DESCRIPTION

A restrictive procedure during which an adjustable gastric band is placed around the upper part of the stomach. This creates a smaller stomach pouch, which restricts the amount of food that can be consumed at one time and increases the time it takes for the stomach to empty. As a result, patients achieve sustained weight loss by limiting food intake, reducing appetite, and slowing digestion

A thin vertical sleeve of the stomach is created using a stapling device, and the rest of the stomach is removed (about 85%). The sleeve is about the size of a banana. This procedure limits the amount of food you can eat and helps you feel full sooner. It allows for normal digestion and absorption. Food consumed passes through the digestive tract in the usual order, allowing it to be fully absorbed in the body.

ADVANTAGES

• Lower short-term mortality rate than gastric bypass
• Minimally invasive surgical approach
• No stomach stapling or cutting, or intestinal rerouting
• Adjustable
• Reversible
• Lower operative complication rate than with gastric bypass
• Low malnutrition risk

• Intermediate initial weight loss
• Less frequent follow-up required
• No implant required
• Laparoscopic approach is possible
• Removes part of the stomach that produces Grehlin (hunger hormone)

DISADVANTAGES

• Slower weight loss
• Regular follow-up critical for optimal results
• Requires an implanted medical device
• In some cases, effectiveness may be reduced due to slippage of the LAP-BAND® Adjustable Gastric Banding System
• In some cases, the access port may leak and require minor revisional surgery

• Stomach cutting and stapling required
• Intermediate complication rates
• Higher short-term mortality rates than the gastric band
• Nonadjustable and nonreversible
• Longer hospital stay and recovery
• No long-term data

RESULTS

A review of published studies showed many laparoscopic adjustable gastric banding (LAGB) and Roux-en-Y gastric bypass (RYGB) patients achieve comparable weight loss at 3 years and beyond (55% for LAGB and 58% for standard RYGB).

RISKS

Mortality rate: 0.05%
Total complications: 9%
Major complications: 0.2%
Most common include:

• Standard risks associated with major surgery
• Nausea and vomiting
• LAP-BAND® System slippage
• Stoma obstruction

• Risks associated with any surgery, including death
  • 0.39% short-term
• Gastroesophageal reflux disease (GERD) 
• Gastritis
• Gastric stricture
• Marginal ulcer
• Leak from staple line along the stomach

COSTS AND INSURANCE

Generally speaking, all three procedures may be covered by insurance, but check with your employer or your surgeon’s office for specific information about your policy. Costs of LAP-BAND® Adjustable Gastric Banding System surgery, gastric sleeve, and gastric bypass surgery will vary depending on the site where the surgery occurs (in-patient or out-patient), the type of bypass procedure (laparoscopic or open), and how long you are required to stay in the hospital.

RECOVERY TIMELINE

• Hospital stay is often approximately 24 hours
• Most patients return to normal activity in about 1 week
• Full surgical recovery usually occurs in about 2 weeks

• Hospital stay is approximately 48 hours
• Most patients return to normal activities in about 2 weeks
• Full surgical recovery is about 3 weeks