Lap-Band Surgery The LAP-BAND® System Advantages at a Glance Minimally invasive surgical approach No intestinal re-routing, cutting or stapling of the stomach wall or bowel as with gastric bypass Often performed on an out-patient basis Small incisions and minimal scarring Reduced post-surgical pain, shorter hospital stay and recovery time Return to work/normal activities typically within a week Fewer Risks and Side Effects Ten times lower short-term mortality rate than gastric bypass1 Low risk of post-surgical nutritional deficiencies associated with gastric bypass Reduced risk of hair loss No "dumping syndrome" (food passes through the system too fast resulting in severe cramping/digestive disruption) related to dietary intake restrictions Adjustable Allows for personalized steady, healthy rate of weight loss No additional surgery for adjustments Supports pregnancy by allowing for increased nutritional needs Surgical weight loss option specifically designed for long term weight maintenance Effective Long Term Weight Loss More than 500,000 LAP-BAND® System devices distributed worldwide #1 selling adjustable gastric band for weight loss worldwide Over ten years of medical studies and academic publications follow-up Sets the "gold standard" of care for obesity treatment for hundreds of surgeons world-wide Reversible While it is intended to be a long-term treatment, the LAP-BAND® System can be removed at any time, in some cases laparoscopically Stomach and other anatomy typically return to their original state/functions What Is a Lap-Band? "Lap-Band System" is the brand name of the FDA-approved, adjustable gastric band used in the procedure. Most simply, a Lap-Band is a silicone belt that goes around the top of the stomach. This results in the ability to control your hunger and achieve a "feeling of fullness," or satiety. Ultimately, you eat much less and should feel full sooner. A key component of the Lap-Band System is its adjustability. The band is connected to a port, which enables the device to be inflated over time to expedite the weight loss. Who Are Candidates for the Lap-Band System? The NIH (National Institutes of Health) requirements for Lap-Band surgery are the same as for any other weight loss surgery. These criteria were originally set in the early 1990s and have not changed. If your BMI, or body mass index, is between 35 and 39, then you must also have associated severe medical problems, or co-morbid conditions, in order to be a candidate for the Lap-Band. These conditions usually include diabetes, hypertension, or high cholesterol. But if your BMI is greater than 40, then it is not required that there be any associated medical problems. Most insurance companies also require a history of previous attempts at weight loss. How stringent these requirements are can differ from one insurance company to another. Many people do not meet the NIH requirements or do not have the insurance benefit for weight loss surgery, but they may still be able to pursue the procedure by paying for it themselves. How the Lap-Band Is Placed in the Body After performing a series of small incisions, your surgeon would use a small camera, called a laparoscope, to visualize placement of the Lap-Band. The Lap-Band is placed around the top of the stomach and secured in place with sutures. The port is then placed underneath the skin on the top part of the abdomen. Surgery should take only about an hour, and an overnight stay in the hospital may or may not be required. How the Port Works Injecting saline into the port inflates the band, making the passage to the lower part of the stomach smaller, which further restricts food intake. Fluid can easily be removed in the doctor's office if it is too tight. After Lap-Band Surgery: Recovery and Aftercare Following surgery, you should be able to return to work within a week, with minimal discomfort. You will need to follow a nutrition plan (which may include vitamin supplements) prescribed by your surgeon and/or nutritionist. The nutrition plan will likely include a liquid diet for a few weeks, until you can tolerate soft foods, and later solid foods. A specific exercise program, as well as behavioral-modification therapy, may also be recommended. Frequent office visits are mandatory to adjust the band. Your surgeon or his assistant will be able to inject the port in the office. On average, patients require six to eight adjustments of the band during the first 18 months following Lap-Band surgery. Weight loss results vary from patient to patient, and the amount of weight you lose depends on several things. The LAP-BAND® System needs to be in the right position, and you need to be committed to your new lifestyle and eating habits. Weight loss surgery is not a miracle cure, and the pounds won't come off by themselves. It is very important to set achievable weight loss goals from the start. A weight loss of 2 to 3 pounds a week in the first year after the operation is possible, but 1 pound a week is more likely. Twelve to 18 months after the operation, weekly weight loss is usually less. Gradual yet steady weight loss with the LAPBAND® System can be healthy for you. Losing weight too quickly creates a health risk and can lead to a number of problems. The main goal is to have weight loss that prevents, improves, or resolves health problems connected with severe obesity. Surgeons have reported that gastric bypass patients lose weight faster in the first year. At 3 years, however, many LAP-BAND® Adjustable Gastric Banding System patients have achieved weight loss comparable to that of gastric bypass patients.1,2 You should focus on long-term weight loss and remember that it is important to lose weight gradually while reducing obesity-related risks and improving your health. Patients typically lose 50% to 60% of their excess body weight within two years after the procedure. Additional plastic surgery may be indicated, depending on how much weight is lost. Lap-Band System Complications As with any surgical procedure, there are known risks. Besides the standard risks of most procedures, including bleeding and infection, there are complications specific to Lap-Band surgery. Slippage of the band can occur as you lose weight and the stomach goes above the band, causing heartburn or vomiting. This can usually be fixed laparoscopically. Rarely, the band may erode into the inside of the stomach. Laparoscopic surgery is not always possible. Your surgeon may need to use an "open" method. This happened in about 5% of the cases in the U.S. clinical study. Other problems can occur that are directly related to the Lap-Band System: The band can spontaneously deflate because of leakage. That leakage can come from the band, the reservoir, or the tubing that connects them. The stomach pouch can enlarge. The stoma (stomach outlet) can be blocked.