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 separating it into a small section and a larger section. Weight loss is achieved by reducing the capacity of the stomach thereby allowing the patient to experience a sense of fullness more quickly, even while consuming less food. Digestion takes place naturally as the now smaller portions of food pass through the stomach. Unlike other restrictive weight loss surgeries LAGB does not require the removal of any part of the stomach or intestine.

Since the band is adjustable it can be loosened or tightened to change the rate of weight loss. By injecting the band system with a sterile saline solution, the lap band inner tubing will outwardly and circumferentially gently compress the upper stomach and thus functionally restrict the size of the stomach. A subcutaneous port is placed during surgery and accessed postoperatively to allow for inflating or deflating the saline filled band as needed.  Here in our program at Advanced Surgical Associates, the first lap band adjustment or "fill" typically occurs at 4-6 weeks post-operatively and then again as needed every 6 weeks until the optimal restriction is reached.  Dr Balder preforms these adjustment himself in the comfort of our office at Advanced Surgical Associates with the aid of an x-ray machine and limited gastrograffin or contrast study.  This serves to optimize the "restriction" or tightening and promote better "satiety" (or the opposite of hunger) than previously done with blind adjustments.  It has also served to be much less costly for our patients care than with previous hospital based adjustments.  The amount and timing with regard to the saline instilled or added into the lap band system is customized for each patients individual care as requirements for optimizing the lap band are unique for each individual person who has the procedure.

• 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.
• Major complications occur at a rate of 3 -10% requiring additional surgery.
• Slipping of the band can require further surgery.
• Should the band  or port become infected - surgery could be needed to replace it.