Gastric banding

A laparoscopic adjustable gastric band, commonly referred to as a lap band, is an inflatable silicone device surgically implanted around the top portion of the stomach to help a person lose weight. A band is placed around the upper part of the stomach, creating a small pouch that can hold only a small amount of food. The narrowed opening between the stomach pouch and the rest of the stomach controls how quickly food passes from the pouch to the lower part of the stomach. The system helps the patient eat less by limiting the amount of food that can be eaten at one time and increasing the time it takes for food to be digested.

Depending on the patient’s needs, after the device is implanted the narrowed opening between the pouch and the lower part of the stomach can be adjusted in size by inflating or deflating the hollow band. Inflating the band makes the opening smaller, causing food to pass more slowly. Deflating the band makes it wider, causes food to pass more quickly. This adjustment is made by adding or removing fluid inside the hollow band. The doctor does this by injecting or removing the fluid through a small button-like part called the access port. This access port is placed under the skin in a muscle in the chest wall. The port is connected to the band by the tubing.

Gastric banding is used for weight loss in severely obese adults who have been obese for at least five years and for whom non-surgical weight loss methods have not been successful. They must be willing to make major changes in their eating habits and lifestyle. Patients must have a Body Mass Index (BMI) of at least 40, a BMI of at least 35 with one or more severe morbid (unhealthy) conditions, or be at least 100 pounds over their estimated ideal weight. In February 2011 the Food and Drug Administration expanded approval of adjustable gastric band to patients with a BMI between 30 to 40 and one weight-related medical condition such as diabetes or high blood pressure. Again, an adjustable gastric band may only be used after other methods such as diet and exercise have previously been tried.

Gastric banding may help the patient lose weight. In a US study, the average weight loss was 36% of a patient’s excess weight three years after the device was implanted. More than half of the patients lost at least 25% of their excess weight; some patients lost over 75%, but some lost no weight. However, most patients experienced at least one side effect. Common side effects include nausea and vomiting, heartburn, abdominal pain, and slippage of the band. The most serious side effects required either another operation or hospitalization.
gastric banding does not require cutting or removing any part of the digestive system. It is removable, requiring only a laparoscopic procedure to remove the band, after which the stomach usually returns to its normal pre-banded size so it is not unusual for a person to gain weight after having a band removed.