Gastric Band
LAP-Band Surgery
What is Laparoscopic Gastric Band (LAGB) surgery?
LAGB is a device manufactured in many different forms, but all have a similar underlying design. A gastric band is a silicone ring with a balloon similar to a tyre tube running around the inside of it. This inflatable area is connected by hollow tubing to a port (a disc a little larger than a 10-cent piece) which sits under the skin of the abdomen. When fluid is put into the port, it inflates the balloon, reducing the space for food to pass into your stomach.
How the gastric band causes weight loss
A gastric band will slow you down when you eat (so it may take 20 minutes to have half a sandwich) and will suppress your appetite so you can stop eating after a small amount of food. The band itself does not make you lose weight – meal planning and conscious portion reduction are needed. The gastric band doesn’t force you to stop eating; a common mistake is for people to eat even when they are no longer hungry.
When you eat, food moves slowly into the stomach and food sitting above the gastric band stretches some of the nerves that help reduce your hunger. The amount of stomach above the band is about the size of a thumbnail. You will be consuming about 600-800 calories per day when losing weight and 1000-1200 calories per day when keeping your weight stable.
If people rely on the feeling of restriction or fullness too much, however, they end up stretching their oesophagus and stomach, which will lead to reflux and band removal. A gastric band itself does not make the patient lose weight, following a healthy diet and making lifestyle changes do.
Am I a candidate for a gastric band?
In general, weight loss surgery is a good option for people who:
- are very overweight
- have medical or other problems caused by their weight
- have tried for several years to lose weight with other methods
- are prepared to go ahead with the follow-up after surgery.
Essentially, the risks of weight loss surgery need to be balanced against the risks of not having surgery. There are many different surgical options available, and it would be foolish to suggest that one solution will suit everyone. It is essential to know about the other options as well to help you make a more balanced decision.
Advantages of the gastric band
- The gastric band is probably the safest effective procedure developed to allow long-term weight loss. Other operations, although also performed by keyhole surgery, are larger and therefore riskier.
- The band will cause scarring around your upper stomach but otherwise does not change the way your insides are put together.
- A gastric band is easier to remove than prosthetics used in other operations. However, removal of the band invariably leads to weight regain.
- The hospital stay and time off work are less than for other weight reduction operations.
Drawbacks of the gastric band
- The gastric band requires quite significant long-term compliance to achieve and maintain weight loss. This requires a degree of retraining, and if you are not able to retrain you will not lose weight. About 10-20% of people find that they are not able to use the band effectively early on, and by 10 years 30-50% have required band removal or revision.
- There will be some foods you will not be able to eat after the operation. These vary from person to person but typically include white bread, chicken, many red meats, and fibrous fruit and vegetables.
- The gastric band is a mechanical device, and like all mechanical devices it can ‘break’. Although the majority of mechanical problems can be fixed, this does mean having another operation. If the band problem is not fixed, about 95% of people will put their weight back on.
Gastric band combined with an
imbrication/plication of the stomach
After placing a gastric band, it is possible to place extra sutures in the stomach to reduce its volume from over 1.2 litres to about 350-400 cc. This is a larger and riskier operation than a normal gastric band, however, it creates a procedure that sits halfway between a gastric sleeve and a band. The band does not need to be as tight, as the stomach below it is small rather than normal-sized.
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Laparoscopic Gastric Band
information booklet
