Adjustable Gastric Band Surgery
At Pioneer Valley Surgical Associates, we have the region’s most experienced surgeons performing laparoscopic adjustable gastric band surgery (also called lap band or o-band surgery). In fact, we’ve performed more gastric band surgeries than any other practice in New England.
Approved by the FDA in June 2001, laparoscopic adjustable gastric band surgery is the safest, least invasive, and only adjustable surgical treatment for morbid obesity in the United States. It induces weight loss by reducing the capacity of the stomach, which restricts the amount of food that can be consumed.
Since its clinical introduction in 1993, more than 200,000 weight loss band surgery procedures have been performed around the world.
- Least invasive surgical option
- No intestinal re-routing
- No cutting or stapling of the stomach wall or bowel
- Small incisions and minimal scarring
- Reduced patient pain, length of hospital stay and recovery period
Fewer Risks and Side Effects
- Significantly lower mortality risk compared to other obesity surgeries¹
- Low risk of nutritional deficiencies associated with gastric bypass
- Reduced risk of hair loss
- No “dumping syndrome” related to dietary intake restrictions
- Allows individualized degree of restriction for ideal, long-term weight loss rate
- Adjustments performed without additional surgery
- Supports pregnancy by allowing stomach outlet size to be opened for increased nutritional needs
- Removable at any time
- Stomach and other anatomy are generally restored to their original forms and functions
Effective Long-Term Weight Loss
- More than 200,000 laparoscopic adjustable gastric bands placed worldwide
- Standard of care for hundreds of practices around the world
- Academic publications with up to 9 years of follow-up
Executive summary: Laparoscopic adjustable gastric banding for the treatment of obesity (Update and Re-appraisal). The Australian Safety and Efficacy Register of New Interventional Procedures – Surgical (ASERNIPS) 2002; 1. (Laparoscopic adjustable gastric banding surgery, like the laparoscopic adjustable gastric band surgery, is associate with a mean short-term mortality rate of around 0.05% compared to 0.50% for Gastric Bypass and 0.31% for Vertical Banded Gastroplasty.)
Am I A Candidate for Adjustable Gastric Band Surgery?
The LAP-BAND® System is not right for everyone. Here are some of the criteria for lap band surgery we will consider when evaluating your candidacy for obesity surgery.
The LAP-BAND System is indicated for use in weight reduction for severely obese patients with a Body Mass Index (BMI) of at least 40 or a BMI of at least 35 with one or more severe co-morbid conditions, or those who are 100 lbs. or more over their estimated ideal weight.
The LAP-BAND System may be right for you if:
- You are at least 18 years old.
- Your BMI is 40 or higher, or you weigh at least twice your ideal weight, or you weigh at least 100 pounds more than your ideal weight. (BMI is calculated by dividing body weight (lbs.) by height in inches squared (in²) and multiplying that amount by 703).
- BMI Calculator
- You have been overweight for more than 5 years.
- Your serious attempts to lose weight have had only short-term success.
- You do not have any other disease that may have caused your obesity.
- You are prepared to make substantial changes in your eating habits and lifestyle.
- You are willing to continue being monitored by the specialist who is treating you.
- You do not drink alcohol in excess.
If you do not meet the BMI or weight criteria, you still may be considered for surgery if your BMI is at least 35 and you are suffering from serious health problems related to obesity.
Laparascopic banding surgery is not recommended for non-adult patients, patients with conditions that may make them poor surgical candidates or increase the risk of poor results, who are unwilling or unable to comply with the required dietary restrictions, or who currently are or may be pregnant.
The LAP-BAND System is not right for you if:
- You have an inflammatory disease or condition of the gastrointestinal tract, such as ulcers, severe esophagitis, or Crohn’s disease.
- You have severe heart or lung disease that makes you a poor candidate for surgery.
- You have some other disease that makes you a poor candidate for surgery.
- You have a problem that could cause bleeding in the esophagus or stomach. This might include esophageal or gastric varices (a dilated vein). It might also be something such as congenital or acquired intestinal telangiectasia (dilation of a small blood vessel).
- You have portal hypertension.
- Your esophagus, stomach, or intestine is not normal (congenital or acquired). For instance, you might have a narrowed opening.
- You have or have experienced an intra-operative gastric injury, such as a gastric perforation at or near the location of the intended band placement.
- You have cirrhosis.
- You have chronic pancreatitis.
- You are pregnant. (If you become pregnant after gastric band system has been placed, the band may need to be adjusted. The same is true if you need more nutrition for any other reason, such as becoming seriously ill. In rare cases, removal may be needed.
- You are addicted to alcohol or drugs.
- You are under 18 years of age.
- You have an infection anywhere in your body or one that could contaminate the surgical area.
- You are on chronic, long-term steroid treatment.
- You cannot or do not want to follow the dietary rules that come with this procedure.
- You might be allergic to materials in the device.
- You cannot tolerate pain from an implanted device.
- You or someone in your family has an autoimmune connective tissue disease. That might be a disease such as systemic lupus erythematosus or scleroderma. The same is true if you have symptoms of one of these diseases.
While the LAP-BAND System is an effective treatment for morbid obesity, the pounds do not come off by themselves. The LAP-BAND System is an aid to support you in achieving lasting results by limiting food intake, reducing appetite and slowing digestion. However, your motivation and commitment to adopt a new lifestyle are extremely important for long-term weight loss. You must be committed to new eating habits for the rest of your life. Exercise is an equally important component of a changed lifestyle.
The LAP-BAND System is a long-term implant. Explant and replacement surgery may be required at some time. Patients who become pregnant or severely ill, or who require more extensive nutrition may require deflation of their bands. Patients should not expect to lose weight as fast as gastric bypass patients, and band inflation should proceed in small increments. Anti-inflammatory agents, such as aspirin, should be used with caution and may contribute to an increased risk of band erosion.
Placement of adjustable gastric bands is major surgery, and like any surgery, death can occur. Gastric band surgery risks include possible complications associated with the medications and methods used during surgery, the risks associated with any surgical procedure, and the patient’s ability to tolerate a foreign object implanted in the body.
Band slippage, erosion and deflation, obstruction of the stomach, dilation of the esophagus, infection, or nausea and vomiting may occur. Reoperation may be required.
Rapid weight loss may result in complications that can require additional surgery. Deflation of the band may alleviate excessively rapid weight loss or esophageal dilation.
Not all contraindications, warnings or adverse events are included in this brief description. More detailed risk information is available at lapband.com or 1-877-LAP-BAND.
Frequently Asked Questions About Gastric Band Surgery
The LAP-BAND System limits food intake. If you feel nauseated or sick on a regular basis, it may mean that you are not chewing your food well enough or that you are not following the diet rules properly. However, it could also mean that there is a problem with the placement of the band so you should contact us if this problem persists. Vomiting should be avoided as much as possible as it can cause the small stomach pouch to stretch. It can also lead to slippage of part of the stomach through the band and reduce the success of the operation. In some cases, it can require another operation.
The Lap Band is adjustable. A band adjustment could consist of using a special needle to access the port underneath your skin and then inserting fluid into the band or taking fluid out. Everyone will have different levels of fluid in their band, so you cannot compare how many CCs of fluid you have to someone else’s experience. The goal is for you to be able to eat 8 ounces of food and feel satiety for at least 4–6 hours before your next meal. If you cannot eat approximately 8 ounces or you are feeling discomfort after a few bites, it may mean your band is too tight and fluid should be taken out. When in doubt, call the office to discuss your symptoms with a trained staff person.
Patients typically spend less than 24 hours in the hospital. It takes most patients about a week to return to work and a month to 6 weeks to resume exercising. In the case of open surgery or if there are complications, recovery may take longer.
Weight-loss results vary from patient to patient, and the amount of weight you lose depends on several things. The band needs to be in the right position, and you need to be committed to your new lifestyle and eating habits. Obesity surgery is not a miracle cure, and the pounds won’t come off by themselves. It is very important to set achievable weight-loss goals from the beginning. A weight loss of 2–3 pounds a week in the first year after the operation is possible, but one pound a week is more likely. Twelve to eighteen months after the operation, weekly weight loss is usually less. Remember that you should lose weight gradually. Losing weight too quickly creates a health risk and can lead to several problems. The main goal is to have weight loss that prevents, improves or resolves health problems connected with severe obesity.
Surgeons have reported that gastric bypass patients lose weight faster in the first year. At five years, however, many LAP-BAND patients have achieved weight loss comparable to that of gastric bypass patients.1 You should focus on long-term weight loss and remember that it is important to lose weight gradually while reducing obesity-related risks and improving your health.
Check-ups are a normal and very important part of the LAP-BAND System follow-up.
The LAP-BAND does not hamper physical activity including aerobics, stretching and strenuous exercise.
Adjustments are often carried out in the X-ray department so the access port can be clearly seen. When X-rays are used, your reproductive organs will be shielded. Sometimes adjustments can be done in an outpatient clinic or office, and local anesthesia may or may not be needed. A fine needle is passed through the skin into the access port to add or subtract saline. This process most often takes only a few minutes and most patients say it is nearly painless.
There are no restrictions based on the access port. It is placed under the skin in the abdominal wall. Once the incisions have healed, it should not cause discomfort or limit any physical exercise. The only sensation you may experience from the port occurs when you go in for adjustments. If you feel persistent discomfort in the port area, let us know as soon as possible.
Although the LAP-BAND System is not meant to be removed, it can be, in some cases laparoscopically. Surgeons report that the stomach generally returns to its original shape once the band is removed. After the removal, though, you may soon go back up to your original weight or even gain more.
That is not always the case. As a rule, plastic surgery will not be considered for at least a year or two after the operation, as sometimes the skin will mold itself around the new body tissue. Give the skin the time it needs to adjust before you decide to have more surgery.
This is a fairly common feeling, especially for people with bands that are tight or just after an adjustment. During the day, the water content in the body changes and this may cause the band to feel “tighter” some of the time. Some women have also noticed that the LAP-BAND feels tighter during menstruation.
The LAP-BAND makes you eat less and feel full in two ways—first by reducing the capacity of your stomach and second by increasing the time it takes food to get through the digestive system. After a small meal, the amount of which varies from person to person, you should feel full. If you follow the nutrition guidelines when you choose your food, and then chew it well, you should not feel hungry or deprived. Remember that the LAP-BAND is a tool to help you change your eating habits.
One of the major advantages of the LAP-BAND System is that it can be adjusted. If your illness requires you to eat more, the band can be loosened by removing saline from it. When you have recovered from your illness and want to lose weight again, the band can be tightened by increasing the amount of saline. If the band cannot be loosened enough, it may have to be removed.
Becoming pregnant can be easier as you lose weight. Your menstrual cycle may become more regular. If you need to eat more while you are pregnant, the band can be loosened. After the pregnancy, the band may be made tighter again, and you can resume losing weight.
You may. It’s possible to not get enough vitamins from three small meals a day. At your regular check-ups, your specialist will evaluate whether you are getting enough vitamin B12, folic acid, and iron.
You should be able to take prescribed medication though you may need to use capsules, break big tablets in half or dissolve them in water so they do not get stuck in the stoma and make you sick. You should always ask the doctor who prescribes the drugs about this.
Order only a small amount of food, such as an appetizer. Eat slowly. Finish at the same time as your table companions. You might want to let your host or hostess know in advance that you cannot eat very much.
Alcohol has a high number of calories and breaks down vitamins. An occasional glass of wine or other alcoholic beverage, though, is not considered harmful to weight loss.
After your stomach has healed, you may eat most foods that don’t cause you discomfort. However, because you can only eat a little, it is important to include foods full of important vitamins and nutrients such as those advised by your dietitian. If you eat foods that contain lots of sugar and fat or drink liquids full of “empty” calories, such as milkshakes, the effect of the LAP-BAND may be greatly reduced or cancelled.
There may be some reduction in the volume of your stools, which is normal after a decrease in food intake because you eat less fiber. This should not cause you severe problems. If difficulties do arise, let us know as soon as possible. And remember to drink at least 6–8 glasses of water a day.
Ready to Get Started?
Watch our informational surgical weight loss seminar video.
- O’Brien P., et al, LAP-BAND: Outcomes and results, J of Laparoend & Adv Surg Techniques, 13(4), 2003, 265-270. Clegg A., Colquitt J., et al, The clinical and cost effectiveness of surgery for people with morbid obesity, Health Technology Assessment, 6(12) 2002, 1-153.
- Dixon J., Dixon A., O’Brien P. Light to Moderate Alcohol Consumption: Obesity and the Metabolic Syndrome. Am J Bariatric Medicine 2002; 17(4): 11-14.