The gastric band system
also known as the LAP-BAND® System is
designed to help you lose excess body weight
for resolution of obesity-related health
conditions. This
approach eliminates
many of the known associated operative
risks and provides unique benefits compared
to other obesity surgeries. This effort
has resulted in the gastric band system,
the only adjustable and reversible obesity
surgery that does not require cutting and
stapling of the stomach or gastrointestinal
re-routing to bypass normal digestion.
Patient benefits include reduced surgical
trauma, complications, pain, and scarring,
as well as shorter hospitalization and
recovery time compared to other obesity
surgeries.
Gastric
Band Overview
The body gets energy from food while it
passes through the alimentary canal, which
consists of the mouth, esophagus, stomach,
and small and large intestines. Digestion
starts in the mouth with chewing and the
addition of saliva. After food passes through
the esophagus, this process continues in
the stomach. The stomach then provides
temporary storage for food. Gastric juices,
which contain enzymes, break down the food
so that it can be absorbed and the energy
can be carried through the body by the
blood.
The gastric band system is
a silicone elastomer ring designed to be
placed around the upper part of the stomach
and filled with saline on the inner surface.
This creates a new small stomach pouch
and leaves the larger part of the stomach
below the band so the food storage area
in the stomach is reduced, and the pouch
above the band can hold only a small amount
of food. The band also controls the stoma
(stomach outlet) between the two parts
of the stomach. The size of the stoma regulates
the flow of the food from the upper to
the lower part of the stomach. When the
stoma is smaller, you feel full sooner
and have a feeling of satiety so you are
not hungry between meals.
The
band is connected by tubing to an access
port that is placed beneath the skin during
surgery. Later, the surgeon can change
the stoma size by adding or subtracting
saline inside the inner balloon through
the access port. This adjustment process
helps drive the rate of weight loss. If
the band is too loose and weight loss 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.
Gastric Band Placement
The gastric band system is
usually placed laparoscopically under general
anesthesia. First the surgeon makes a few
small incisions in the abdominal wall for
the insertion of long, thin surgical instruments.
A narrow camera is also passed through
a port so the surgeon can view the operative
site on a nearby video monitor. A small
tunnel is made behind the top of the stomach
to let the band through and allow it to
be wrapped around the upper part of the
stomach, almost like a wristwatch. The
band is then locked securely in a ring
around the stomach. The gastric band is
usually left empty or only partially inflated
for the first 4-6 weeks after surgery.
Gastric Band Weight-Loss
Results
The gastric band system is
a tool to help you achieve sustained weight
loss by limiting how much you can eat,
reducing your appetite, and slowing digestion.
Remember, though, the the gastric band system
by itself will not solve morbid obesity,
nor will it ensure that you reach your
goal weight or even that you lose weight
at all. The amount of weight you lose depends
both on the band and on your motivation
and commitment to a new lifestyle and eating
habits. Below is a sample of published
results from around the world:
| A
Sample of Published Results From
Around The World: |
% of Excess Weight Lost |
Years of Patient Follow
Up |
# of Patients Studied |
| Rubenstein, et al, Us |
53.6% |
3 |
63 |
| Dargent, France |
64% |
3 |
500 |
| O'Brien et al, Australia |
68.2% |
4 |
302 |
| Nehoda et al, Austria |
72% |
1 |
250 |
| Forestieri et al, Italy |
88.5% |
2 |
62 |
| Fielding et al, Australia |
68% |
3 |
620 |
Some people lost more than others, and
though you may never reach your ideal weight,
chances are good that with weight loss
our health and self-image will improve.
Gastric Band Removal
If there is a problem with the band, if
you can't lose enough weight or can't adjust
to the new eating habits, your surgeon
may suggest removal of the band. This decision
will come after your surgeon consults with
you. Generally after gastric band system
removal, your stomach will be restored
to its original form, and the digestive
tract should function normally. Please
keep in mind that when the band is removed
your weight will likely increase.
Gastric Band Advantages
Minimal Trauma
- Least invasive surgical option
- No intestinal re-routing
- No cutting or stapling or 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 surgeries
- Low risk of nutritional deficiencies
associated with BPD and Gastric Bypass
- Reduced risk of hair loss
- No "dumping syndrome" with
certain dietary elements
Adjustable
- 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 to accommodate
increased nutritional needs
Reversible
- Removable at any time
- Stomach and other anatomy are generally
restored to their original forms and
functions
Effective Long-Term Weight Loss
- More than 100,000 gastric bandS
placed worldwide
- Standard of care for hundreds of surgeons
around the world
- Academic publication with up to 7 years
of follow-up
Gastric Band Candidates
You may be eligible for gastric band system
surgery if:
1. You are at least 18 years old.
2. Your BMI is > 40 or you weigh at
least 100 pounds more than your ideal
weight.
3. You have been overweight for more
than 5 years.
4. Your serious weight-loss attempts
have only had short-term success.
5. You are not suffering from any other
disease that my have caused your obesity.
6. You are prepared to make substantial
changes in your eating habits and lifestyle.
7. You are willing to continue being
monitored by the specialist treating
you.
8. 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 over 35 and you are suffering
from serious health problems causes by
your weight. Your surgeon may have additional
criteria to those listed above.
Gastric Band Contraindications
The gastric band system is
not right for you if:
- You have an inflammatory disease
or condition of the gastrointestinal
tract, such as ulcers, severe esophagitis.
- 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 telangiectasias
(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 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 the gastric band system
has been placed, the band may need
to be deflated. 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.
Your surgeon will not do the operation
unless he or she knows you understand the
problems your excess weight is causing.
Also, your surgeon will make sure you know
that you have responsibilities, such as
adopting new eating patterns and a new
lifestyle. If you are ready to take an
active part in reducing your weight, your
surgeon will consider the treatment. You
should be well-informed about the advantages,
disadvantages, and risks involved. Be sure
to investigate whether this treatment is
right for you.
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