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Lap-Band Surgery

LAP-BAND SURGERY

LAP-BAND: or Laparoscopic adjustable gastric banding (LAGB) is a surgical procedure in which an adjustable silicone band is placed around the upper part of the stomach, which is designed to restrict and limit food intake. During the surgery, a small reservoir (or port) is placed under the abdomen and is connected by tubing to the Lap-Band. This access reservoir is where the doctor puts in a needle to add or take away saline. Adding saline will tighten the band, making the stomach smaller. The doctor can also take that saline away to loosen the band as well. Having the access reservoir the doctor will be able to tighten or loosen whenever it is needed after the surgery, although the first tighten is not usually performed until 4 to 6 weeks after surgery.

The operation can last between 30 minutes and 1 hours and is performed under general anesthesia. First, you will have to go through an extensive review to determine whether this operation is safe and a healthy option for you. Click Here to Book an Appointment for your initial review.

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Candidates for Lap-Band Surgery:

Candidates for the Lap-Band Surgery will have to undergo critical tests with a doctor to make sure they are healthy enough for the minimally invasive procedure.

However here are some guidelines for those thinking about this procedure:

-          You are at least 18 years of age

-          Your Body Mass Index (BMI) is at least 40 OR You are at least 30 pounds overweight with a BMI of 30k/m(2) or more and have to have at least one obesity related comorbid condition

-          You have taken many serious attempts at weight loss and have only had short term success

-          You are not currently pregnant

-          You do not have a condition or disease that may have caused you to gain weight

-          You do not excessively drink alcohol

-          You are ready and willing to make major changes in your lifestyle, diet, and eating habits

It is also very important for you to know that this is not an instant fix. You will still have to maintain a healthy and active lifestyle to reach your goal weight, but this will help you get there quicker.

After the Surgery: Once the surgery is completed your doctor may prescribe pain medications to help with any discomforts and soreness. However, you will be asked to start moving regularly to speed up the healing process. Your doctor will give you a specific diet and instruction on what to eat after the surgery, but for about the first 2 weeks you will only be able to handle small portions of liquids. You will be encouraged to drink water throughout the day as to not get dehydrated.  During these first 2 weeks it is common that your bowel movements may not be regular.

Soon after the first 2 weeks you will be able to add more solid foods back into your diet. You will have to get used to chewing your food completely and stopping when you are full. You will need to really pay attention to your stomach as to you will feel full after eating a more minimal amount than you are used to. Nausea, vomiting, or discomfort might happen otherwise.

Once you are able to eat solid food on a normal basis (About 4 to 8 weeks) your doctor will be able to tighten the band. Expect many visits for tightening, as your doctor and you will need to find the right balance to get you to start losing weight while still being able to feel full without vomiting.

Weight Loss Expected: Weight loss with Lap-Band is a gradual process. However, the weight loss in the beginning will be more dramatic, about 2-3 pounds a week, but will slow down to a pound or so weekly over the long-term. Healthy eating is also critical to this weight loss and lifestyle. The average Lap-Band patient will lose about 40% of excess weight in the first year and about 10-20% in the second.

Again, it is important for patients to be in contact with their surgeon during these first two years for adjustments and checkups.

Although studies show that Lap-Band is successful in weight loss it may be generally slower and less than with gastric bypass surgery.

Side Effects/Emotions:

Side effects of this procedure include:

-          Vomiting

-          Nausea

-          Ulceration at the band site

-          Indigestion

-          Dehydration

-          Constipation

-          Weight Regain

Emotions are also a huge factor to this procedure. Although weight will be coming off fairly quickly in the beginning, and that will be an exciting and happy time, you will have to be aware that the weight loss will slow down. You also need to be aware that you are going to make extreme life changes and have to take those into consideration. Talk with your doctor regarding these concerns for help and answers.

Things to Think About:  Studies have shown that being overweight and obese has led to health conditions such as heart problems, cancer, and diabetes. Having the Lap-Band surgery can help to minimize those risks.

Again, you will have to be willing to change your lifestyle and diet dramatically and this is not a cosmetic surgery. Results will not happen overnight and you will have to commit if you want to see the changes.

Advantages:

-          No cutting or stapling of the stomach

-          The band can be adjusted after the surgery without operations to fit the patient’s need

-          Fully reversible

-          48 hours or less hospital stay

-          Weight loss

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Potential Risks: The Lap-Band procedure has a low risk rate compared to other weight reduction surgeries. The mortality rate is low, about 1 in 2000.

Risks for all weight loss surgeries include:

-          Blood clot in the legs (deep vein thrombosis, or DVT)

-          Blood clot in the lung (pulmonary embolism)

-          Gallstones

-          Nutritional deficiency such as anemia or osteoporosis

Potential Lap-Band Procedure Risks:

-          The band can cause obstruction, usually from food. This can lead to nausea, vomiting, or pain

-          The band may slip out of place. If this happen you might feel some belly pain or heartburn. This might also need a second operation

-          Reservoir access problems might occur. You could get an infection, it could leak or disconnect, or the tube that connects the reservoir to the band might become blocked

-          It is possible to develop gastroesophagel reflux disease or GERD

-          Getting enough nutrients is key to keeping this procedure healthy. If you do not eat enough or get enough of those nutrients it can lead to other health problems. Your doctor might even suggest taking supplements for the rest of your life.

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Online References:

Hopkins Medicine: /wp/healthlibrary/test_procedures/gastroenterology/laparoscopic_adjustable_gastric_banding_135,63/

Medicinenet: /wp/lap_band_surgery_gastric_banding/article.htm

WebMD: /wp/diet/weight-loss-surgery/lap-band-surgery

Sutter Health: /wp/obesity/lapband.html

Obesity Lapband Surgery: /wp/tecmain.html