Laparoscopic Adjustable Gastric Banding
What is laparoscopic adjustable gastric banding?
Laparoscopic adjustable gastric banding (LAGB) is one of the least invasive operations
available for obesity. It’s done with a few tiny abdominal cuts, instead of with one
large cut. The surgeon puts instruments through the cuts. One of those instruments
is a laparoscope, a tool with a tiny camera. The surgeon uses these tools to place
a band around the top portion of the stomach, leaving a very small pouch available
for food. The small pouch means that you feel full after eating only small amounts
of food. This will help you lose weight. As its name suggests, the procedure can be
adjusted and even reversed.
Why might I need a laparoscopic adjustable gastric banding?
LAGB is used to treat severe obesity, which is linked to high blood pressure, high
cholesterol, type 2 diabetes, sleep apnea, and arthritis. It is recommended for people
who have tried other weight loss plans without long-term success. Once you lose a
significant amount of weight, your risk falls for these weight-related health problems.
Adjustable gastric banding may help you live longer if you can’t lose weight in other
Your doctor might recommend LAGB if you are severely obese with a body mass index
(BMI) greater than 40. Your doctor might also recommend it if you have a BMI between
35 and 40 and a medical condition such as sleep apnea, high blood pressure, heart
disease, or type 2 diabetes.
What are the risks for laparoscopic adjustable gastric banding?
Laparoscopic surgery carries fewer risk factors than open surgery because you don’t
need a major cut, or incision. Although complications from surgery are less common
with laparoscopic surgery, they could include life-threatening blood clots, bleeding,
or infection. The procedure also carries the same risk of any general anesthetic for
breathing problems and reactions to medication or anesthesia. Other LAGB complications
can include band slippage, puncturing the stomach, or blocking the flow of food through
Food intolerance after gastric band surgery is common. For instance, you might not
be able to digest red meat, a major source of dietary iron. This would put you at
a higher risk for anemia.
Other complications include severe, life-threatening vitamin and mineral deficiencies
such as beriberi (Vitamin B1 deficiency). This is particularly true if you don’t eat
a high-protein diet and don’t take you daily supplements as prescribed. But, nutritional
deficiencies can occur even if you closely follow the diet and supplements prescribed
for you. Your doctor will typically order regular blood tests to watch your levels.
There may be other risks, depending upon your specific medical condition. Be sure
to discuss any concerns with your doctor before the procedure.
How do I get ready for laparoscopic adjustable gastric banding?
- Your doctor will make sure that you are a good candidate for LAGB. You should also
get surgical clearance from your own health care provider. It is not unusual to have
an office visit, blood work to test for nutritional deficiencies and other problems,
and an electrocardiogram (ECG) to make sure you have no pre-existing problems.
- Your bariatric surgery center will ask you to enroll in a special pre-surgery program
of education about healthy living and about the operation to prepare for the operation.
Surgery isn’t recommended for people who are abusing drugs or alcohol, who may have
other serious medical problems, or who are not willing to make a commitment to life-long
diet and exercise programs.
- If you’re a smoker, you must quit before surgery and should not start again.
What happens during a laparoscopic adjustable gastric banding?
- You will have general anesthesia during the surgery.
- The surgeon will make several small cuts in your abdomen so he or she can put in the
necessary surgical instruments.
- A gastric band made of a special rubber material will be put in place around your
stomach and then tightened so that the upper part of the stomach forms a small pouch.
- The surgeon will leave a small port under the skin of your stomach. If the size of
the pouch needs to be increased or decreased, a doctor can insert a needle into the
port and inflate or deflate the band, which works like a balloon, and compresses the
channel in the stomach around which the band has been placed.
- LAGB usually takes 30 to 60 minutes.
What happens after laparoscopic adjustable gastric banding?
You will typically be able to go home the day after the procedure. Your diet will
be mostly liquids and pureed food for 2 to 3 weeks. You will then slowly begin adding
soft foods, then regular foods. You can return to a regular (but smaller) diet after
about 6 weeks.
As part of necessary lifestyle changes, you'll need to eat smaller meals. You'll need
to chew your food slowly and repeatedly into a liquid slurry before swallowing. You
also need to eat a healthy diet high in protein, vitamins, and minerals, and low in
LAGB does not make you lose weight suddenly. But it is a safer, less invasive procedure
than other weight-loss surgery, including traditional gastric bypass. You'll have
to be prepared to eat appropriately and exercise. But you can expect long-term weight
loss equaling one fourth to one third of your original weight.
Because you'll be at high risk for nutritional deficiencies for the rest of your life,
you'll need to take daily supplements as prescribed. You'll also need to have life-long
medical care to watch for any nutritional problems.
Before you agree to the test or the procedure make sure you know:
- The name of the test or procedure
- The reason you are having the test or procedure
- The risks and benefits of the test or procedure
- When and where you are to have the test or procedure and who will do it
- When and how will you get the results
- How much will you have to pay for the test or procedure