The Laparoscopic gastric band is one of several surgical methods designed to help obese and morbidly obese patients lose weight. During the surgery, a ring made of biocompatible materials to increase adaptation to the body is placed around the upper part of the stomach. The device creates a small stomach pouch, separating the stomach into two parts, which limits the size and capacity of the organ, as well as the amount of food that can be ingested by the patient.
The gastric band is an adjustable device filled with a saline solution that can be inflated or deflated to increase or decrease hunger. This procedure is performed by the physician during the recommended monthly visits following the surgery. Laparoscopic gastric band is currently the second most popular weight loss procedure in the United States, after it was approved by the U.S. Food and Drug Administration (FDA) in 2001. In Europe, however, the laparoscopic gastric band has been available since the 90s.
Laparoscopic Gastric Band Eligibility
Surgical procedures to lose weight are usually the last option offered to patients by their physicians, after the failure of other methods of medically supervised weight loss, including diet and exercise, pre-packed meals and pharmacotherapy. The laparoscopic gastric band may be recommended by physicians for patients with a Body Mass Index (BMI) higher than 40 or for patients with a BMI higher than 35, but that also suffer at least one co-morbidity, such as diabetes, heart disease, high blood pressure or sleep apnea.
In the US, the procedure is approved for both adults between the ages of 18 and 70 and adolescents from 13 to 17, while in Europe, it is only performed in adults. Due to this limitation in Europe, recent research titled “Primordial Influence of Post-operative Compliance on Weight Loss After Adolescent Laparoscopic Adjustable Gastric Banding” studied adolescent patients who underwent the procedure and revealed that it effectively resulted in weight loss.
Laparoscopic Gastric Band As Alternative to Open Surgery
The laparoscopic gastric band procedure is the least invasive surgery for weight loss and the only adjustable one approved in the US. During the procedure, surgeons make five to six small incisions in the abdomen, with just enough size to insert surgical instruments and a video camera, the laparoscope, which names the method. Through this method, surgeons have direct vision, without the need for an open surgery.
The majority of weight loss procedures can be performed either through laparoscopy or open surgery, according to the indications of the physician, but the laparoscopic method is usually less painful and involves less scarring and shorter recovery time. Open surgery also comprises a higher risk of infections and adhesions, since the internal scarring can cause additional complications.
Currently, open surgery, during which surgeons make a large incision in the abdomen, are only required in special situations, such as a build up of scar tissue from previous operations. The study “Laparoscopic adjustable gastric banding versus open vertical banded gastroplasty: a prospective randomized trial,” which was published in 2005, demonstrated that despite an initial better weight loss associated to open surgery vertical banded gastroplasty (VBG), the laparoscopic gastric band is preferred due to lower complication rates, shorter hospital stays and less postoperative morbidity.
Laparoscopic Gastric Band Recovery
Smaller incisions associated with laparoscopic surgery also mean that the time of healing is faster in comparison to open surgery. While patients who undergo laparoscopic procedures usually stay in the hospital one or two days after the procedure, following an open surgery, hospital stays are often longer than five days. The laparoscopic gastric band is also thought to be a safe procedure, with only a 0.1% mortality rate.
Despite the safety of the surgery, between five and 10% of the patients suffer postoperative complications, which may include band erosion into the stomach, band slippage, port and tubing problems, esophageal dilation or reflux. Following the surgery, patients initiate a liquid diet and will gradually readapt to a normal diet. However, eating healthy food and exercising are crucial factors for the success of the surgery.