Laparoscopic gastric banding is a surgery used for people who are overweight, or people for whom excess weight poses serious health risks. These patients usually have failed to lose weight using typical weight-control methods, like diet restriction and exercise.
This procedure is referred to by several names, including Lap-Band and laparoscopic adjustable gastric banding (LAGB).
Your surgeon will place a silicone band around a small upper section of your stomach. The band will create a small pouch in this upper part of your stomach, which will fill up quickly and make you feel full after you’ve eaten only a small amount of food. The band can be adjusted later to control how quickly food travels through your digestive system.
This surgery is recommended for patients 18 years or older who:
- have a body mass index higher than 40
- have a body mass index between 35 and 39.9, as well as health problems caused by weight, such as hypertension, sleep apnea, heart disease, or Type 2 diabetes
- are not willing to radically change their eating habits or lifestyles to lose weight
- have been obese for more than five years
You physician will likely advise you to stop taking medications that prevent your blood from clotting, such as aspirin, Plavix, ibuprofen, vitamin E, and blood thinners such as warfarin (Coumadin). You will also be told not to eat or drink anything after midnight the night before your surgery.
In addition, your doctor may ask you to have certain tests performed beforehand, such as blood tests and an ultrasound of your gall bladder, to ensure that you are healthy enough to have major surgery. You may also need mental health and nutritional counseling to ensure you are prepared and fully understand the lifestyle changes you will need to make after surgery.
The procedure is performed under general anesthesia. This means that you will be given medication to put you into a deep sleep state and prevent feeling pain during the surgery. Once you are asleep, a tube may be placed in your trachea, or windpipe, to help keep your airway open during the procedure.
While you are asleep, your surgeon will make several small incisions in your abdomen, through which the laparoscope with camera and small instruments can be inserted. During the procedure, an inflatable, belt-shaped band is placed around the upper portion of your stomach.The band is inflated with a saline (salt water) solution. By adjusting the band, your surgeon will create two pouches in your stomach separated by a small opening. Imagine placing your hands around the outside of a circular balloon and squeezing, and you can visualize the shape of your “new” stomach. The band can remain in place permanently.
The surgery typically lasts between 30 and 60 minutes. After the initial small incisions, no other incisions and no staples are required. The old phrase “stomach stapling” is not an accurate description of what occurs in this procedure.
Laparoscopic gastric banding is surgery and every surgery carries the risk of rare complications, including:
- allergic reactions to anesthesia
- breathing difficulties
- blood clots
- blood loss
- heart attack or stroke during the procedure
Unfortunately, carrying excess weight puts you at an increased risk for complications from surgery.
This procedure also carries specific risks, including:
- gastroesophageal reflux disease (GERD)
- abdominal pain
- esophageal stretching
- gastric band leaking of saline (salt water)
- gastric band movement (typically requires surgery to reposition the band)
After surgery, you can expect to spend a day or two recovering in the hospital, followed by another five days or so recuperating at home, though you’ll be able to resume most normal activities after one or two days at home. For the first two to three weeks after surgery, you’ll be on a liquid diet. After this time, and with your physician’s approval, you’ll be able to slowly add in soft foods, with the goal of eating a normal diet after about five weeks.
This surgery is designed to make you feel full after eating small amounts of food. After surgery, you should be eating less and losing weight steadily. The inside of your gastric band has an inflatable balloon, which can be loosened or tightened in the future so you can eat more or less food. This can help to alleviate vomiting or help you lose weight faster if you have reached a plateau.
Your weight loss may continue for up to three years, and during this time you may see improvement in weight-related health problems, including sleep apnea, hypertension, and diabetes. You should talk to your doctor about adopting healthy habits, such as regular exercise and quitting smoking.