How LAP-BAND Surgery Works

The LAP-BAND® Adjustable Gastric Banding System is a form of weight loss surgery that is is becoming more popular because of its lower costs and quicker recovery times.

The operation is also perceived as being less invasive than the more commonly used Roux-en-Y gastric bypass procedure.

The laparoscopic adjustable gastric banding procedure is often called LAP-BAND® system, after the inflatable silicon band that divides the stomach, creating a very small stomach pouch with an adjustable opening to the rest of the stomach. The diameter of the band is usually about two inches, but the surgeon can adjust its diameter by pumping saline into it from a reservoir implanted under the patient's skin.

When the band is in place, the stomach takes on an uneven hour-glass shape, with the smaller portion at the top.

Unlike the Roux-en-Y gastric bypass surgery, the gastric banding procedure does not reroute the upper intestine. Weight loss occurs solely because the size of the stomach is restricted. The adjustable band decreases the amount of food the patient can eat at one time, but does not otherwise interfere with the digestive process.

Because the procedure does not bypass any portion of the intestines, patients who have the gastric banding operation don't usually experience one of the Roux-en-Y operation's more uncomfortable side effects, the dumping syndrome. After a Roux-en-Y gastric bypass operation the patient is unable to eat sugary foods, and some patients are also unable to eat red meats and any food with high fat contents. When patients attempt to eat these foods they become nauseous and may vomit, making the experience extremely uncomfortable.

Since the lap band operation does not cause this side effect, post-operative patients are still able to eat the foods that originally led them to obesity, and for this reason long-term nutritional and behavioral counseling is usually recommended.

Gastric banding patients do not lose weight as quickly as patients who undergo the full gastric bypass procedure. This may be the reason why many U.S. surgeons prefer to offer the Roux-en-Y operation for their obese patients. Surgeons in Europe and Australia appear to show a preference for the less invasive Lap Band surgery, because it is usually safer.

Although weight loss is slower with the gastric banding procedure, after 3 to 5 years both gastric banding and gastric bypass patients show comparable weight loss, according to recent studies.

If no complications occur, a gastric banding patient can expect to go home in a day or two after the operation. This helps to reduce the total cost of the surgery, which may run around $14,000 to $18,000 if there are no complications, as opposed to the commonly quoted $35,000 to $40,000 that gastric bypass surgery will cost in the United States.

The gastric banding procedure is less invasive than gastric bypass, and there are fewer reported complications and deaths from this type of surgery. However, complications do occasionally occur, and a second operation is sometimes needed. A recent study that looked at the records of 300 gastric banding patients found a 5% complication rate, while other studies have found the rate of complications to be higher. Some patients will need a second operation due to band slippage or because the stomach pouch becomes dilated.

As with all patients who undergo rapid weight loss, gall stones are common, and long-term nutritional and behavioral counseling is needed for the best outcomes.