Adjustable Gastric Banding
The LAP-BAND® System is an adjustable silicone gastric band designed to help you lose excess body weight, improve weight-related health conditions and enhance quality of life. It reduces the stomach capacity and restricts the amount of food that can be consumed at one time. The LAP-BAND® System procedure does not require stomach cutting and stapling or gastrointestinal re-routing to bypass normal digestion. The LAP-BAND® System is the only adjustable and reversible weight-loss surgery available in the United States and the only weight-loss surgery approved for use by the Food and Drug Administration (FDA).
The name “LAP-BAND” comes from the surgical technique used, laparoscopic, and the name of the implanted medical device, gastric band. The LAP-BAND® System is a silicone ring designed to be placed around the upper part of the stomach and filled with saline on its inner surface. This creates a new, smaller stomach pouch that can hold only a small amount of food, so the food storage area in the stomach is reduced. The band also controls the stoma (stomach outlet) between the new upper pouch and the lower part of the stomach. When the stomach is smaller, you feel full faster, while the food moves more slowly between your upper and lower stomach as it is digested. As a result, you eat less and lose weight. The success of this process, however, also depends on how motivated you are and how committed you are to your goal of long lasting weight loss.
Adjustable Weight Loss
Once placed around the stomach, tubing connects the LAP-BAND® to an access port fixed beneath the skin of your abdomen. This allows the surgeon to change the stoma (stomach outlet) size by adding or subtracting water, inside the inner balloon through the access port. This adjustment process helps determine the rate of weight loss. If the band is too loose and weight loss is inadequate, adding more saline can reduce the size of the stoma to further restrict the amount of food that can move through it. If the band is too tight, the surgeon will remove some saline to loosen the band and reduce the amount of restriction.
The diameter of the band can be modified to meet your individual needs, which can change as you lose weight. For example, pregnant patients can expand their band to accommodate a growing fetus, while patients who aren’t experiencing significant weight loss can have their bands tightened.
The Roux-en-Y gastric bypass is the most frequently performed weight loss procedures in the United States. In this procedure, the surgeon creates a small stomach pouch, about the size of a large egg. The pouch is created by dividing the small intestine just beyond the first 50cm of small intestine, also called the duodenum, for the purpose of pulling it up and attaching it with the newly formed stomach pouch. The other end of the small intestine is connected into the side of the Roux limb (the portion of the small intestine attached to the new small stomach) creating the “Y” shape that gives the technique its name.
The Sleeve Gastrectomy generates weight loss by restricting the amount of food that can be eaten without any bypass of the intestines or malabsorption of food because the continuity of the stomach remains intact. In addition to avoiding foreign bodies such as the lap band, the other advantage over other procedures is that the excess stomach volume is removed. This helps patients control their hunger.
How it Works
The procedure generates weight loss solely through gastric restriction, or reduced stomach volume. The stomach is restricted by dividing it vertically and removing more than 85%. This part of the procedure is not reversible. The remaining stomach is shaped like a banana and measures from two to five ounces, depending on the surgeon performing the procedure. The nerves to the stomach and the outlet valve (pylorus) remain intact to preserve the functions of the stomach while reducing the volume. By comparison, in a Roux-en-Y gastric bypass, the stomach is divided, not removed, and the pylorus is excluded. The Roux-en-Y gastric bypass stomach can be reconnected (reversed) if necessary.
Revision Weight Loss Surgery
Revision Weight Loss Surgery is a surgical procedure that is performed on patients who have already undergone a previous bariatric surgery, and have either had complications from such surgery or have not successfully achieved significant weight loss results from the initial surgery. Even the most successful operations may require a revision from time to time. Obesity is a chronic disease and not easily treated. As with any serious health condition, if the first treatment is not effective, then the doctor will recommend additional treatment options. With weight loss surgery, a revision surgery may be necessary as an additional treatment for obesity.