost at least 33% of their excess weight. 22% lost at least 50% of their excess weight, and 10% lost at least 75% of their excess weight.

You should lose weight gradually. Losing weight too fast creates a health risk and can lead to a number of problems. Nausea and vomiting are only the most minor examples. A weight loss of 2 to 3 pounds a week in the first year after the operation is possible, but one pound a week is more likely. Twelve to 18 months after the operation, weekly weight loss is usually less. Remember that your main goal is to have a weight loss that prevents, improves, or resolves health problems connected with severe obesity.