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Gastric Banding

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Before reading this paragraph please remeber that Dr. Spivak does not consider Gastric Banding to be the first or the best weight loss surgery choice for high BMI patients.

The LAP-BAND® System consists of an adjustable lap band designed to help you lose excess body weight, improve weight-related health conditions and enhance quality of life. The laparoscopic adjustable gastric banding reduces the stomach capacity and restricts the amount of food that can be consumed at one time. The LAP-BAND® System procedure, or laparoscopic gastric banding surgery, does not require stomach cutting and stapling or gastrointestinal re-routing to bypass normal digestion.

The name “LAP-BAND” comes from the surgical technique used, laparoscopic, and the name of the implanted medical device, gastric band. The LAP-BAND® System is a silicone ring designed to be placed around the upper part of the stomach and filled with saline on its inner surface. This creates a new, smaller stomach pouch that can hold only a small amount of food, so the food storage area in the stomach is reduced. The laparoscopic band also controls the stoma (stomach outlet) between the new upper pouch and the lower part of the stomach. When the stomach is smaller, you feel full faster, while the food moves more slowly between your upper and lower stomach as it is digested. As a result, you eat less and lose weight.

Once placed around the stomach, tubing connects the LAP-BAND® to an access port fixed beneath the skin of your abdomen. This allows the surgeon to change the stoma (stomach outlet) size by adding or subtracting saline, or salt water, inside the inner balloon through the access port. This adjustment process helps determine the rate of weight loss. If the band is too loose and weight loss is inadequate, adding more saline can reduce the size of the stoma to further restrict the amount of food that can move through it. If the band is too tight, the surgeon will remove some saline to loosen the band and reduce the amount of restriction.  In addition, The diameter of the band can be modified to meet your individual needs, which can change as you lose weight. For example, pregnant patients can expand their band to accommodate a growing fetus, while patients who aren’t experiencing significant weight loss can have their bands tightened if the band is loose.

The LAP-BAND® System Advantages

• Least invasive surgical option
• No intestinal re-routing
• No cutting or stapling of the stomach wall or bowel
• Small incisions and minimal scarring
• Reduced patient pain, length of hospital stay, and recovery period
• Fewer risks and side effects
• Removable at any time
• Stomach and other anatomy are generally restored to their original forms and functions

Disadvantages

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  • Long-term commitment and serious self control (very difficult task on the long run)
  • High maintanace operation (many adjustments and office visits)
  • Patients can potentially consume a high-calorie liquid diet and do not lose weight
  • Many times patients feel that food "gets stuck" at their chest and they don't have the fullness experience
  • Weight loss is less than gastric bypass or gastric sleeve 
  • Expect 50% of excess weight loss on average
  • About 25% of patients will not lose enough weight
  • In 10 years, 25% of the bands will need to be removed and many patients will be converted to gastric sleeve or gastric bypass

View a Gastric Banding Animation Video

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