Gastric Banding: Realize® Band, Lap-Band®
Gastric banding is a purely restrictive surgical procedure, meaning that it limits the amount of food a patient can eat before they feel full. The band is the only fully adjustable and reversible major bariatric surgery procedure. It is also the only major bariatric procedure that does not alter the stomach or small intestine in a permanent way.
While the gastric band was very popular in years past, it does require a greater degree of follow up than other bariatric procedures. Further, complications, while relatively minor compared to other bariatric procedures may occur more frequently, requiring additional intervention. With that said, the gastric band can be revised easily should it not offer the patient the weight loss they expect. A new band can be placed, or the band can be converted to a gastric sleeve or gastric bypass.
The gastric band offers the lowest potential weight loss of the three major bariatric procedures.
A very unique feature of the gastric band, and specifically the Lap-Band®, is that it has been approved by the FDA for patients with a BMI of as low as 30 (with one or more obesity related diseases). It is the only bariatric surgical procedure available to those with a BMI of less than 35.
How The Gastric Band Works
During the procedure, a silicone band is placed around the uppermost part of the stomach. This band divides the stomach into two portions: one small upper pouch and one larger lower chamber. Since the food gets held up in the smaller upper chamber, most patients feel full faster. After passing through the narrowed stomach opening, the food is digested as it was before the procedure.
The band is connected to a small tube which in turn leads to a reservoir positioned under the skin called an injection port. The injection port allows the surgeon to adjust the diameter of the band by making it tighter or looser, depending on the patient’s individual degree of restriction. This is done by injecting or removing sterile saline to tighten or loosen the band respectively. If the rate of weight loss is not acceptable, the band can be adjusted. Adjustments are performed on a regular basis after surgery until the ideal degree of restriction is reached.
Results of Gastric Banding
While the gastric band offers the lowest potential weight loss of the major bariatric surgery procedures, patients may still be able to lose a significant amount of weight and improve or resolve many of the diseases associated with morbid obesity including sleep apnea, high blood pressure, high cholesterol and type 2 diabetes.
Patients can expect to lose between 40 and 50% of their excess body weight over the course of two years after their surgery. However, patients will need to follow a strict nutritional and exercise lifestyle overhaul.
Recovery after Gastric Banding
Because of the minimally invasive nature of the procedure, gastric banding patients may be able to have the procedure performed on an outpatient basis. However it is more likely that they will spend one night in the hospital under observation for any complications after surgery.
Because of the band’s relatively low level of invasiveness, patients should be able to return to work within a week and return to normal activity within four weeks. As with any other surgical procedure, lifting heavy items and performing strenuous activity should not be performed until cleared by our office.
Benefits of Gastric Banding
- A 2004 analysis of more than 22,000 patients showed that those who underwent a bariatric surgical procedure experienced complete resolution or improvement of their co-morbid conditions including diabetes, hypertension and sleep apnea. Patients lost roughly 47% of their excess weight
- The amount of food that could be consumed at a meal is significantly restricted
- Patients do not suffer from dumping syndrome as do gastric bypass patients
- Patients experience fewer dietary restrictions than those who undergo a sleeve or bypass
- Food passes through the digestive tract in the usual manner, allowing it to be absorbed fully, No permanent changes are made to the stomach or small intestine
- The band can be adjusted to increase or decrease restriction
- The surgery can be reversed and easily revised to another bariatric procedure
- In studies involving more than 3,000 patients, excess weight loss ranged from 28%-87%, with a minimum of two-year postoperative follow-up
- The surgery is less costly than staples procedures
- Hospital stay and recovery time is shorter than those of a sleeve or bypass patient
Risks of Gastric Banding:
- The access port may leak or twist, which can require an operation to correct the problem
- Surgery may not provide the necessary feeling of fullness
- Dumping syndrome, which may provide important warning signs, does not occur
- The band may erode into the stomach wall
- The band may move or slip
- Weight loss is slower than that following gastric bypass or gastric sleeve surgery
Gastric Band FAQs
Q: Who Is The Ideal Gastric Bypass Patient?
A: The gastric band, and particularly the Lap-Band is available to patients with BMIs as low as 30 if they also suffer form an obesity related disease. The band offers the least weight loss potential of any of the procedures we offer, so it may be more suitable for those who are on the lower end of the obesity scale.
Q: Is The Gastric Band Performed Laparoscopically?
A: Yes, the gastric band is meant to be placed in a minimally invasive manner.
Q: How Long Is The Hospital Stay After A Gastric Banding Procedure?
A: A typical, uneventful recovery from a laparoscopic gastric band will require a 1 night stay in the hospital. It can sometimes be performed on an outpatient basis.
Q: Can The Gastric Band Be Reversed?
A: Yes, in case of illness or pregnancy, the band can be removed. However, the patient should expect to regain most if not all of the weight they lost as they will no longer have the band’s restriction to assist.
Q: Can You Revise A Gastric Band?
A: Yes, the gastric band can be revised relatively easily. Since it can be removed, it can be substituted for any other bariatric procedure, assuming the patient is a candidate for the new surgery. Please learn more about gastric band revisions.
Q: I’ve Heard That The Gastric Band Has A High Risk Of Long-Term Complications. Is This True?
A: Since every patient will experience a different outcome from their banding procedure, it is hard to predict exact outcomes, especially over the longer term. What we do know is that over the longer-term, yes, the gastric band has a higher rate of revisions than the other two major bariatric surgeries we offer.
Q: Will I Feel The Band?
A: Some patients experience sensation from the band. Usually, it is a feeling of tightness – most often in the morning. You will be able to feel the access port, placed just under the skin, but it shouldn’t cause any discomfort and will quickly become “normal” to you.
Q: Does The Gastric Band Require More Follow Up Than Other Procedures?
A: Yes, it does. Since the gastric band is adjustable, it requires several follow-up visits to get the ideal restriction. The process requires some trial and error.
Q: Is The Gastric Band Right For Me?
A: Before making the decision as to which procedure is right for your circumstance, you will need to consult with us. We will perform pre-operative testing that will assist you in making the right decision during your consultation with one of our surgeons. You should also attend one of our free weight loss surgery seminars.