The LAP-BAND® System and Realize® are both considered adjustable gastric bands. They are silicone adjustable bands that are placed around the upper portion of the stomach to restrict the amount of food that can be consumed and to create a longer feeling of satiety. An adjustable band is placed laparoscopically without cutting or stapling the stomach and does not bypass a portion of the bowel as does the gastric bypass operation. The band has an adjustable inflatable balloon that is connected to an access port that is placed under the skin in the abdomen.
The procedure is less invasive than other weight-loss surgeries and is the only adjustable and reversible option for patients. The Food and Drug Administration approved adjustable gastric banding systems in June 2001 and patient interest is growing rapidly due to the unique features of the product and procedure. To date more than 550,000 patients worldwide have undergone the procedure. For every six gastric bypass surgeries performed in the United States, there is only one adjustable gastric band surgery performed, despite the fact that gastric bypass demonstrates a mortality rate that is ten times greater than the adjustable gastric banding surgery.
This surgery is performed laparoscopically and patients typically go home the day following surgery. Recovery time is usually one week (or less) following surgery.
Weight Loss with adjustable gastric bands is a little slower initially than the gastric bypass. Patients can expect to lose 1-2 pounds per week. Weight Loss usually continues over a 5 year period. It is very important that the patient continue to follow-up with the surgeon and team so that adjustments can be made to the band as necessary.
The two most common complications associated with the adjustable gastric banding procedure are band slippage (up to 3-5%) and band erosion (up to 1%). A band slippage can be described as when a portion of the stomach slips up through the band and causes dysphagia (difficulty swallowing), nausea/vomiting, and acid reflux. Band slippage can be caused by a repeated or sudden increase in intraabdominal pressure. This could be related to repeated vomiting or even trauma caused by a car accident. A band slippage usually requires the patient to return to the operating room for repair. A band erosion is related to the pressure of the band being wrapped around a hollow organ. Over time, the band may erode through the stomach wall and if this occurs, reoperation is required.