Laparoscopic Adjustable Gastric Banding: A Restrictive Procedure

The Laparoscopic Adjustable Gastric Banding procedure is a purely restrictive surgical procedure in which a band is placed around the uppermost part of the stomach. This band essentially separates the stomach into two portions: one small upper portion and one larger lower portion.  Once the band is in place, foods consumed rapidly fill the upper potion of the stomach leading to and early sensation of fullness.  As the name indicates, the band is adjustable.  If the rate of weight loss or the sensation of fullness after meals is not acceptable, the band can be adjusted.  Digestion of food happens through a standard route so there are less chances of complications from vitamin and mineral deficiencies.

Advantages

• The band is the least invasive weigh loss procedure currently available
  
  
• No cutting or rerouting of the intestines is required
  
  
• The procedure can often time be performed as a same day or outpatient surgery
  
  
• The device remains adjustable to promote weight loss
  
  
• 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
  
  
• Band can be adjusted to increase or decrease restriction via an access port.
  
  
• The procedure is reversible
  
  

Risks and Disadvantages

• The band requires routine follow up, approximately one visit every six weeks for at least a year to achieve proper adjustment and maximal results.
  
  
• The access port may leak or the tubing may twist, which can require an operation to correct the problem.
  
  
• Band may erode into the stomach wall.
  
  
• Band may move or slip which might require surgical repositioning.
  
  
• Weight loss is slower than that following Roux-en-Y gastric bypass surgery.
  
  
• The procedure could result in death.

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References

3 Buchwald H, Avidor Y, Braunwald E, et al. Bariatric Surgery. A Systematic Review and Meta-Analysis. JAMA 2004;292(14):1724-37.

16 Dr. Joseph F. Smith Medical Library. Polycystic Ovary Syndrome. [Online] 1 August 2005. <http://www.chclibrary.org/micromed/00061250.html>.