The escalating concern about obesity prompts a search for effective solutions. Defined by a body mass index (BMI) exceeding 30 kg/m2, obesity invites exploration beyond lifestyle changes. Laparoscopic adjustable gastric banding (LAGB), commonly known as lap band surgery, emerges as a surgical option for weight management. This article delves into the specifics of LAGB, shedding light on its procedure, candidates, preparation, recovery, and associated lifestyle changes.
What is Lap Band Surgery (LAGB)?
LAGB involves the placement of an adjustable silicone belt around the upper stomach through a laparoscope. This band, commonly known as the LAP BAND®, can be tightened by adding saline, restricting stomach size and slowing food passage to the intestine. The resulting signals to the brain induce a sensation of fullness and satiety with less food consumption.
The LAP BAND® and Alternatives
The LAP BAND® by Allergan Inc. is a well-known brand, yet other options include the REALIZE® adjustable gastric band (Ethicon), MIDBAND®, and Heliogast® gastric band (not available in the US).
Candidates for Lap Band Surgery (LAGB)
Generally recommended for those with a BMI over 40 kg/m2, or between 35-40 kg/m2 with weight-related medical conditions, LAGB is not advised for individuals under 18 years old. Candidates must demonstrate an understanding of the procedure and commit to necessary lifestyle changes. Contraindications may include difficulties understanding the procedure, emotional instability, substance dependence, gastrointestinal issues, or high surgical risk due to medical conditions.
Lap Band Surgery (LAGB) Procedure Details
Conducted under general anesthesia, LAGB is a laparoscopic procedure taking 1 to 2 hours. The surgeon places the band and port through small incisions, allowing for quicker recovery compared to gastric bypass procedures.
Preparation
Preoperative preparation varies, with some programs emphasizing commitment to lifestyle changes beforehand. Suggestions may include dietary adjustments and risk reduction for individuals with a BMI over 50.
Recovery
Recovery times differ, but in general, LAGB offers a shorter hospitalization and quicker return to normal activities compared to other procedures.
Lap Band Fills
Post-surgery, adjustments, known as “fills,” involve injecting saline into the port connected to the band. These are performed to enhance weight loss or address side effects.
Lifestyle Changes
Immediate post-surgery involves discomfort, but after 6-8 weeks, normal activities can resume. Weight loss is gradual, with regular follow-ups for potential band adjustments.
Side Effects of Lap Band Surgery (LAGB)
Common side effects include nausea, vomiting, indigestion, weight regain, and constipation. Nutrient deficiencies are rare due to the surgery’s restrictive nature.
Risks and Complications
LAGB has a low risk of surgical complications, with a mortality rate of approximately 1 in 2000. Possible complications include band slipping, erosion, mechanical malfunction, infection, bleeding, and abdominal pain.
Choosing a Surgeon
Selecting a qualified bariatric surgeon, preferably one performing 100 or more procedures annually, ensures better outcomes. An experienced surgeon as part of a comprehensive clinical team provides essential counseling and support throughout the pre- and postoperative phases.
References
- Dixon JB., O’Brien PE. Changes in comorbidities and improvements in quality of life after LAP-BAND placement. The American Journal of Surgery, December 2002; Vol 184: pp S51-S54.
- Favretti F., Ashton D., Busetto L., Segato G., De Luca M. The Gastric Band: First-Choice Procedure for Obesity Surgery. World Journal of Surgery, October 2009; Vol 33(10): pp 2039-48.
- Ren CJ., Horgan S., Ponce J. US experience with the LAP-BAND system. The American Journal of Surgery. December 2002; 184(6B): pp 46S-50S.