Types of Bariatric Surgery
Laparoscopic Adjustable Gastric Band
Laparoscopic adjustable gastric band is a device that is used in approximately 25 percent of all bariatric surgery patients in the U.S. Adjustable gastric band has been used in the U.S. since 2001, and in Europe and elsewhere for much longer. In this laparoscopic procedure a silicone band with an inflatable inner cuff is wrapped around the upper stomach to form a small upper stomach pouch. This is, therefore, a gastric restrictive procedure designed to limit how much is eaten.
The inflatable cuff on the band is filled with saline, which is connected by a tube to a small port, or reservoir, implanted beneath the skin during surgery. The port is accessed by a needle through the skin to “adjust” the band so that food can pass out of the upper stomach with more, or less, difficulty. Routine follow-up visits to your physician are necessary so the gastric band can be adjusted.
Patients with gastric banding will need to eat very small meals, augment with supplements, have regular lab work, and have follow-up with their physician.
Advantages of Laparoscopic Adjustable Gastric Band
- Simple operation to perform, less operative time.
- Few early complications over the first 1-6 months.
- Fewer alterations in gastrointestinal anatomy than other operations.
Disadvantages of Laparoscopic Adjustable Gastric Band
- Less effective than gastric bypass: 33 percent excess body weight loss at one year and 47 percent at two years.
- Frequent post-operative visits for adjustments: nine per year in one study.
- Increased risks of complications over time.
- European experience indicates perhaps up to one third must be removed over 5-7 years’ time.
Patient Responsibility
Your success with an adjustable gastric band will depend greatly on your involvement in an exercise program and adherence to nutritional guidelines.
