The laparoscopic adjustable gastric band is one of the minimally invasive surgical processes available for the treatment of the obesity. An adjustable gastric band is also known as ‘lap band’. The procedure includes implantation of a soft silicone ring with a stretchable balloon in the center, around the top segment of the stomach. As a result of this stomach effectively gets two compartments with a much smaller segment at the top of the band. Patient undergoing such treatment takes sufficient food only to fill the upper banded smaller part of the stomach. Over time after food intake, the food comes down to the larger portion of the stomach and gets digested. Excess weight loss, what has been reported in this treatment is ranging from 40 to 60%.
What is an adjustable gastric band?
Laparoscopic adjustable gastric banding (LAGB) is one of the surgical procedures for weight loss. It is generally done by making few small holes on the abdominal wall. The surgeon introduces instruments through these holes. One of the instruments is a laparoscope with a very small camera. A silicon band at the top segment of the stomach is placed by means of these devices. This way your stomach will be divided into two compartments. The band is connected to an injection port below the skin through a soft tube, which supports to adjust the tightness of the band by expanding or contracting the balloon in the band. Adjustment whenever necessary can be made possible in the office without any special preparation. Orifice between the two parts of the stomach gets smaller as soon as the saline solution is added to the band. As a result food from the upper compartment above the band drops very slowly to the larger compartment below the band. Removal of saline gives reverse effect. Orifice gets larger food passage from the upper chamber to lower one becomes faster.
Who is suitable for an adjustable gastric band?
The laparoscopic adjustable gastric band is approved for the patients with BMI above 35 or between 30 – 35 with a co-morbid syndrome such as type 2 diabetes mellitus (T2DM), sleep apnea, hypertension etc., who couldn’t achieve sustainable weight loss by medication. In most of the cases, the procedure can be as executed outpatient surgery and the patient can be discharged to go home within the day after observation.
What is the post-operative advice after lap band?
A patient should keep in mind that surgery is performed on him or her to control the body weight at a required level of body mass index. Therefore the patient has to be liable to make a gross change of lifestyle and quality food habit as prescribed by the surgeon. Planned food intake and healthy diet chart, careful chewing is must in such treatment. Mixing of liquid with solid food at the meal-plate is better avoided. Non-compliance with this guidance may result in a severe adverse reaction like vomiting, pain or reflux. A comprehensive check-up programme along with dietary consultation and regular physical work-out will increase the durability of the success of LAGB surgery.
What are the complications of adjustable gastric band surgery?
The complication in the short term is very rare for this surgery.Some of the known complications are the erosion of the band into the stomach, slippage of the band etc.
Authored By Dr G Parthasarathy - Surgical Gastroenterologist, Hyderabad