Gastric Band

Laparoscopic Gastric Band

The adjustable gastric band is often referred to by one of its trade names Lap-Band® or Realize® Band. The r Realize band is no longer being manufactured. The gastric band is the simplest and safest of all the bariatric procedures we offer since there is no cutting of the stomach or alteration of the gastrointestinal tract. It is a restrictive procedure which restricts gastric intake by narrowing the inlet with the gastric band. It is also the least effective form of weight loss that is offered.

How the Gastric Band Works: 

The gastric band is a laparoscopic procedure which works by restricting the amount of food the patient can eat in one meal. The abdomen is accessed through five tiny incisions created to allow the ports to be placed and the laparoscopic instruments to pass into the abdomen. The surgeon places the band around the very top of the stomach and tightens it. Once the band is tightened, it molds the gastric chamber into two separate pouches that resembles a figure 8. . The smaller pouch created above the band becomes the primary receptacle for the food that is consumed. It significantly reduces the size of the pouch and will limit the amount of food the patient consumes. It often makes the patient feel full earlier and feel satisfied longer. The food then slowly trickles into the lower stomach where it is digested in a normal fashion. The band is connected to a port placed under the skin and connected to the band by a thin catheter. This port is fastened to the abdominal wall under the skin and is used to adjust the band after surgery in the office. The surgeon uses a special needle to inject or remove sterile saline from the band to tighten or loosen it respectively. It currently is the only adjustable form of weight loss surgery offered. Patients that are successful with a gastric band are often younger, more active, with few medical conditions.

Advantages of the Gastric Band: 

• The band is reversible with simple removal
• The band is adjustable with a simple office visit to increase or decrease the amount of restriction
• It is an operation that is quick with few complications and can be placed in an outpatient setting.

Disadvantages of the Gastric Band: 

• • This procedure historically has the least amount of weight loss over period of time and may only reduce excess weight by 30 – 40 %, compared to the sleeve where weight loss is 50 -60% and the gastric bypass where a patient may lose as much as 60 -70% of excess weight.
  • Patients require frequent follow-up initially until the band is filled to an appropriate level that restricts dietary intake without emesis
  • Often associated with more emesis than the other procedures
  • Follow-up visits require a visit to the office, insurance copay or cash to fill
  • The band can erode into the esophagus, slip, and the injection port can flip – all these conditions lead to additional surgery
  • Often the bariatric surgery that returns to surgery the most frequently for correction of the above
  • Patients will have to live with a foreign body
  • Long term use of the band can cause esophageal aperistalsis or dilatation that can result in frequent emesis and necessitate removal