Adjustable Gastric Band

A laparoscopic adjustable gastric band, commonly referred to as a lap band, is an inflatable silicone device that is around the top portion of the stomach, via laparoscopic surgery, in order to treat obesity. Adjustable gastric band surgery is an example of bariatric surgery designed for obese patients with a body mass index (BMI) of 40 or greater—or between 35–40 in cases of patients with certain comorbidities that are known to improve with weight loss, such as sleep apnea, diabetes, osteoarthritis, high blood pressure, or metabolic syndrome, among others.

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Gastric banding is the least invasive surgery of the bariatric surgery solutions kind. Gastric banding using laparoscopic surgery and usually results in a shorter hospital stay, faster recovery, smaller scars, and less pain than open surgical procedures. The patient can continue to absorb nutrients from food normally. Gastric bands are made entirely of biocompatible materials, so they are able to stay in the patient’s body without causing harm. However, not all patients are suitable for laparoscopy. Patients who are extremely obese, who have had previous abdominal surgery, or have complicating medical problems may require the open approach.

A small incision near the belly button and carbon dioxide is into the abdomen to create a workspace for the surgeon. Then a small laparoscopic camera is through the incision into the abdomen. The camera sends a picture of the stomach and abdominal cavity to a video monitor. It gives the surgeon a good view of the key structures in the abdominal cavity. The surgeon makes a few small incisions in the abdomen. The surgeon watches the video monitor and works through these small incisions using instruments with long handles to complete the procedure. The surgeon creates a small, circular tunnel behind the stomach, inserts the gastric band through the tunnel, and locks the band around the stomach. Clinical studies of laparoscopic bariatric surgery patients found that they felt better, spent more time doing recreational and physical activities, benefited from enhanced productivity and economic opportunities, and had more self-confidence than they did prior to surgery. The placement of the band creates a small pouch, or stoma, at the top of the stomach. This pouch holds approximately ½ cup of food. (The typical stomach holds about 6 cups of food.) The pouch fills with food quickly, and the band slows the passage of food from the pouch to the lower part of the stomach. As the upper part of the stomach registers as full, the message to the brain is that the entire stomach is full, and this sensation helps the person to be hungry less often, feel full more quickly and for a longer period, eat smaller portions, and lose weight over time.

As patients lose weight, their bands will need adjustments, or “fills,” to ensure comfort and effectiveness. The gastric band adjustment by introducing a saline solution into a small access port placed just under the skin. There are many port designs and they may be placed in varying positions based on the surgeon’s preference, but are always attached through sutures, staples, or another method to the muscle wall in and around the diaphragm.