Laparoscopic adjustable gastric band surgery, also known as Lap-Band surgery, is a type of weight loss surgery. During the surgery, a surgeon places an elastic band around the top of the stomach to create a small pouch. Food enters the small pouch before entering the larger lower stomach. This reduces the amount of food that can be eaten, leading to weight loss. The surgeon uses saline to inflate or deflate the band device, allowing it to be repositioned. The procedure is typically used to treat morbidly obese patients.
Rates of Incidence
Although the Lap-Band procedure is normally safe and effective, 89 percent of patients report experiencing at least one complication after having Lap-Band surgery. Lap-Band surgery has a mortality rate of 0 to 0.1 percent, according to an article in the June 2009 issue of the "World of Surgery."
Time Frame
Certain complications occur immediately after surgery, whereas others may not manifest for months following the procedure. According to the December 2002 issue of "The American Journal of Surgery," the U.S. clinical trial of the Lap-Band device followed patients for nine to 12 months. In that trial, 2.2 to 13 percent of patients experienced long-term complications while .4 to .6 percent of patients experienced complications within three weeks of surgery.
Infection
All surgical procedures carry the risk of infection. The Lap-Band surgery is normally done laparoscopically, requiring several small incisions. This minimizes the risk of infection. But during Lap-Band surgery, the surgeon installs a port under the skin that can be used to inflate or deflate the band with saline. Infection can occur at the port site. According to "The American Journal of Surgery," post-surgery infections affect about 4 percent of patients.
Pouch-Related Complications
After surgery, the small upper pouch can twist or swell, causing an obstruction that prevents food from moving down to the larger stomach. This can occur when the band is positioned too tightly. Surgeons treat the problem by repositioning or replacing the Lap-Band device. During the first few weeks following Lap-Band surgery, a patient must pay particular attention to pouch care and strictly follow the diet guidelines outlined by his physician.
Device-Related Complications
Band erosion occurs when the band device gradually cuts into the stomach. This condition is rare and may not occur for several months after the surgery. Treating the condition requires additional surgery. The band must be removed and, if the patient desires, repositioned. The stomach wall must also be sutured. In the February 2001 issue of "Obesity Surgery," Dr. Subhi Abu-Abeid wrote that band erosion is often the result of the abdominal wall being injured during the original surgery. Sometimes the Lap-Band can deflate on its own, resulting in saline leakage. In a February 2003 article published in "Obesity Surgery," Dr. Sergio Susmallian wrote that this postoperative complication occurs in 11 percent of surgeries. A patient may notice a change in pressure or the amount of food she is able to eat in one sitting. Depending on the cause of the leak, the band may need to be refilled or replaced.
References
- Food and Drug Administration: Lap-Band Summary of Effectiveness
- "World Journal of Surgery"; The Gastric Band: First-Choice Procedure for Obesity Surgery; Franco Favretti, M.D.; June 2009
- "The American Journal of Surgery"; U.S. Experience With the Lap-Band System; Christine J. Ren, M.D.; December 2002
- "Obesity Surgery"; Laparoscopic Management of Lap-Band Erosion; Subhi Abu-Abeid, M.D.; February 2001
- "Obesity Surgery"; Access-Port Complications After Laparoscopic Gastric Banding; Sergio Susmallian, M.D.; February 2003
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