Laparoscopic gastric banding is surgery to help with weight loss. The surgeon places a band around the upper portion of your stomach to create a small pocket to hold food. The band limits the amount of food you can consume by making you feel full after eating small amounts of food.
Lap-Band; LAGB; Laparoscopic adjustable gastric banding; Bariatric surgery - laparoscopic gastric banding
Description of Procedure
You will receive general anesthesia prior to the procedure. The surgery is done using a laparoscope, which is small camera used to aid the surgeon in seeing inside of your stomach. The surgeon will make 1 to 5 small surgical cuts in your abdomen, and then place a band around the upper portion of your stomach to separate it from the lower part. This will create a small pouch that has a narrow opening that goes into the larger, lower part of your stomach. The surgery is not invasive, and does not involve any cutting or stapling inside your stomach. It only takes roughly 30 to 60 minutes.
The final weight loss with gastric banding is not as large as with gastric bypass. The average weight loss is about one-third to one-half of the extra weight you are carrying. Speak with your doctor to find out which procedure is best for you.
Why the Procedure is Performed
If you have been severely obese for more than 5 years and have not been able to lose weight through diet and exercise, you may want to consider weight-loss surgery. While laparoscopic gastric banding may not be a “quick-fix” for obesity, it does help aid in losing weight over time. Exercise and a good diet also help improve weight loss. Doctors often use body mass index (BMI) measures to identify which patients would benefit the most from weight-loss surgery. A normal BMI is between 18.5 and 25.
You may want to consider this surgery if you have:
- A BMI of 40 or more. This usually means that men are 100 pounds overweight and women are 80 pounds over their ideal weight.
- A BMI of 35 or more and a serious medical condition that might improve with weight loss. Some of these conditions are sleep apnea, type 2 diabetes, high blood pressure, and heart disease.
Benefits of Surgery
Sufficient weight loss following surgery can improve several medical conditions you may have, such as: asthma, high cholesterol, high blood pressure, sleep apnea, Type 2 diabetes, and gastroesophageal reflux disease (GERD).
Before the procedure
Your doctor will recommend you have a series of tests administered prior to the surgery. Some of these are:
- Complete physical exam
- Nutritional counseling
- Blood test, ultrasound of your gallbladder, and other tests to make sure you are healthy enough to have surgery
- Visit with a mental health provider to check you are emotionally ready for major surgery. You must be able to make major changes in your lifestyle following the surgery.
- Visits with your doctor to make sure other medical problems you may have, such as diabetes, high blood pressure, and heart or lung problems are under control
If you’re a smoker, it’s strongly recommended that you stop smoking several weeks prior to the surgery and not start smoking again after surgery. Smoking slows down the recovery process and increases the risk of problems. If you need help quitting, your doctor or nurse can help.
Always make sure to tell your doctor or nurse if you are or could be pregnant. Also communicate what drugs you are currently taking, as well as any drugs or herbs you have bought without a prescription.
During the week before your surgery
- Ask your doctor what drugs you should still take on the day of the surgery.
- You may be asked to stop taking aspirin, ibuprofen (Advil, Motrin), vitamin E, warfarin (Coumadin), and any other drugs that make it hard for your blood to clot.
On the day of the surgery
- Do not eat or drink anything after midnight the night before surgery.
- Take the drugs your doctor advised you to take with a small sip of water.
- Your doctor or nurse will tell you when to arrive at the procedure.
After the procedure
You will most likely go home the day after surgery. Most patients are able to revert back to their normal routine 1 or 2 days after going home. However, several people often opt to take 1 week off of work to fully recover.
You will have a liquid or mash-up food diet for 2 to 3 weeks following surgery. You will slowly incorporate soft foods and then regular foods to your diet. Six weeks after the surgery, you will most likely be able to eat regular foods again.
The band is made of silastic rubber, and the interior of the band has an inflatable balloon. This allows the band to be adjusted. If needed, your doctor can adjust the band to make food pass more slowly or quickly through your digestive system.
The band is connected to an access port that is under the skin of your abdomen. Placing a needle into the port and filling the balloon with water can tighten the band. Your surgeon may tighten or loosen the band if you are:
- Having problems eating
- Not losing enough weigh
- Vomiting after you eat
- Gastric band erodes through the stomach. If this happens, the band must be removed.
- Weight-loss surgery may increase your risk for gallstones.
- Gastric band may slip partly out of place.
- Gastritis (inflamed stomach lining), heartburn, or stomach ulcers.
- Infection in the port, which may need antibiotics or surgery.
- Injury to your stomach, intestines, or other organs during surgery.
- Poor nutrition.
- Scarring inside your stomach, which could lead to a blockage in your bowel.
- Your surgeon may not be able to reach the access port to tighten or loosen the band. Therefore, you would need minor surgery to fix this problem.
- Vomiting from eating in excess of what your stomach pouch can hold.