Restrictive (including gastric band/lapBand)

Laparoscopic Adjustable Gastric Band (LAGB)

History

Gastric Banding was first introduced in the late 1970's with the use of a fixed non- adjustable band. There were problems with a large amount of patients suffering from complications such as pouch dilatation and vomiting.

In the early 1980's the adjustable gastric band was then introduced where the inner surface of the 'band' was covered with an inflatable balloon. This balloon was attached to tubing and then a 'port', placed underneath the skin, to allow inflation of the balloon and thus adjust the restriction of the upper stomach pouch.

With the introduction of laparoscopic, or keyhole surgery, adaptations to this method have given us the laparoscopic adjustable gastric band (LAGB).

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How it works

• A band is placed around the upper most part of the stomach separating the stomach into a small upper pouch and a larger lower pouch
• on the inner surface of the band there is a balloon which can be inflated, via the port, to either increase or decrease restriction
• the restriction allows food to enter the upper pouch but delays its entry into the larger stomach. This causes the upper pouch to fill and as a consequence to this, hunger disappears
• over a few hours (3-4) the upper pouch releases food into the larger stomach where it is digested and hunger returns, and you're ready for your next meal
• a well adjusted band will
  • allow you to eat normal types of food from all the different food groups
  • maintain satiety (lack of hunger) between meal times
  • not lead to vomiting
  • allow a gentle, healthy weight loss of between 0.5-1 kg per week

Advantages

• Usually performed via keyhole (laparoscopic) surgery
• Digestion and absorption of food is normal
• there is no cutting and joining of the stomach or bowel
• it can be reversed if necessary

Risks

All major surgery involves a certain level of risk and lap gastric band surgery is no different. The following risks and considerations are specific to this procedure:

• Gastric perforation or tearing of the stomach
• Access port leakage or twisting
• nausea and vomiting
• outlet obstruction
• pouch dilatation
• band migration and slippage