Lap Band Surgery - What To Know Before You Commit

When you choose to undergo any weight loss surgery it's important to know that you've exhausted all your other options first, because it isn't only an important medical decision but a significant financial decision as well. And if your lap band surgeon approves you for lap band surgery after having an extensive consultation, you'll be required to undergo pre-op exams and lab tests before you can be medically cleared for surgery. The LAP-BAND System received its approval from the FDA (Food and Drug Administration) for use in the United States in June of 2001.

Having inflammatory diseases of the gastrointestinal tract like ulcers, esophagitis or Crohn's disease does not make a person a good candidate for lap band surgery. The lap band surgery is usually not performed if someone has an untreated glandular disease such as hypothyroidism, where other measures may still be undertaken. A possible allergic reaction to materials in the band or for anyone who has exhibited pain intolerance to medically implanted devices are contraindications for lap band surgery.

People who are eligible for lap band surgery are between the ages of 18 and 55 years, although there are bariatric doctors who will work outside of these ages, some as young as 12 years old. And mentally disabled or emotionally unstable people cannot be considered for lap band surgery. Medifast Specials  

How it works - the band is inflated and adjusted by way of a small access port placed just beneath the skin subcutaneously, then radiopaque isotonic solution or saline solution is introduced into the band through the port. The adjustable gastric band or Lap Band is an inflatable, silicone, prosthetic device that is placed around the upper portion of the stomach and using keyhole laparoscopic surgery. And the port membrane may be sutured in place.

The placement of the adjustable gastric band creates a small pouch at the top of the stomach which holds about 50 ml. The pouch fills with food quickly and the passage of food from the top to the bottom of the stomach is slowed down. Gastric dumping syndrome problems don't occur in lap band surgeries because none of the intestines are removed or re-routed. When the upper part of the stomach believes it is full the message is sent to the brain that the stomach is full. This sensation helps the person eat smaller portions and thus lose weight over time.

The initial weight loss in gastric banding is slower than with Roux-en-y gastric bypass surgery but the statistics indicate that over a five-year period the weight loss outcome is very similar. The World Health Organization recommendation for monthly weight loss is about 1.1 to 2.2 pounds a week.  An average gastric-banded patient may lose this amount of weight.

Following the surgery, adjustments, which are also called 'fill's may be performed using a fluoroscope so the radiologist can assess the placement of the band, the port and the tubing, which runs between the port and the band. Some patients may find that before their first fill they're still able to eat fairly large portions of food. And also regarding 'fill's, some weight loss doctors are more aggressive than others, but most appear to require a two to four week wait between the 'fill's.

Slippage can happen.  Slippage is an unusual occurrence where the lower part of the stomach prolapses over the band and cause an obstruction. Some of the mechanical malfunctions that can occur after surgery are leakage from the port, cracking of the kink-resistant tubing or a disruption of the tubing connection from the port to the band, port site pain and port displacement.

Some of the complications of adjustable gastric band post-surgery are nausea, vomiting, gastroesophageal reflux, stoma obstruction, constipation, dysphagia, diarrhea, and abnormal stools. A common occurrence for lap band patients is regurgitation of some of the non-acidic swallowed food from the upper pouch, which is commonly known as productive burping. This should not be considered normal.

One should be aware that some people have died while undergoing adjustable gastric band surgery. Some post-surgical weight loss surgery teams do offer support groups, but some of them mix gastric bypass surgery patients with the gastric banding patients.  If you undergo this surgery and would like to join a group, try to find a support group for gastric banding only. All in all it's important to find a weight loss team with a good post-surgical plan because the follow-up recommendations can vary dramatically. Medifast Specials  

copyright©2007 J. Johanson All Rights Reserved. No permission is given to copy nor reprint this article.