Understanding lap band surgery with the LAP-BAND® System.
As our society has accepted morbid obesity as a serious problem, attempts to combat obesity have grown.
First standardized in the 1990s in Belgium and Italy, lap band surgery or gastric banding surgery squeezes closed the upper part of the stomach with an inflatable band. Patients quickly feel full after eating a little. The new stomach pouch dilation or adjustments can be accomplished at the office.
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LAP-BAND® System for morbid obesity surgery approved by the FDA in June of 2001.
“Over the past seven years in Europe, thousands of these adjustable gastric bands have been placed,” Katkhouda (one of the nationally recognized lap band surgeons) says. “And now they can place a band in one hour, with a one-day hospital stay, and through only three small incisions. This does not mean that this operation is devoid of risks; careful patient selection and technique is required.”
Considered one of the safest surgeries for 
weight loss because there is no cutting or stapling of the stomach involved. the gastric
LAP-BAND® System is reversible. Surgery usually takes about one hour and patients are usually discharged from the hospital on either the same day as the surgery or the day after. The diet for two weeks after surgery will be limited to liquids and protein shakes with a slow progression to solid foods. Patients should learn the rules of good nutrition by attending nutrition classes after LAP-BAND® System surgery to maximize the effects. See at right the LAP-BAND® System adjustable gastric band.
It also will require replacement or removal at some point in the future. Only recently approved in the U.S. by the Food and Drug Administration, lap band pouch dilation is managed through a catheter placed under the skin. Surgery can be reversed by removing the band, says Katkhouda, one of the first approved gastric banding surgeons in Los Angeles.
An adjustable silicone band is placed around the upper stomach to create a small (one half ounce) pouch with a narrowed opening. The opening size is adjusted at the time of surgery, and then connected by I.V. tubing. The small pouch fills quickly with solid food and empties slowly to relieve hunger and produce a feeling of fullness. Overeating is painful and may lead to vomiting. Purely restrictive operations only limit food intake and do not interfere with the normal digestive process.
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.
Even though considered the safest morbid obesity surgery, it is not completely without risk! It is possible for the band to slip, or to erode into the stomach or there could be total malfunction of the band. All of these conditions are correctable, but do require another surgery to be corrected. These incidents may occur in approximately 10-20% of patients.
“While laparoscopic gastric bypass surgery is good for the morbidly obese patient, the adjustable gastric
LAP-BAND® Adjustable Gastric Band surgery may help those who are morbidly obese under 20 years old,” he says. “It also is an option for those over 60, or for those patients at high risk for complications.”
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