Lap-Band, Providing an Adjustable Weight-Loss Option

Those seeking significant weight loss have more options than ever before.

The Lap-Band System is one of the most recent of these options. It reduces the stomach’s capacity and restricts the amount of food that can be consumed at one time, yet doesn’t require stomach cutting and stapling or gastrointestinal rerouting to bypass normal digestion.

The Lap-Band System is the only adjustable, reversible weight-loss surgery available in the country, and the only weight-loss surgery approved for use by the Food and Drug Administration. More than 200,000 Lap-Bands have been placed in patients around the world.

The term "Lap-Band" comes from the surgical technique used, laparoscopic, and the name of the implanted medical device, gastric band. The band itself is a silicone ring that is placed around the upper part of the stomach and filled with saline on its inner surface.

Adjustable weight loss

By design, Lap-Band is a fully adjustable system. The actual Lap-Band is connected via tubing to an access port fixed beneath the skin of the patient’s abdomen. This allows the surgeon to change the stomach outlet size by adding or removing saline from the system. This adjustment process helps determine the rate of weight loss.

Clear goals

The Lap-Band System helps patients achieve weight loss goals by limiting food intake, reducing appetite and slowing digestion, but it’s important to remember that it will not solve health problems nor ensure weight loss. The amount of weight loss depends both on the band and on the patient’s motivation and commitment to a healthy lifestyle and eating habits.

Experts say it’s important to set achievable weight-loss goals from the beginning. Losing one to three pounds per week during the first year following the operation is possible. But that rate slows after those initial 12 months.

It’s important to keep in mind that weight should come off gradually. Rapid weight loss can cause health risks and a variety of other problems.

The procedure

During a Lap-Band installation, surgeons make tiny incisions and use long-shafted instruments to wrap the band around the patient’s stomach. The band is fastened around the upper stomach to create the new stomach pouch, and then locked securely in a ring around the stomach – the process is similar to putting on a wristwatch.

The laparoscopic approach to the surgery reduces post-operative pain, shortens hospital stays and leads to a quicker recovery. And if the Lap-Band system needs to be removed, the stomach generally returns to its original form.

General Risks

The Lap-Band System carries the same risks associated with all major surgeries. And like other surgeries, the likelihood of those risks increases for seriously overweight patients. Most complications are not serious, but some may require hospitalization. Most common side effects occur after surgery, and may include nausea and vomiting, gastroesophageal reflux, band slippage, pouch dilation and stomach obstruction.

But serious complications like gastric perforation (a tear in the stomach wall) are possible, which can happen during or after surgery and might require another surgery to repair. And like any operation, the risk of death is always present despite all the precautions.

Activity

Patients usually return to normal activity levels relatively quickly after surgery. The length of the hospital stay is usually less than 24 hours, though it takes most people about a week before they’re able to return to their jobs and four to six weeks before they can resume strenuous exercising. Recovery can take longer if surgeons elect an open surgery or if there are complications during the process.

Removal

The lap-Band System is a long-term implant, but it may have to be removed or replaced at any time.

Common questions

Prospective patients usually have quite a few questions about the procedure. While a qualified medical professional or surgeon can address specific concerns, here are the answers to some of the most frequentlyasked questions.

How much will I lose?

Weight loss results vary from patient to patient, and the amount of weight you lose depends on several factors. For instance, the positioning of the Lap-Band System, as well as a commitment to healthy eating and lifestyle habits play a large role.

It’s important to remember that obesity surgery is not a miracle cure – the pounds won’t magically come off by themselves. That’s why it’s critical to set achievable weight-loss goals from the beginning, remembering that weight loss should happen gradually. The main goal is to improve overall health by reducing the problems and risks associated from unhealthy weight.

How does Lap-Band compare to Gastric Bypass?

Many surgeons have reported that gastric bypass patients lose weight faster during the first year after surgery. At the five year mark, however, many Lap-Band patients have achieved weight loss results comparable to those of gastric bypass patients.

Will I feel hungry or deprived with Lap-Band?

The Lap-Band makes patients eat less and feel full faster by reducing the capacity of the stomach by increasing the time it takes food to get through the digestive system. Patients usually feel full after a small meal. Following the nutritional guidelines and chewing food will should reduce the likelihood of feeling hungry or deprived.

Does Lap-Band limit physical activity?

The Lap-Band does not hamper physical activity, including aerobics, stretching and even strenuous exercise.

How long will it take to recover from surgery?

If surgery is performed laparoscopically – as it most frequently is – patients usually spend less than 24 hours in the hospital. It takes most patients about a week before they can resume normal activities, such as returning to their jobs. Strenuous exercise and movement is usually cleared within a month to six weeks. This is just a guideline, however. It should be noted that complications can extend these times.

Will I be sick after the operation?
If a patient feels nauseated or sick on a regular basis, it might be because he or she is not chewing food thoroughly, or that the diet rules aren’t being followed properly. But it could also mean that there is problem with the placement of the band, so it’s a good idea to contact the doctor if problems persist.

Vomiting should be avoided as much as possible as it can cause the small stomach pouch to stretch. It can also cause part of the stomach to slip through the band, thus negating the operation. In some cases, excessive vomiting can necessitate another operation entirely.

Are frequent doctor visits required after surgery?

Check-ups are normal and are a very important. Many surgeons see their patients weekly or biweekly during the first few months immediately following the operation. That way the surgeon can make necessary adjustments. After the first year or so, the frequency of the visits reduces to once every three to six months.

What about excess skin?

Patients frequently worry about excess skin following weight loss, and even though cosmetic surgery can alleviate this, it’s a good idea to wait a year or two because the skin often readjusts itself to fit around the new body shape. Most doctors encourage patients to give the skin the time it needs to adjust before electing for additional surgery.

What can I eat after the operation?

Patients can eat most foods so long as they don’t cause discomfort. But it’s important to eat vitamin and mineral-rich foods, especially now that portion sizes are smaller. Eating unhealthy foods or drinking unhealthy beverages greatly reduce the effectiveness of the procedure and may even completely counteract its effects. Patients are encouraged to ask their surgeons and dieticians about proper eating habits.