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Laparoscopic Adjustable Banding – A Safe Method Of Restrictive Weight Loss

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There are different ways in which bariatric surgery can help those who are obese. Not all methods are suitable for everyone. Before you decide which method or even methods are the most appropriate for your weight loss, consult with a medical professional. Your doctor can help you understand which form of bariatric surgery will achieve the best initial and long term results. If you are considering a restrictive form of weight control, you may want to consider laparoscopic adjustable banding or LAGB.

What is LAGB?

This type of bariatric surgery was developed in 1986.  LAGB is a form of pure restrictive surgery. In other words, it relies solely on a specific method of surgery to decrease the amount of food you ingest at one time. This may vary for different forms of restrictive bariatric surgery, but all have the same goal in mind – reduction of the food entering from your throat into your stomach.

In the case of LAGB surgery, the means of restricting food flow is simple. The doctor inserts a small, flexible, silicone band (or ring). He or she places it around the very top of the stomach. Once in position, it gently squeezes the stomach into a tight, narrow opening. This checks the ability of food to enter.

To further facilitate any changes of the needs of an individual or to either slow down or increase the input of food, there is an additional device incorporated into the band. This is a balloon. The surgeon can carefully manipulate this to increase or decrease the size of the opening to the stomach.

The surgery can be performed as an “open” form. Open surgery requires the actual invasive opening of the body to insert the device. Modern technology has resulted in a decrease of this practice. It is now preferable to rely on the less invasive laparoscopic surgery. The laparoscopic technique of inserting the bands reduces possible complications and reduces any discomfort characteristic of an open procedure.

There are various different LAGB devices available on the market. The two most popular current bands in both the United States and Europeare the LAP BAND (approved by the Food and Drug Administration in 2001) and the REALIZE Band. These bands differ somewhat in design but all have the same purpose – to restrict the ability of your stomach to eat large quantities of food so you can lose weight.

Advantages

There are both advantages and disadvantages to most methods of weight loss surgery. You need to discuss these with your doctor. LAGB has the following advantages recorded from various studies including recent comparative studies by Franco1.

  • The overall time for the operation is approximately 30 to 45 minutes.
  • The patient spends only between 40 and 50 minutes under anesthesia
  • Overall, recovery time may be as low as 4 hours
  • The band is adjustable
  • The band is removable and therefore the process is reversible
  • There are fewer immediate comlications than either Laparoscopic roux-en-y gastric bypass (RYGB) and laparoscopic sleeve gastrectomy (LSG) surgeries
  • Few of the nutritional and mineral deficiencies common with other bariatric procedures
  • Fewer long term complications than found in other forms of weight loss surgery

Disadvantages

Yet, research also indicates there are several disadvantages to this form of weight reduction surgery. Among the most common are the following characteristics:

  • Individuals lose weight at a slower rate than in other forms of surgery
  • Compared to both RYGB and SG, Schweige (2011) found LAGB to result in greater limitations and problems in ingesting a wider variety of food2
  • Requires strict patient adherence to food restrictions
  • Must attend follow-ups of the surgical procedure. This may involve the tightening or otherwise adjusting of the band in addition to monitoring your weight loss and any possible symptoms

Effectiveness

LAGB is perceived as an effective and safe method of losing weight. It is not, however, as effective as both LRYGB and LSG. Two years after surgery, most patients lost 40-60% of their excess weight.

Complications

Whether the operation is open or laparoscopic, the most common long-term complication is the slipping of the band. It may affect as many as 15% to 20% of all patients. Other possible complications may occur postoperatively. They include:

  • The balloon or tubing may leak
  • An infection of the port
  • An infection of the actual band
  • Obstruction
  • Vomiting or nausea

Later problems, according to the American Society for Medical Bariatric Surgery, may consist of band erosion, the dilation of the esophagus or even a failure to continue to lose weight3. Yet, overall, LAGB is a method of weight loss surgery that has a very low rate of critical complications.

Conclusion

It is possible your doctor may decide you qualify for bariatric surgery. It is also possible, that he or she may opt for laparoscopic adjustable banding. If this is the case, be aware of the possible complications. You also need to understand the necessity of following the post-operative diet and exercise plan. If you adhere to the instructions required by LAGB, you are likely to be successful in achieving your weight loss goal. With care and continued monitoring of your body, you will also be able to maintain the weight reduction.

 


References        

1 Franco, JVA;Ruiz,PA;Palermo, M; and Gagner, M (2011). “A Review of Studies Comparing Three Laparoscopic Procedures in Bariatric Surgery: Sleeve Gastrectomy, Roux-en-Y Gastric Bypass and Adjustable Gastric Banding.” Obesity Surgery 21(9): 1458-1468.

Schweiger, C; Weiss, R; and Keidar, A. (2010). “Effect of Different Bariatric Operations on Food Tolerance and Quality of Eating. Obesity Surgery 20 (10):1393-1399.

3 ASMBS (2005). Story of Obesity Surgery Retrieved from asmbs.org/story-of-obesity-surgery/

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