Lap banding surgery, also known as gastric banding, is a procedure that has been used since 1993. Over 50,000 banding surgeries have been done since then, according to a U.S. Food and Drug Administration (FDA) report. While many patients experience serious complications as a result of the surgery, the University of California, San Diego Medical Center (UCSDMC) claims that the risks of gastric banding are "significantly less than other forms of bariatric surgery."
Surgery-Related Complications
The lap band is an adjustable silicone gastric band that is implanted during a surgical procedure. Errors in surgery include suturing the band to the stomach (resulting in erosion of the device), laparoscopic insertion errors (when the physician uses this type of surgical procedure), damage to the gastrointestinal tract, and accidental perforation of the esophagus or stomach. Other surgical complications may result from insertion of a band that becomes contaminated due to handling, allowing talc, lint or fingerprints to be introduced into the body and resulting in an immune system reaction. The gastric band, access port, and tube all require individual calibration. The FDA "Summary of Safety and Effectiveness Data" for the Lap-Band System includes five pages of cautions and warnings for the insertion.
Band-Related Complications
Several complications may result due to the band itself. The surgical bands may erode in the stomach. According to the FDA, over-restriction of the band may cause esophageal distension and create a stomach obstruction.
Patient-Related Complications
Patient-related complications result from patient body mass. While lap banding is restricted to morbidly obese patients who are at least 100 pounds overweight or have a Body Mass Index (BMI) of 40 or more, this fact also adds significantly to the possibility of complications. When weight is lost in patients with greater body mass, the stomach pouch does not shrink proportionally with the reduction in weight, and extra tissue is created that may interfere with the stomach wall pouch. The resultant stretching leads to band slippage. UCSDMC reports that this is the most damaging and significant complication of lap banding surgery .
Disease Factors
Patients with prior conditions may also experience complications related to the disease. This includes individuals with Crohn's disease, atresias or stenoses (both GI tract conditions), cirrhosis, chronic pancreatitis, drug addiction, long-term steroid use, autoimmune diseases such as lupus erythematosus or scleroderma, and portal hypertension. Patients with allergic reactions to implants should not be considered for the procedure, according to the FDA summary.
Mild Complications
Other complications include gastritis, constipation, dehydration, nausea and reflux, according to the UCSD Medical Center. The FDA report of a clinical study found that 82 percent of patients had mild complications, most frequently abnormal stools, nausea and vomiting.
Serious Complications
Lap band patients may experience high homocysteine levels as they lose weight. These may increase the risk of heart attack and stroke. Each patient signs a waiver prior to surgery acknowledging that the procedure may be life-threatening. The FDA summary warns that "death can occur." The clinical data reported severe complications (defined as "life threatening, permanently disabling, unexpected, fatal, requiring hospitalization or prolonged hospitalization") in 34 percent of the patients undergoing the procedure. Two of the 266 patients involved in the study died of complications directly related to the lap band surgery, according to the FDA review.
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