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Lap Band Procedure |
How the Lap Band Procedure WorksA laparoscopic adjustable gastric band, commonly referred to as a lap band, is an inflatable silicone device that is placed around the top portion of the stomach, via laparoscopic surgery, in order to treat obesity. Adjustable gastric band surgery is an example of bariatric surgery designed for obese patients with a body mass index (BMI) of 40 or greater—or between 35–40 in cases of patients with certain co-morbidities that are known to improve with weight loss, such as sleep apnea, diabetes, osteoarthritis, GERD, Hypertension (high blood pressure), or metabolic syndrome, among others. The placement of the band creates a stoma, or small pouch at the top of the stomach that holds approximately 110 to 220 grams of food each meal. This pouch fills with food quickly and the band slows the passage of food from the pouch to the lower part of the stomach. As the upper part of the stomach registers as full, the message to the brain is that the entire stomach is full and this sensation helps the person to be hungry less often, to feel full more quickly and for a longer period of time, to eat smaller portions, and lose weight over time.
Diagram of an adjustable gastric band.
The gastric band is inflated and adjusted via a small access port placed just under the skin. Saline solution is introduced into the gastric band via the port. A specialized non-coring [Huber point] needle must be used to avoid damage to the port membrane. There are different port designs (such as high profile and low profile) and they may be placed in varying positions near the left rib margin based on the surgeon's preference. The port is usually sutured or, in the case of the Realize Band, stapled into place, although some surgeons prefer to omit this step. When saline is introduced into the band it expands, placing pressure around the outside of the uppermost part of the stomach, and thereby creating a small pouch. This pouch has a very limited capacity for food and when full will cause the patient to feel satiated. If food intake continues beyond the capacity of the pouch (usually less than 40 cc), the patient will usually be forced to regurgitate the excess (due to the gastric band restricting the passage in to the rest of the stomach, the pouch can only empty at a slow rate). Gastric Bands systems usually hold up to 14 cc of saline depending on model and manufacturer's specifications. Over the course of several visits to the doctor, the band is filled to an extent where the patient feels he or she has found what is colloquially known as the "sweet spot" or "green zone", where optimal restriction has been achieved, neither so loose that food intake is not controlled, nor so tight that little or no food and fluids will pass. What advantages does it have? Bariatric surgery, in the form of laparoscopic weight loss banding, is for patients who have a body mass index (BMI) of 40 kg/m2+ or those with BMI of 35+ who suffer from obesity-related morbidity. The age range is from 14 to 65; nevertheless, there can be exceptions to this rule. Advantages of adjustable gastric banding:
Some of its disadvantages are:
Potential complications are:
Technical descriptionProcedure – Weight loss surgery of this type (laparoscopic adjustable gastric band) is a procedure to place a devise around the stomach, through laparoscopic surgery, which has an adjustable band with a valve. In this way, the devise limits the amount of food intake and makes the person feel full sooner. Each time the patient eats more than is allowed, some discomfort will be experienced.
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