Laparoscopic adjustable gastric banding (LAGB) is a restrictive weight loss procedure. The LAGB surgery was originally introduced in 1993. Today the surgery is widely known by the name LAP-BAND^®. LAP-BAND^® is a specific brand of adjustable gastric band used by many surgeons. LAP-BAND^® was approved for use by the FDA in 2001 and according to the manufacturer has been placed into more than 190,000 patients.

General Procedure

In this procedure a band is secured around the upper portion of the stomach creating a very small pouch to receive and store ingested food in preparation for the gastric phase of digestion.  Weight loss is achieved by 2 mechanisms: 1) reduction of hunger by the constant pressure of the band on the upper stomach (no snacking) and 2) reduction of the the capacity of the stomach thereby reducing meal portions while preserving satisfaction (fullness). Digestion takes place without physiologic alteration. In other words, no malabsorption occurs, which is the mechanism by which the Roux Y gastric bypass achieves it's effect.

Adjustment of the band is necessary to optimize weight loss.  This is done by by injecting the subcutaneous access port with a sterile saline solutionon a periodic basis, usually monthly. This is not painful or risky. Return of appetite and/or eating too much are indicators that it's time for adjustment. Most adjustments are needed during the earlier phase of weight loss when the stomach wall thickness and surrounding fat are diminishing quite rapidly, lessening the contact pressure of the band on the stomach receptors. Replacement of fat with saline keeps the contact, thereby regaining the effect.

Advantages of Laparoscopic Adjustable Gastric Banding or LAP-BAND^®

• Gastric banding is the least invasive weight loss procedure.
• No re-routing of the intestine.
• No opening of the stomach or intestine.
• Less pain than most weight loss surgeries.
• Shorter hospital stay.
• Reduced recovery time.
• Reduced chances of nutritional deficiencies.
• Mortality rate is greatly reduced when compared with other weight loss procedures.
• No dumping syndrome associated with this surgery.
• Band is adjustable.

Disadvantages of Laparoscopic Adjustable Gastric Banding or LAP-BAND^®

• Potential for injury to stomach during surgery (rare) 
• Erosion of the Band into the stomach requiring removal (rare)
• "Slipping" of the band caused by dysfuctional eating. Extreme delay in treatment can result in the need for additional surgery.
• Infection.  This can jeapordize the access port and even the entire system requiring removal and replacement at a later date.
• It needs to be adjusted.

Insurance Coverage

Insurance usually covers the LAP-BAND procedure. Check with your insurance carrier for more information and visit our list of Accepted Insurance Providers.