Lap Band Surgery - An Overview

Introduction:

This procedure is also called gastric band surgery. It is a procedure where the stomach’s storage capacity is reduced by placing a silicone (a synthetic material used in making cooking vessels, medical equipment, adhesives, thermal insulators, etc.) band encircling the stomach. The people eligible for this surgery should have a body mass index (BMI) of 40 and more or a BMI of 35 or more with obesity-related health problems like high blood pressure, diabetes, osteoarthritis (cartilage or bone damage), etc. Cartilage is a protective layer of tissue at both ends of bones. Body mass index is the body fat measure calculated with the height and weight of a person.

What Is Lap-Band Surgery?

Lap band surgery is a type of weight-loss surgical procedure that involves placing a movable silicone band in the upper region of the stomach. The doctor will recommend this procedure if no other weight loss programs or methods are helpful in weight reduction. After placement of the silicone band around the stomach, it restricts the quantity of food intake and makes one feel full with reduced food consumption, which will eventually result in weight loss. The silicone band adjustments can be made in later stages. This is not a permanent procedure or a non-reversible method.

How Is the Lap-Band Surgery Procedure Performed?

• General anesthesia is administered during this procedure, where a medication is injected, so the patient becomes unconscious and does not feel anything.

• Lap-band surgery is a minimally invasive laparoscopic procedure performed by creating a small opening in the stomach.

• A flimsy, flexible tube with a camera and a light is inserted into the stomach through the tiny holes, and the internal part of the stomach is viewed on the monitor outside.

• A silicone band is inserted and placed in the upper portion of the stomach. It looks like a ring put around the stomach.

• A tube with a device is attached to the soft silicone band. The device part of the tube is placed underneath the stomach wall's skin so the device can be accessible.

• The device serves as a portal through which the doctor injects saline, and the tube inflates like a balloon and constricts the space between the stomach.

• It creates a pouch in the upper part, leaving a small portion of the stomach for storing the food consumed. It looks like a sand clock (hourglass) with a narrow connection between the upper and lower parts of the stomach.

• The silicone tube is not attached permanently and can be removed or adjusted accordingly.

What Are the Benefits of Lap-Band Surgery?

• The lap band procedure is minimally invasive, unlike other surgical procedures for weight loss, like a surgical gastric sleeve, in which a huge part of the stomach is removed.

• It has low levels of post-surgical complications than other procedures.

• After the lap band surgery, it can be easily reversed, and the silicone band can be removed whenever the patient wishes.

• It does not affect the usual digestive process and does not affect nutritional absorption from the food.

• It benefits the person with long-term weight loss.

• No pain while exercising after surgery.

• Quick recovery after surgery.

• Good quality of life.

What Are the Complications of Lap-Band Surgery?

There are no significant complications with lap-band surgery. However, a few complications are listed below:

• Delayed Weight Loss: It results in less weight loss than other types of weight reduction surgeries.

• Doctor Visits: Frequent visits to the doctor's office for band adjustments within the first year of surgery.

• Infection: A few patients have reported wound infection in the surgical area, or minor bleeding occurs.

• Nausea and Vomiting: A few cases of nausea and vomiting are reported due to the band's tightness around the stomach.

• Heartburn: A few patients develop heartburn after the surgery.

• Esophageal Dilatation: It may develop due to the restricted stomach capacity. There are possibilities for the food to get stuck in the esophagus leading to dilatation (widening).

• Band Slippage: The silicone band slips from the site in some cases, and this results in the removal of the band.

• Band Erosion: The silicone band sometimes results in erosion, causing injury to the tissues in the site where the band is placed. This occurs in rare cases.

Who Is Eligible to Undergo Lap-Band Surgery?

• Eighteen Years: The person should be 18 years of age.

• Body Mass Index (BMI): The BMI of the patient should be 40 and above or 35 and above with obesity-related health problems like diabetes, high blood pressure, sleep apnea (breathing difficulty while sleeping or lying down), etc.

• Unsuccessful Weight-Loss Attempts: People who had unsuccessful weight loss attempts like diet, exercise, and a few medications.

• Non-Pregnant Females: People who do not plan pregnancy.

• Non-dependent on Alcohol or Drugs: People who are not alcoholics or drug dependent.

• Ready for Lifestyle Changes: People who agree to modify their lifestyle after surgery.

What Is the Recovery Time and How Much Weight Is Lost With Lap-Band Surgery?

It usually takes two to three days for the patient to recover. However, a week's rest is generally recommended. Up to 40 percent weight loss is expected in patients undergoing lap-band surgery. For example, if a patient is overweight by 100 pounds (45.35 kilograms), the expected weight loss will be around 40 pounds (18.14 kilograms).

What Are the Dietary Recommendations After Lap-Band Surgery?

• A restricted diet starting with water and fluids like thin soup is recommended in the first few days.

• Liquid foods like yogurt and blended vegetables can be consumed till the end of four weeks.

• Soft foods like mashed fruits or vegetables are allowed to eat between four to six weeks.

• The patient can restart a normal diet after six weeks.

What Follow-up Care Needs to Be Followed After Lap-Band Surgery?

• Frequent visits to the physician’s office in the first year of the surgery for adjustment of the band.

• Tightening the band after weight loss to sustain the weight loss.

• Regular blood check-ups to have a look if the nutrients are adequately consumed with alterations in the diet.

• Counseling by a nutritionist may be needed to follow a new diet plan in accordance with the band placement.

• Nutritional supplements may be recommended in some cases when there is a nutrient deficiency.

Conclusion:

The lap-band surgery helps people lose weight with the surgical placement of a silicone band. It is a minimally invasive technique where a pouch is formed in the upper segment of the stomach. This allows a limited amount of food intake. It results in weight loss as the food intake is reduced and stomach fullness is felt with little food. However, the band may sometimes loosen, and adjustments must be made to secure it by injecting saline through the device attached to the stomach wall. Frequent physician visits are mandatory for band adjustments in the first year after surgery. As weight loss progresses, the band will be adjusted to sustain weight reduction. Although nutrient deficiency may result in reduced food intake, nutritional supplements will be considered in such cases. Though there are other methods of surgical weight reduction, lap-band surgery is safe with fewer complications and speedy recovery.