Laparoscopic Adjustable Gastric Banding

Over the years, weight-loss surgery has proven to be a successful method for the treatment of morbid obesity. Surgical options have continued to evolve and Cahaba Valley Surgical Group, PC and Shelby Baptist Medical Center are pleased to be able to offer patients the Laparoscopic Adjustable Gastric Banding® System surgery. This procedure is the safest, least traumatic and only adjustable and reversible obesity surgery available in the United States. The Laparoscopic Adjustable Gastric Banding System provides a unique tool that can help you achieve and maintain significant weight loss, improve your health, and enhance your quality of life.

Laparoscopic Adjustable Gastric Banding System Overview

Approved by the FDA in June 2001, the adjustable gastric banding system is the newest and the only device globally with FDA approval for adjustable surgical treatment for morbid obesity in the United States. It induces weight loss by reducing the capacity of the stomach, which restricts the amount of food that can be consumed. Since its clinical introduction in 1993, more than 180,000 Laparoscopic Adjustable Gastric Banding procedures have been performed around the world.

Laparoscopic Adjustable Gastric Banding- Click on the image for an enlarged image.

Minimally Invasive Approach

During the procedure, surgeons usually use laparoscopic techniques (using small incisions and long-shafted instruments), to implant an inflatable silicone band into the patient's abdomen. Like a wristwatch, the band is fastened around the upper stomach to create a new, tiny stomach pouch that limits and controls the amount of food you eat. It also creates a small outlet that slows the emptying process into the stomach and the intestines. As a result, patients experience an earlier sensation of fullness and are satisfied with smaller amounts of food. In turn, this results in weight loss.

Click Here for an interactive presentation on the Laparoscopic Adjustable Gastric Banding procedure.

Safest and Least Traumatic Procedure

Since there is no cutting, stapling or stomach re-routing involved in the Laparoscopic Adjustable Gastric Banding procedure, it is considered the least traumatic of all weight loss surgeries. The laparoscopic approach to the surgery also offers the advantages of reduced post-operative pain, shortened hospital stay and quicker recovery. If for any reason the band needs to be removed, the stomach generally returns to its original form.

Adjustable Treatment

As opposed to other types of weight loss surgery the lapband system is adjustable and can be easily adjusted after surgery to meet patients requirements. The diameter of the band is adjustable for a customized weight-loss rate. Your individual needs can change as you lose weight. For example, pregnant patients can expand their band to accommodate a growing fetus, while patients who aren't experiencing significant weight loss can have their bands tightened.

Click on the image for an enlarged image

To modify the size of the band, its inner surface can be inflated or deflated with a saline solution. The band is connected by tubing to an access port, which is placed well below the skin during surgery. After the operation, the surgeon can control the amount of saline in the band by entering the port with a fine needle through the skin.

Click on the images for enlarged images.

Indications
Laparoscopic Adjustable Gastric Banding may be right for you if:

• You are at least 18 years old.

• Your BMI is 40 or higher or you weigh at least twice your ideal weight or you weigh at least 100 pounds more than your ideal weight. (BMI is calculated by dividing body weight (lbs.) by height in inches squared (in2) and multiplying that amount by 704.5).
  

  Classification BMI Underweight  <19 Ideal BMI 19-25 Overweight 25-30 Obese >30 Severely Obese >35 Morbidly Obese >40 Super Obese >50

• You have been overweight for more than 5 years.

• Your serious attempts to lose weight have had only short-term success.

• You do not have any other disease that may have caused your obesity.

• You are prepared to make substantial changes in your eating habits and lifestyle.

• You are willing to continue being monitored by the specialist who is treating you.

• You do not drink alcohol in excess.

If you do not meet the BMI or weight criteria, you still may be considered for surgery if your BMI is at least 35 and you are suffering from serious health problems related to obesity.

Contraindications
Laparoscopic Adjustable Gastric Banding is not right for you if:

• You have an inflammatory disease or condition of the gastrointestinal tract, such as ulcers, severe esophagitis, or Crohn's disease.

• You have severe heart or lung disease that makes you a poor candidate for surgery.

• You have some other disease that makes you a poor candidate for surgery.

• You have a problem that could cause bleeding in the esophagus or stomach. This might include esophageal or gastric varices (a dilated vein). It might also be something such as congenital or acquired intestinal telangiectasia (dilation of a small blood vessel).

• You have portal hypertension.

