Formally called Laparoscopic Adjustable Gastric Banding

Lap-Band Brochure in Adobe PDF format

Description - The LAP-BAND® has been used in the European community, Australia, and Mexico since 1993. It was approved for use in the United States by the FDA in June of 2001. Dr. Deol began performing the Lap-Band procedure in August of 2001. The LAP-BAND® is a flexible silicone band (much like a belt buckle) placed around the top part of the stomach. The inner surface of the band is lined with an inflatable balloon that is connected to a reservoir by tubing. The balloon can be filled with water by injecting the reservoir to make the band tighter around the stomach. LAP-BAND® is available in three different sizes.

The band works primarily by taking away your hunger. Secondarily, the Lap-Band works by decreasing the amount of food you can eat at one time. The adjustability of the band allows the surgeon some level of control over your weight loss. The amount of stomach above the band can hold approximately 15 to 30ml. The Lap-Band is the least invasive, only adjustable, and completely reversible form of bariatric surgery.

To view a movie of the band adjustment procedure click here

Risks - Following are some, but not all, of the things that may occur during or after surgery. Precautions are taken to prevent these things; however, despite preventive measures, these things will occur in a certain percentage of patients undergoing this procedure. An approximate percentage is listed after the complication.

1. Gastric Perforation- (0% to 0.4%) Rarely, during placement of the band, a small hole may develop in the stomach. Occasionally, this may lead to severe infection, or even death.

2. Band Erosion- ( 1.9% to 2.2%) Over time, some bands may wear into the wall of the stomach. Patients may notice increased hunger, ability to eat larger meals, and weight re-gain. This can be diagnosed, and sometimes treated, with EGD. Treatment may involve removal of the band.

3. Band Slippage- (8% to 10%) In some cases, the larger part of the stomach below the band may slip up through the band. You may have pain and vomiting after taking in food or drinks. Treatment of this condition may require an operation to reposition the band. Many times, this can be done laparoscopically.

4. Pulmonary Embolus - (less than 0.5%) This potentially fatal complication occurs when a blood clot, usually from the leg, travels to the lung. It may cause severe chest pain and shortness of breath. Treatment may involve hospitalization with intravenous blood thinners. Eventually, you may be sent home with blood thinner pills that are taken for up to six months.

5. DVT - (0% to 1.6% ) Deep venous thrombosis is the condition where a blood clot forms in a large vein in the body (usually in the leg). It may cause leg pain and swelling. Treatment may involve hospitalization with intravenous blood thinners. Eventually, you may be sent home with blood thinner pills that are taken for up to three months.

6. Heart Attack- (The percentage of heart attacks is dependant on patient's pre-existing heart condition) This may occur due to the stresses placed on the heart by anesthesia and surgery. You may also have some degree on heart disease secondary to your obesity. This would give an additional risk of heart attack. Heart tests are done before surgery; however, these may not identify all cases of heart disease.

7. Abdominal Hernia - (4% to 20%) The abdominal wall will be naturally weaker at the site of a prior incision. Hernias may develop at these points of weakness. These usually require an operation to be repaired. Some may be repaired with the laparoscopic technique; however, some may require a larger incision.

8. Lung Failure- Several things may lead to lung failure. you may develop pneumonia . you is given instructions on lung exercises to help prevent this. Infection in the abdomen can travel to the lung and lead to lung failure. If lung failure develops, you may be placed back on the breathing machine in order to help treat this. Rarely, lung failure can lead to death

9. Death- ( 0% to 0.3% ) The most serious complication. The potential for death exists with any surgery. Causes can be anything from anesthesia to one of the above listed complications.

Side Effects -

1. Vomiting- This will occur if food is eaten too quickly, food is not well chewed, or too much food is eaten.

2. Port Migration- In some cases, the reservoir port used to fill the band may change position making it difficult to access. This may be fixed with an outpatient surgical procedure.

3. Catheter Disconnection- In some cases, the catheter (tubing connecting the band to the reservoir port) may become disconnected. These also may usually be repaired with an outpatient surgical procedure.

Weight Loss - you may expect to loose approximately 50% to 70% of your excess body weight over 2 to 3 years. This weight loss will be more rapid over the first month and then will have periods of slowing. you may then notice that they are able to eat more and their excessive hunger has returned. At this point, you will return for a band adjustment. This is done in a radiology suite or GI lab. A small amount of water is placed into the band (sometimes with the help of X-ray). This will make the band tighter around the stomach. If you would like to view an animation of this procedure please click here .

Everyone will have to have their band adjusted. Your first adjustment will be around 4 weeks after surgery. You can come in as often as you need to have your band adjusted. It is important not to feel like “you have failed” if you need your band tightened. Imagine having a suit made at a tailor. You bring the fabric and then go for many fittings before the suit fits perfectly. The band is similar. It does not fit everyone the same way and needs to be adjusted for some more than others. As you loose weight, the belt around your waist will get looser; and, the Lap-Band around your stomach will get looser. Your stomach will actually get thinner. This is why you will need to return every so often for a band adjustment. Just ask yourself the following questions: Are you still hungry after half a cup of food? Are you hungry between meals? Are you hungry more than 2 or 3 times a day? If the answer is yes, you probably need another band adjustment. Never try to “test” the LAP-BAND® to see if you can eat more.

The purpose of the band is to take away your hunger , not to physically restrict your intake by causing you to regurgitate if you eat too much. Stop eating when you are no longer hungry, not when you are full. The key to successful permanent weight loss is learning to eat out of hunger only . If you find that you are eating out of stress or boredom, please contact the psychologist to discuss stress management techniques or diversion therapy to help you cope with these issues before scheduling another adjustment. 

It is important to understand the concept of the “Weight Loss Triangle": .

Advantages - This type of surgery does not require cutting and reconnecting the intestine. In this regard, the risks of surgery are less than for the bypass. It does not cause malabsorption of nutrients; you simply eat less. It is adjustable, allowing the surgeon some control over the weight loss after the day of surgery. This may be important for people who become pregnant or develop a medical condition (such as cancer) who need to maximize their nutrition. In the extreme case, the band can even be removed.