Laparoscopic Adjustable Gastric Banding

Understanding Laparoscopic Adjustable Gastric Banding

Laparoscopic Adjustable Gastric Banding (also known as Lap-Band^® or AGB) is a restrictive type of bariatric surgery. That means weight loss occurs because the stomach is made smaller, not because of changes to the way food is absorbed. AGB does not involve cutting or stapling of the stomach.

Wellstar bariatric surgeons are highly experienced in this safe procedure. It typically results in a loss of 45% to 55% of excess body weight over about a two-year period.

A hollow silicone ring (band) filled with saline solution is wrapped around the upper part of your stomach and locked in place. This creates a small pocket for food. The band includes an inflatable balloon connected to a tube that is connected to a port. During the procedure the port is placed on the abdominal wall so that it can be accessed in the weeks and months following the surgery. The balloon is inflated in increments until the optimal stomach outlet size restriction is achieved. The tighter the band (to a degree), the more weight loss is possible because the pouch and pouch outlet become smaller.

Bariatric surgery is an option for morbidly obese individuals who have not been successful with other weight loss methods. Your Wellstar physician will discuss your situation to determine if AGB is a good choice for you. Considerations include your body mass index (BMI) and related medical conditions such as diabetes, high blood pressure, sleep apnea and/or disabling osteoarthritis. Like any bariatric surgery, AGB is not a quick fix. Patients must commit to long-term lifestyle changes including diet and exercise.

Losing weight after surgery can improve a number of serious medical conditions including Type 2 diabetes, asthma, gastroesophageal reflux disease, high blood pressure and sleep apnea.

Although gastric banding has a low complication rate, possible risks include those associated with any surgery (such as blood clots and infection). Other risks are possible slippage or erosion of the band, stomach injury or inflammation, poor nutrition and difficulty accessing the band port to loosen or tighten it. Weight regain may be greater with AGB than with other procedures, such as Roux-en-Y Gastric Bypass, also offered by Wellstar.

Before the procedure

Stop smoking and begin eating five-to-six small meals per day.
Consider joining a Wellstar support group.
Your medical history will be reviewed. Medical tests may include a urinalysis, glucose test for diabetes, thyroid analysis, chest x-ray, electrocardiogram and psychiatric evaluation. You may also have an upper GI or upper endoscopy test, lung function test and a gall bladder ultrasound.
Your Wellstar bariatric surgeon will talk with you about other relevant medical issues.
You will receive counseling on nutrition and fitness to help you modify your habits and maximize post-surgery results.
Tell your doctor about any medications or supplements you take. You may need to discontinue those that can increase bleeding.

During the procedure

You will be given an anesthetic to put you to sleep for the surgery.
Your Wellstar physician will make five small incisions in your belly. A tiny video camera (laparoscope) and thin surgical instruments will be inserted into the incisions.
Viewing your belly on a video screen, the surgeon will laparoscopically position the band to create a very small partition of the stomach above the band. Once it is properly filled (inflated) the result is a narrow passage for food to traverse.
The surgery takes about an hour.

After the procedure

You will be monitored in a recovery room before being moved to a hospital room.
A nurse or therapist will help you get up and walk soon after your surgery to keep your blood moving and improve healing.
A swallow test may be conducted to ensure proper placement of the band before you start drinking.
You will remain in the hospital overnight and will be able to return to light work about a week after surgery, and all normal activities within two weeks.
You will remain on liquids or mashed foods for two-to-three weeks after surgery, slowly adding regular food to your diet.
You will see your Wellstar bariatric surgeon regularly to monitor your progress and address any complications. You will also be monitored to determine if the band should be made tighter or looser.