Laparoscopic LAP-BAND® Surgery
The UT MIST Center for Bariatric and Metabolic Surgery offers gastric banding surgery, also known as LAP-BAND® surgery, for Houston-area residents who wish to lose 30 percent to 40 percent of their excess weight. During this minimally invasive procedure, the surgeon implants an adjustable silicone band, or collar, around the neck of the stomach. This collar narrows the size of the opening between the esophagus and the stomach and creates a small stomach "pouch" above the band. Once in place, the gastric band restricts the amount of food you can eat, helps you to feel full soon after eating, slows the emptying into the lower stomach, and curbs hunger pangs. These changes in eating and digestion can lead to significant weight loss.
LAP-BAND® surgery has many benefits over other bariatric procedures:
- The minimally invasive operation is performed as an outpatient procedure.
- LAP-BAND® surgery has a quick recovery time of approximately one week.
- The laparoscopic operation results in less post-surgical pain and scarring.
- No portion of the stomach is stapled, cut, or removed.
- The biocompatible LAP-BAND® System is adjustable and completely reversible.
LAP-BAND® surgery does not require cutting the stomach or intestines, and it has less peri-operative risk than sleeve gastrectomy, gastric bypass, or duodenal switch bariatric procedures. Nevertheless, it is still a major abdominal operation. Most LAP-BAND® surgery patients lose an average of 30 percent of excess body weight at one year and 40 percent at two years. Briefly stated, the benefit of the gastric band is its safety profile; the down sides are variable weight loss and the need for post operative adjustments.
UT MIST board-certified surgeons are among the most skilled bariatric specialists in the country, offering advanced minimally invasive technologies and techniques. They can help you evaluate the risks and benefits of LAP-BAND® surgery so you can decide if it is right for you. If it is not, your surgeon might recommend another bariatric procedure such as gastric bypass, sleeve gastrectomy, or duodenal switch. Whatever option you choose, the UT MIST team will support you 100 percent in your decision. We look forward to helping you on your life-changing path to better health and wellness.
Lapband Surgery for Houston Residents: What You Should Know
During LAP-BAND® surgery, also known as laparoscopic adjustable gastric band surgery or LAGB, a saline-filled, adjustable silicone device called the LAP-BAND® System is placed around the top portion of the stomach through small incisions in your abdomen. Many abdominal surgical procedures are safely and effectively performed through minimally invasive laparoscopy.
The laparoscopic technique is named after the laparoscope, a narrow, tube-shaped instrument that has a camera and light attached to one end. During LAP-BAND® surgery, the surgeon inserts the laparoscope through one of the small abdominal incisions, enabling clear visualization of the procedure on a nearby screen. The other incisions are used for inserting the surgical instruments, placing the gastric band around the upper part of the stomach, and adjusting it to fit your unique anatomy.
The LAP-BAND® System restricts the amount of food you can eat, slows the passage of food to the lower stomach, and helps you to feel full sooner and longer. The reduction in calories consumed leads to significant weight loss for most of our patients. Because the LAP-BAND® System is made from a bio compatible material, it is designed for long-term use and can be customized for each patient. Following LAP-BAND® surgery, the band size can be easily adjusted by adding or removing saline from a small port in the patient's abdomen, and it can be readjusted over time to accommodate individual weight loss, side effects, or dietary changes.
Benefits of Adjustable Gastric Band Surgery
LAP-BAND® surgery patients who closely follow their doctor's diet and exercise regimen can lose an average of 30 to 40 percent of their excess weight over two years. This weight loss typically leads to a significant improvement in their quality of life, as they feel better and begin to move easily to accomplish everyday activities or exercise. LAP-BAND®surgery offers additional potential benefits for many of our Houston patients:
- Resolve high blood pressure
- Control type II diabetes
- Decrease high cholesterol
- Relieve back and osteoarthritis pain
- Resolve obstructive sleep apnea
- Improve asthma, arthritis, or acid reflux
- Relieve urinary stress incontinence
- Improve mood and self-esteem
LAP-BAND® surgery is one of the least invasive bariatric procedure available at the UT MIST Center for Bariatric and Metabolic Surgery, and it is completely adjustable and reversible. Because it is performed using laparoscopic surgery, most patients have a shorter hospital stay, faster recovery, smaller scars, and less pain than other procedures. Another advantage is that no portion of the stomach is stapled, excised, or removed, and intestines are not re-routed, so the digestive tract is not altered. The LAP-BAND® System is made of biocompatible materials, so it can stay in a patient's body for many years.
Ideal Candidates for Adjustable Gastric Band Surgery
LAP-BAND® surgery should not be considered as the first line of defense against obesity, and most surgeons will want to see evidence that a potential candidate has tried unsuccessfully to lose weight through conventional means, including diet, exercise, and medical weight loss. Patients must also fully understand the procedure itself and commit to adopting lifestyle changes that complement LAP-BAND® surgery and lead to successful long-term weight loss.
In general, the best candidates for LAP-BAND® surgery are adults over 18 who have a body mass index (BMI) of 35 to 40, meaning they are at least 100 pounds over their ideal body weight. This procedure can also be performed on patients with a BMI of 30 to 35 who have weight-related health conditions such as diabetes, high blood pressure, or heart disease.
LAP-BAND® surgery is contraindicated in mentally unstable patients. In addition, it is not appropriate for patients who have a history of ulcers or gastrointestinal disorders, underlying high-risk medical conditions, an unresolved drug or alcohol addiction, or a BMI of 50 or above. Some surgeons will consider performing LAP-BAND® surgery after a patient has lost a percentage of body weight through non-surgical means; doing so decreases risks and increases the likelihood of long-term weight-loss success.
