Laparoscopic Adjustable Gastric Banding - Lap Band® Procedure
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Bariatric surgeons often state that weight loss surgery gives patients a tool to
help them lose the excess weight and keep it off long-term. This is especially true
for the Lap Band® procedure, which is an adjustable tool that can be
customized to each patient's individual needs. The Lap Band® is an inflatable
silicone band placed around a very specific portion of the upper stomach, creating
a small stomach pouch above the band and acting as an adjustable valve that slows
passing of the food into the remaining stomach below the band. The more the band
is inflated, the longer it takes to empty the small stomach pouch of food. Patients
feel full after eating a very small amount of food and remain free of hunger for
hours after a small meal.
The
Lap Band® System is currently the only weight-loss surgical device
approved by the FDA for BMI of 30-35, or approximately 50-70 lbs overweight. On
February 16, 2011, the FDA approved the expanded use of the
Lap Band®
for obese adults with a Body Mass Index (BMI) of 30-40 and at least one obesity-related
health condition, who have failed more conservative weight reduction methods, such
as diet, exercise and pharmacotherapy. This decision is very timely, as the US struggles
with the obesity epidemic and Louisiana climbs to #2 on the list of the most obese
states in the country. One-third of Louisiana's population - or almost 1.5 million
people - has a BMI of at least 30 and may now be eligible for the
Lap Band®
procedure. Those suffering from obesity can finally benefit from long-term, surgical
weight loss and have their weight-related health conditions, such as type II diabetes,
sleep apnea, heart disease and joint problems, improved or even resolved.
The
Lap Band® procedure is purely a
restrictive surgery. The anatomy
of the patient’s gastrointestinal tract is essentially unchanged while the capacity
of the stomach is greatly reduced, so less food can be consumed at each meal. There
is no intestinal re-routing so the risk of malnutrition and vitamin deficiencies
is negligible. Most patients can expect to lose 55 to 60% of their excess body weight
over 1 to 2 years. Weight loss tends to be slower than with other procedures such
as the gastric bypass, but the long-term weight re-gain frequently seen with the
gastric bypass is not common with the
Lap Band®. The complication rate
of the
Lap Band® procedures is less than half that of the more complex
gastric bypass (9% versus 23%), and the mortality rate is over 10 times less than
the gastric bypass (0.1% versus 1.0 %). The safety profile of the
Lap Band®
allows us to perform
>65% of our procedures as same day surgeries. The
Lap Band®
procedure is also easily reversed if necessary.
Lap Band® Advantages
- Only bariatric procedure approved for BMI as low as 30
- Least invasive bariatric procedure
- No stomach stapling, cutting or removal
- No intestinal re-routing (anastomosis)
- Adjustable
- Reversible
- Lowest complication rate of all bariatric procedures (9%)
- Lowest mortality rate (0.1%)
- Lowest risk of malabsorbtion or vitamin and mineral deficiencies
- Least expensive option for patients paying for their procedure
Patients considering the
Lap Band® procedure should be prepared to make
a commitment to regular follow-up visits with their surgeon and nurse coordinator
for ongoing educational support and
Lap Band® adjustments. Most patients
require up to six adjustments to reach their optimal level of restriction. Monthly
office visits for adjustments for the first 12 months is typical for optimal weight
loss.