Laparoscopic Adjustable Gastric Banding: A Restrictive Procedure

When diets don’t work, a surgical weight loss procedure can provide new hope for improved health and quality of life.

The laparoscopic adjustable gastric banding procedure is a surgical procedure based on restricting the patient’s food intake while helping the patient feel full faster and longer. The surgeon places a band around the uppermost part of the stomach; after surgery, the band is injected with saline solutions so that it squeezes the stomach, dividing it into two portions: one small and one larger. When the patient eats, the food quickly fills the smaller portion of the stomach, tricking the body so that it feels full faster.

As the name indicates, the band is adjustable. So if the rate of weight loss is not acceptable, the band can be adjusted to make the stomach feel smaller or larger. Food digestion happens through normal digestion.

Laparoscopic adjustable gastric banding is a minimally invasive procedure, so there are just a few small incisions used by the surgeon to view the stomach and to manipulate the gastric band into position. The procedure has been safely used outside the U.S. for more than a decade, and has now been FDA-approved for use in the U.S.

Advantages

• A 2004 meta-analysis of more than 22,000 patients showed that those who underwent a bariatric surgical procedure experienced complete resolution or improvement of their co-morbid conditions including diabetes, hyperlipidemia, hypertension, and obstructive sleep apnea.¹⁶
• 47.9 percent of type 2 diabetes cases were resolved.³
• Significant improvements in overall cholesterol occurred, including a boost in HDL levels.³
• 70.8 percent of hypertension cases were resolved or improved.³
• Patients lost roughly 47 percent of their excess weight.³
• The amount of food that could be consumed at a meal was restricted.
• Food passed through the digestive tract in the usual order, allowing it to be absorbed fully by the body.
• In studies involving more than 3,000 patients, excess weight loss ranged from 28 to 87 percent, with a minimum of two-year postoperative follow-up.³
• Band can be adjusted to increase or decrease restriction via an access port.
• Surgery can be reversed.

Risks and Disadvantages

• The access port may leak or twist, which can require an operation to correct the problem.
• Surgery may not provide the necessary feeling of satisfaction that one has had enough to eat.
• Dumping syndrome, which may provide important warning signs, does not occur.
• Band may erode into the stomach wall.
• Band may move or slip.
• Weight loss is slower than that following Roux-en-Y gastric bypass surgery.
• The procedure could result in death.

Single Incision Lap Band Surgery

Your navel may now be the doorway to improved health, thanks to a new procedure that enables surgeons to perform the laparoscopic banding procedure through the navel. Called single incision laparoscopic surgery (SILS™), it’s the most advanced laparoscopic surgical technique available today, and we're the first in the region to offer it.

One of the benefits of the laparoscopic banding procedure is that it’s minimally invasive. Until now, surgeons have performed the procedure using several small incisions. But using this new technique, the surgeons at the Center for Bariatric Surgery have a new technique that enables them to perform the surgery using just one incision in the navel.

To perform the surgery, our bariatric surgeons will make a small incision in the navel and insert the SILS device, a firm but flexible plug that stays in the navel throughout surgery. The device has four holes: one to pump in air, creating an open space in which to work; one for a camera; and two through which the surgeons will place their instruments. The device is airtight, allowing the surgical field to remain sterile. Once the lap band is in place, the surgeons will remove their instruments and the SILS device, then close the incision.

Because the technique is so new, our surgeons will initially perform single-incision laparoscopic surgery only with select patients, generally women with a BMI of 45 or less who have never had abdominal surgery before. 

Patients appreciate the cosmetic benefit of this surgical technique. In the past they might have had three or four small scars; now, they have one inside the navel, or none at all. But there’s another, more important benefit to single-incision surgery. With fewer cuts, patients experience less pain.

Best of all, they get the same great health benefits from laparoscopic banding as before: significant weight loss and improvement of co-morbid conditions, such as type 2 diabetes, hypertension, hyperlipidemia, and obstructive sleep apnea.