The LAP-BAND® Adjustable Gastric Banding System is an adjustable gastric band designed to help obese individuals achieve sustained long-term weight loss and has been demonstrated to lead to resolution or improvement of comorbid conditions such as type 2 diabetes, hypertension, and obstructive sleep apnea. It induces weight loss by reducing the stomach capacity and restricting the amount of food that can be consumed at one time, but it is unlikely that it will interfere with normal digestion and absorption of food and nutrients. The differentiating factor for the LAP-BAND® System from gastric sleeve or gastric bypass is that it does not require stomach cutting, stapling, or intestinal re-routing.
During the procedure, surgeons use a laparoscopic technique, which involves making tiny incisions and inserting thin surgical instruments through narrow, hollow tubes called trochars. A small camera also goes through the trochars to allow the surgeon to see inside the abdomen and view it on a video monitor. Using this technique, the surgeon is able to wrap the LAP-BAND® System around the top of the patient’s stomach, with no cutting, stapling, or intestinal re-routing.
The LAP-BAND® System is looped and fastened around the upper stomach in order to create a small pouch that limits and controls the amount of food that can be eaten. The band is then locked securely around the stomach.
Once the band is around the stomach, tubing connects the LAP-BAND® System to an access port fixed beneath the skin of the abdomen. This allows the surgeon to change the stoma size by adding or removing sterile saline inside the inner balloon through the access port with a thin needle. This adjustment process helps determine the rate of weight loss.
The diameter of the band can be modified to meet individual needs and change as a patient loses weight or needs to gain weight for medical reasons such as pregnancy. If the band is too loose and weight loss is inadequate, adding more saline can reduce the size of the stoma and further restrict the amount of food intake. If the band is too tight, saline can be removed to loosen the band and reduce the amount of restriction.
After two to four visits during the first couple of months, surgeons and/or their clinical staff usually see their LAP-BAND® patients every 4-8 weeks during the first year to determine if adjustments need to be made. These frequent visits allow the patients to discuss any questions or concerns they may have as well as engage in nutritional counseling to improve weight loss success. Adjustments are typically done in an office-based setting.
Although some people question whether Body Mass Index (BMI) is the best and most accurate way to determine whether someone is considered Normal Weight, Overweight or Obese, it remains the most important measurement in the eyes of insurance companies when they determine whether or not someone is eligible for bariatric surgery. Although each insurance provider has a different policy, which is subject to change, the general rule of thumb to qualify for surgery is as follows: