The laparoscopic adjustable band (LAGB), also known as Lap Band®, or Realize® Band, has been available in the US since 2002 after a trl period overseas. Though the concept of oral intake restriction through surgery is not new, previous iterations, such as the banded gastroplasty or the Angelchik® prosthesis, have subsequently been abandoned due to complications or ineffectiveness.
In its current format, an inflatable (adjustable) silicone ring is placed around the upper stomach. It is then connected to a port reservoir that’s attached to and buried in the abdominal wall. The band’s tightness can be adjusted by accessing the port via a needle stick and injecting or removing saline. To achieve the proper balance between satiety, weight loss, and obstructive symptoms, bands do require frequent adjustments, with or without fluoroscopic or ultrasound assistance. Only a limited number of these adjustments are covered by health plans and most patients when faced with high out of pocket costs, would forego additional visits and adjustments.
Compared to stapled operations, the LAGB surgical procedure has a much shorter learning curve for surgeons, and can often be performed on an outpatient basis. In addition, the initial recovery period is quicker than the other operations. Since no stapling or partitioning is involved, it is considered a safer operation initially albeit more (but less severe) complications are seen down the road. Furthermore, in the absence of any intestinal rerouting, the procedure is free of malabsorption issues and does not cause some of the gastrointestinal side effects of the more aggressive stapled operations such as the gastric bypass and duodenal switch.
Finally, the device complex can be removed at any point, although that does cause scarring in the implanted area, which potentially makes future procedures riskier.
Adjustable bands have a 100% lifetime re-operation rate. The revisional surgeries can include placement of another band, simultaneous or staggered conversion to a stapled procedure, or a simple explanation without additional surgeries. There are pros and cons to each choice.
At University Bariatrics, one of our primary goals is to educate patients about all of the available options. The ultimate decision, however, rests with you but must be made after serious discussions with your doctor and family. Should you choose to pursue a procedure not offered directly by us, we can help navigate you through the hype and help you reach your goals. If you’re interested in more information on Lap Band Revision in Thousand Oaks or one of our many other effective bariatric procedures, contact our highly trained specialists today at (805) 379-9796.
To watch an animated video of a gastric band, please click here .