Main types of bariatric surgery
Adjustable gastric banding procedures
Approved by the Food and Drug Administration in 2001, the Lap-Band® procedure involves implanting an adjustable band that contains saline solution around the stomach to reduce its size. This surgery is reversible, causing no permanent change in patient anatomy. As the "Lap" part of the name suggests, it is usually performed laparoscopically (through a small incision). In recent years, the Realize Band®, another form of adjustable gastric band, has also been FDA approved for use in the United States.
Because the band restricts the amount of food that can be consumed, patients feel full sooner than they did before the procedure. Neither the production of digestive enzymes nor the body's ability to absorb vitamins and nutrients is affected by this surgery.
In accordance with the patient's weight loss and wellness goals, the Lap-Band can be loosened or tightened with a needle that increases or decreases the amount of saline solution in the band through a "port" placed underneath the skin during the surgery. These adjustments can be made during regular outpatient physician visits. About a half-dozen adjustments are usually required during the one to two years after surgery and only once or twice a year after that.
The Lap-Band procedure is safe for the majority of patients, but, as with any surgery, there are risks. Most of them are not life-threatening.
While more than 300,000 Lap-Band procedures have been performed worldwide, the resulting weight loss is usually less significant for these patients than for those who opt for combined surgeries (such as the Roux-en-Y), which both restrict stomach size and disrupt the digestive process.
The band can be removed—typically laparoscopically—although experts often recommend leaving it implanted indefinitely in patients who are benefiting from it. Because this procedure is relatively new, data about the effects of long-term implantation are not yet available.
Bariatric surgeons often recommend the Lap-Band procedure for patients who need to lose 50 pounds or less, who do not want a permanent change in their digestive system via surgery, or who are at very high risk from open surgery.
It is important that patients who opt for Lap-Band surgery commit themselves to meaningful long-term weight loss and the lifestyle changes necessary to achieve that