What to Expect from LAP-BAND® Surgery
Laparoscopic LAP-BAND® surgery is performed under general anesthesia as an outpatient procedure and typically lasts one to two hours. The entire surgery is performed through several one-inch incisions in your abdomen. A very narrow laparoscope is inserted into one of those openings, enabling your UT MIST bariatric surgeon to see on a video monitor the interior of your abdomen. The other incisions are used for surgical instruments and for placing the band around your upper stomach.
During LAP-BAND® surgery, your surgeon positions the band around the uppermost portion of your stomach, creating a small pouch and restricting the size of the opening between your esophagus and your stomach. The device is held in place with small sutures. The port, or point of access for your device, is connected to the lap band with thin, flexible tubing. Once the port is positioned in your abdomen, it is also sutured into place. After LAP-BAND® surgery, the surgical instruments and laparoscope are removed and all incisions closed. You will have six to eight weeks to heal from LAP-BAND® surgery before having your first adjustment, or "fill."
Recovery from Gastric Band Surgery
After LAP-BAND® surgery, most patients are able to return home the same day. The first few days after surgery will likely be the most difficult, and you should expect to experience some pain and discomfort. Both can be controlled with medication and will gradually subside.
Apart from this, you will receive specific post-operative instructions regarding diet and exercise. If you are responsible and careful about following these instructions, your recovery time will be minimal, usually two to ten days. Most LAP-BAND® surgery patients return to work one week after surgery and resume all normal activities within six to eight weeks.
What to Expect for Your "Fills" or Adjustments
Approximately six to eight weeks after your LAP-BAND® surgery, your surgeon will fill your band with a sterile saline solution through the small port in your abdomen. Thin tubing connects the device to the port, enabling easy, painless, and quick adjustments to the size of the band by adding or removing saline.
Once the band is in place and inflated with saline, most patients experience immediate and significant changes in their appetite and feelings of satiety. These changes help them to eat less without feeling hungry, which leads to gradual, sustained weight loss. After time, if weight loss begins to plateau, your surgeon may add more saline to the device, increasing its size and helping you to control your appetite and feel full after eating even smaller quantities of food. Conversely, LAP-BAND® surgery patients who experience nausea or vomiting typically obtain relief with a small decrease in the size of the band. Most of our patients feel comfort in knowing that their band can be adjusted to accommodate changes over time.
How Much Weight Will You Lose with the LAP-BAND® System?
Weight loss following LAP-BAND® surgery is gradual. In the beginning, many patients lose two or three pounds each week, which then decreases to one pound per week. After 18 months, weight loss decreases substantially, and many find that they require an adjustment at this time. Naturally, food choices affect weight loss as well, so for those who follow a sensible, low-calorie diet, this is the kind of weight loss they can generally expect.
Following LAP-BAND® surgery, our Houston patients typically lose 30 percent of their excess weight the first year, and they continue to lose weight for up to two years. The average weight loss from this procedure is 40 percent of excess body weight. It's important to remember that LAP-BAND® surgery alone is not a solution to losing weight. You will learn to eat less, but in order to meet your individual weight-loss goals, you will need to carefully follow your doctor's and dietician's exercise and eating guidelines.
Dietary Changes Following LAP-BAND® Surgery
Like any bariatric surgery, LAP-BAND® surgery is not a magic wand that will make patients lose weight; instead, it is a tool that can help motivated patients reach their weight-loss goals without suffering from hunger pangs. Once your device is in place, you will need to follow these basic dietary guidelines to increase your chance of successful long-term weight loss:
- Eat regular, well-balanced meals three times each day.
- Avoid consuming excess calories from snacks between meals.
- Decrease portion sizes to accommodate your new stomach size, and stop eating when you feel full.
- Focus on savoring each bite, and chew it slowly and thoroughly. Each bite should have a smooth, paste-like consistency before swallowing. This will help your stomach to easily digest the food and avoid unpleasant symptoms.
- Begin each meal by eating high-protein foods first. Protein deficiency can occur with some bariatric patients, so it is important to incorporate low-fat, high-quality protein sources into your diet. These can include lean meat or fish, tofu, beans or legumes, and low-fat dairy products.
- Avoid consuming "empty calories," or those that are low on nutrition but high in sugar, fat, and chemical additives.
If it seems overwhelming at first, remember that changing behavior takes time and daily effort. To lose weight successfully and keep it off, you will need to adjust your entire approach to eating. This means choosing the right kinds of foods when you shop or dine out, preparing or purchasing well-balanced meals, and learning to slow down and savor the food you consume.
Risks of LAP-BAND® Gastric Banding Surgery
Compared to other bariatric surgical procedures, LAP-BAND® surgery is one of the safest, with the least likelihood of serious complications or side effects. In spite of its impressive safety profile, LAP-BAND® surgery still carries some risks. At the UT MIST Center for Bariatric and Metabolic Surgery, we make every effort to inform patients about potential risks, some of which may include band slippage, erosion, gastric reflux, infection, or nausea. During your consultation, your surgeon will thoroughly explain potential risks and answer any questions you might have.
How to Choose a Surgeon for LAP-BAND® Surgery
When choosing a surgeon for LAP-BAND® surgery, it is imperative to find a board-certified, highly qualified bariatric surgeon. This type of surgeon specializes in weight-loss surgery and has additional, specific training in bariatric and/or gastrointestinal procedures. In addition, choose a surgeon who is experienced in LAP-BAND® surgery. Practice makes perfect, after all.
Finally, for total support during your weight-loss journey, focus not only on the surgeon, but also on his or her support team of weight-loss physicians, nutritionists, nurses, and psychologists. A collaborative approach to weight loss can lead to greater long-term success. At the UT MIST Center for Bariatric and Metabolic Surgery, all of our bariatric surgeons are board certified, and they have a full staff to support patients on their transition to a new way of living.