First approved for use in the United States in 2001, the Lap-Band is an adjustable gastric band used to help obese patients lose weight. As of January 2011, the Lap-Band is the highest-selling brand of adjustable gastric bands, having sold more than 650,000 units worldwide, according to the manufacturer. Although laparoscopic gastric banding -- LAGB -- is less invasive than other weight loss surgery procedures, the rate and percentage of weight loss with it appear to be lower.
Lap-Band Procedure
Laparoscopic adjustable gastric banding procedures involve slipping a silastic band around the upper portion of the stomach to form a tiny, egg-sized pouch. Using a tiny video camera and special instruments, the surgeon operates through one to five small incisions in the abdomen. Because the procedure does not involve rerouting the digestive system, as is done in the gastric bypass, patients recover quickly but must return to the surgeon's office periodically for band adjustments that tighten or loosen the band, making it easier or more difficult for the patient to eat.
Typical Results
LAGB patients typically lose between 28 percent and 65 percent of their excess weight by the second year after surgery, and have lost an average of 54 percent at five years, according to the American Society of Metabolic and Bariatric Surgeons. As a result, patients experience improvement in obesity-related diseases such as sleep apnea, type II diabetes, high blood pressure and gastroesophageal reflux. Among type II diabetes, 64 percent to 66 percent experience remission within one year after surgery and 80 percent are in remission after two years.
Considerations
The rate and percentage of weight loss depends on compliance with post-procedure instructions. Eating high-calorie foods, drinking fluids during meals, snacking or grazing, and avoiding exercise will slow or prevent weight loss. Patients also must return to the office periodically for adjustments, a procedure in which the surgeon injects or withdraws sterile fluid to tighten or loosen the band. During the first year, patients often need between five and eight adjustments, according to the product website.
Expert Viewpoint
Although some gastric band studies document weight loss percentages as high as those of gastric bypass patients, others report long-term complications such as band erosion, slippage and unsatisfactory weight loss that require further surgery in up to 20 percent of patients, says George L. Blackburn, M.D., lead researcher in a study published in the journal "Obesity" in February 2009. In fact, Swiss researchers suggested in an article published in the June 23, 2006, issue of "Obesity Surgery" that only 60 percent of the 317 LAGB patients they followed over eight years maintained a satisfactory weight loss of at least 25 percent.
References
- Lap-Band AP: Lap-Band Results
- Lap-Band AP: About Lap-Band Adjustments
- American Society of Metabolic and Bariatric Surgeons: Gastric Banding
- "Obesity;" Expert Panel on Weight Loss Surgery: Executive Report Update; George L. Blackburn, M.D., et al.; Feb. 19, 2009
- "Obesity Surgery;" A 10-year Experience with Laparoscopic Gastric Banding for Morbid Obesity: High Long-Term Complication and Failure Rates; M. Suter, M.D.; J.M. Calmes, M.D.; A. Paroz, M.D.; et al.; June 23, 2006
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