Lap-BandŽ

The LAP-BAND® is a tool to help a patient achieve sustained weight loss. There have been more than 250,000 LAP-BAND® procedures performed worldwide. The Food and Drug Administration approved the LAP-BAND® in the United States in 2001. Dr. Elmer Valin is the first surgeon in the State of Connecticut to perform this procedure.

The LAP-BAND® is a purely restrictive procedure compared with the gastric bypass which is restrictive and malabsorptive. This means the band will limit the amount of food a person can take in. This will cause a decrease in calories, hence producing weight loss. It is designed to give you the sensation of feeling full faster.

The LAP-BAND® system is a silicone band that is wrapped around the upper portion of your stomach. This creates a small pouch that only holds a small amount of food. The band will create a small outlet between the upper pouch and your stomach. The food will move more slowly between your pouch and your lower stomach as it is digested.

SURGERY

The LAP-BAND® is placed by the laparoscopic approach. The laparoscopic approach has been know to decrease post-operative pain, decrease length of hospital stay, decrease the risk of infection and quickens recovery time. This means that small incisions are made through the abdominal wall and the procedure is performed using long instruments. A camera is used during the operation so that Dr. Valin can visualize the surgery. The LAP-BAND® is placed around the upper portion of the stomach creating a small pouch. The pouch is approximately one ounce in size. The band is locked together and secured in place with three stitches. The band is then attached to a reservoir port. Dr. Valin will place your port under your skin on the right lower part of your abdomen. There is no cutting of the stomach or small intestine during this procedure. The surgical time is approximately 45 – 90 minutes.

If you have a hiatal hernia, Dr. Valin will need to repair this at the time of your surgery.

ADJUSTABILITY

The LAP-BAND® is adjustable. There is a balloon located on the inner portion of the band. After receiving a small amount of topical anesthesia, a small needle is inserted into the port to inflate this balloon with normal saline. This is called a fill. This is done in small increments. This decreases the diameter of the band. Adjustments are based on weight loss, the amount food you can eat and how much fluid is in the band. An ideal fill should be tight enough so you are gradually losing weight.

Advantages:
- Low Mortality Rate
- Minimally invasive
- No stomach stapling, cutting or intestinal surgery
- The band is adjustable
- Low obesity surgery complication rate
- Low risk of vitamin and mineral deficiencies
- Low risk for infection
- Reduced pain
- Small incisions and minimal trauma
- Shorter recovery time
- Overnight hospitalization
- Reduced hair loss
- No “Dumping Syndrome” related to dietary intake
- Reversible (if medically necessary)

Adjustable:
- Allows individualized degree of restriction for ideal weight loss
- Adjustments are a short office procedure (no surgery)

Risks/Complications:
- Infection
- Band slippage
- Band Erosion
- Port Disconnect
- Tubing Malfunction

Weight Loss:
The LAP-BAND® produces slower initial weight loss than other bariatric procedures. Successful weight loss is one-two pounds per week.

Note: Many surgeons report that at 5 years, many LAP-BAND® and gastric bypass patients achieve comparable weight loss (55% for LAP-BAND® and 59% for gastric bypass).

1. Ren C., Horgan S., Ponce J., US Experience with the LAP-BAND® System, Am J Surg. 2002;184(suppl):46-50
2. Rubin M., Spivak H., Prospective Study of 250 Patients Undergoing Laparoscopic Gastric Banding Using the Two-Step Technique; Surgi Endosc. 2003;17:857-860.
3. Rubenstein R., Laparoscopic Adjustable Gastric Banding at a U.S. Center with Up to 3 Year Follow-Up, Obes Surg.2002;12:380-384.
4. Jan J., Hong D., Pereira N., Patterson E., Laparoscopic Adjustable Gastric Banding Versus Laparoscopic Gastric Bypass for Morbid Obesity: A Single-Institution Comparison Study of Early Results, J Gastrointerst Surg, 2005; 9(1):30-41.
5. Zinzindohoue F., Chevallier J.M., et al, Laparoscopic Gastric Banding: a Minimally Invasive Surgical Treatment for Morbid Obesity: Prospective Study of 500 Consecutive Patients, Annals of Surgery. 1, 237, 2003;237(1): 1-9.
6. Fielding G., LAP-BAND® Experience with 620 Cases over Forty-Five Months, Obes Surg. 2000;10:143.
7. Korenkov M., Kneist W., Heintz A., Junginger Th., Laparoscopic Gastric Banding as a Universal Method for the Treatment of Patients with Morbid Obesity, Obes Surg. 2004:14: 1123-1127.
8. Weiner S., Engert R., et al, Outcome after Laparoscopic Adjustable Gastric Banding – 8 Years Experience, Obes Surg. 2003:13:427-434.

Hospitalization/Recovery Time

All of our patients are hospitalized overnight. Recovery time varies. Most patients can return to work in one week. However, this time may be increased for strenuous jobs.