The LAP-BAND® Adjustable Gastric Band is a small device made of plastic, metal and silicone rubber which is wrapped around the very uppermost portion of the stomach. Gastric banding works by decreasing the functional size of the stomach. The LAP-BAND turns the stomach into an hourglass shape — the upper portion of the hourglass is called the stomach pouch. The food you eat quickly fills the pouch, then empties very slowly through the constriction created by the band, just like sand passing through an hourglass.
The LAP-BAND was approved by the FDA for general use in June 2001. Some research studies suggest that Americans can lose about 40% of their excess body weight with this device. This is less than the 50-80% of excess weight loss with sleeve gastrectomy, gastric bypass and BPD-DS.
Advantages of the LAP-BAND
The LAP-BAND has a very low operative risk. No cutting or stapling of the stomach is required, and the small intestine is not rerouted.
Disadvantages of the LAP-BAND
Some disadvantages include:
- The LAP-BAND is a foreign body. Any time a foreign body is placed around the stomach, problems such as infection or erosion may occur.
- Everyone requires multiple band adjustments (at least 3 or 4). Some people require substantially more adjustments. For some people, it may be difficult to find the “sweet spot” where the band is tight enough for good weight loss but not so tight that it causes vomiting.
- Weight loss with the LAP-BAND is quite variable. While some patients have excellent weight loss with the device, others have very little.
- The LAP-BAND may have a higher need for reoperation than other procedures. Up to 10-20% of patients or more may need revisional surgery after the LAP-BAND.