• Your esophagus, stomach, or intestine is not normal (congenital or acquired). For instance you might have a narrowed opening.

• You have or have experienced an intra-operative gastric injury, such as a gastric perforation at or near the location of the intended band placement.

• You have cirrhosis.

• You have chronic pancreatitis.

• You are pregnant. (If you become pregnant after the Laparoscopic Adjustable Gastric Banding System has been placed, the band may need to be deflated. The same is true if you need more nutrition for any other reason, such as becoming seriously ill. In rare cases, removal may be needed.)

• You are addicted to alcohol or drugs.

• You are under 18 years of age.

• You have an infection anywhere in your body or one that could contaminate the surgical area.

• You are on chronic, long-term steroid treatment.

• You cannot or do not want to follow the dietary rules that come with this procedure.

• You might be allergic to materials in the device.

• You cannot tolerate pain from an implanted device.

• You or someone in your family has an autoimmune connective tissue disease. That might be a disease such as systemic lupus erythematosus or scleroderma. The same is true if you have symptoms of one of these diseases.

Your Motivation

While the Laparoscopic Adjustable Gastric Banding is an effective treatment for morbid obesity, the pounds do not come off by themselves. Laparoscopic Adjustable Gastric Banding is an aid to support you in achieving lasting results by limiting food intake, reducing appetite and slowing digestion. However, your motivation and commitment to adopt a new lifestyle are extremely important for long-term weight loss. New eating habits must be adhered to for the rest of your life. Exercise is an equally important component of a changed lifestyle.


Risk Information

Indications: The Laparoscopic Adjustable Gastric Banding System is indicated for use in weight reduction for severely obese patients with a Body Mass Index (BMI) of at least 40 or a BMI of at least 35 with one or more severe co-morbid conditions, or those who are 100 lbs. or more over their estimated ideal weight.

Contraindications: The Laparoscopic Adjustable Gastric Banding System is not recommended for non-adult patients, patients with conditions that may make them poor surgical candidates or increase the risk of poor results, who are unwilling or unable to comply with the required dietary restrictions, or who currently are or may be pregnant.

Warnings: The Laparoscopic Adjustable Gastric Banding System is a long-term implant. Explant and replacement surgery may be required at some time. Patients who become pregnant or severely ill, or who require more extensive nutrition may require deflation of their bands. Patients should not expect to lose weight as fast as gastric bypass patients, and band inflation should proceed in small increments. Anti-inflammatory agents, such as aspirin, should be used with caution and may contribute to an increased risk of band erosion.

Adverse Events: Placement of the Laparoscopic Adjustable Gastric Banding System is major surgery and, like any surgery, death can occur. Possible complications include the risks associated with the medications and methods used during surgery, the risks associated with any surgical procedure, and the patient’s ability to tolerate a foreign object implanted in the body.

Band slippage, erosion and deflation, obstruction of the stomach, dilation of the esophagus, infection, or nausea and vomiting may occur. Reoperation may be required.

Rapid weight loss may result in complications that can require additional surgery. Deflation of the band may alleviate excessively rapid weight loss or esophageal dilation.


Not all contraindications, warnings or adverse events are included in this brief description. More detailed risk information is available at www.Laparoscopic Adjustable Gastric Banding.com or
1-877-Laparoscopic Adjustable Gastric Banding.

Laparoscopic Adjustable Gastric Banding® System Advantage

Minimal Trauma

• Least invasive surgical option
• No intestinal re-routing
• No cutting or stapling of the stomach wall or bowel
• Reduced patient pain, hospital length-of-stay and recovery period

Fewer Risks and Side Effects

• Significantly lower mortality risk than other obesity surgery procedures
• Low risk of nutritional deficiencies associated with gastric bypass
• Reduced risk of hair loss
• No “dumping syndrome” related to dietary intake restrictions

Adjustable

• Allows individualized degree of restriction for ideal, long-term weight loss Adjustments performed without additional surgery
• Supports pregnancy by allowing stomach outlet size to be opened for increased
  nutritional needs

Reversible

• Removable at any time
• Stomach and other anatomy are generally restored to their original forms and functions

Effective Long-Term Weight Loss

• More than 180,000 cases performed worldwide
• Standard of care for hundreds of practices around the world
• Academic publications with up to 7 years of follow-up

Find out more about Laparoscopic Adjustable Gastric Banding with the following links.

Interactive Movie

Text version

Patient Info handout