Laparoscopic Adjustable Gastric Banding

Laparoscopic adjustable gastric banding (LAGB) is a restrictive weight loss procedure. The LAGB surgery was originally introduced in 1993. Worldwide, there are probably half a dozen brands of adjustable gastric bands.  The most known are the Swedish Band, the French Band, and the Lap Band. 

Today, particularly in the U.S., the LAGB surgery is widely known by the name LAP-BAND. However, please note that LAP-BAND® is only one specific brand of adjustable gastric bands. It is manufactured by INAMED Health (formerly BioEnterics®) which is now a wholly owned subsidiary of Allergan, USA. A laparoscopic surgical procedure, it was initially implanted by an open surgery when invented by Dr. Lubomyr Kuzmak (New Jersey) in the 1980's.

Till recently, the Lap Band brand was the only one that was available in the USA.  On September 28, 2007, Ethicon Endo-Surgery, Inc. (a subsidiary of Johnson & Johnson) announced that the U.S. Food and Drug Administration (FDA) approved for marketing their product, the REALIZE™ Adjustable Gastric Band.  The REALIZE™ Band, has been marketed under the name Swedish Adjustable Gastric Band (SAGB) outside the U.S., and has been commercially available outside the U.S. since 1996.

General Procedure

In this procedure a band is secured around the upper portion of the stomach separating it into a small section and a larger section. Weight loss is achieved by reducing the capacity of the stomach thereby allowing the patient to experience a sense of fullness or satisfaction more quickly, while consuming less food. Digestion takes place naturally as the now smaller portions of food pass through the stomach. LAGB does not involve the removal of any part of the stomach or intestine.

Since the band is adjustable, its inner diameter can be loosened or tightened to change the rate of emptying from the pouch to the remaining stomach, and therefore, indirectly, affects weight loss. By injecting the balloon lining of the band with a sterile saline solution the opening between the pouch and the rest of the stomach is made smaller. A subcutaneous port is developed and is connected to the balloon of the band by a small tube, to allow for inflating or deflating the balloon lining the band.

Advantages of Laparoscopic Adjustable Gastric Banding:

  • Gastric banding is a less invasive weight loss surgical procedure.
  • No re-routing of the intestine.
  • No opening of the stomach or intestine.
  • Less pain than most weight loss surgeries.
  • Shorter hospital stay.
  • Reduced early recovery time.
  • Reduced chances of nutritional deficiencies.
  • Mortality rate is reduced when compared with other weight loss procedures.
  • No dumping syndrome associated with this surgery (you decide whether this is an advantage or a disadvantage).
  • Band is adjustable.

Disadvantages of Laparoscopic Adjustable Gastric Banding: (Please note: this is not a comprehensive list of surgical complications)

  • There is probably a 10% chance of needing another surgery after a Band placement.
  • Less weight loss than gastric bypass (45-60% of the excess weight in 1-2 years).  This is not necessarily a disadvantage.  Some continue to lose weight after 2 years, and may catch up with some gastric bypass patients.  Everyone is different. 
  • Slower weight loss (this may or may not be a disadvantage, depending on what you want to achieve)
  • Potential for injury to stomach during surgery.
  • Slipping of the band or prolapse of the stomach can require further surgery.
  • Mechanical dysfunction of the band needing another procedure
  • Should the band become infected surgery would be needed to remove it.