Adjustable Gastric Band

The adjustable gastric band (or LAP-BAND) is similar in size and shape to a napkin ring, 1½ inches across. It’s connected by a plastic tube to a “port” or filling station. The lap band itself is positioned around the top of the stomach, while the port is fixed to the abdominal wall muscles near the belly button. The port is usually invisible to the eye even after weight loss; your provider will typically have to feel around a bit to find it. He (or she) will need to access that port with a small needle to adjust your band.

How Does an Adjustable Gastric Band Work?

The lap band works like all restrictive operations do: it seeks to make you feel full with less food, so that you eat less. When the band is positioned right, there will be only a very small pouch of stomach--think walnut size-- above it; the rest of the stomach is below the "waist" created by the band.

When a patient with a band eats, the esophagus pushes each swallow of food toward the stomach. When the food reaches that tiny pouch above the band, however, it has to stop, or at least pause there. The center channel through a Lap-Bad that is adjusted right is quite narrow – about the width of your pinky finger. Each swallowed bite of food has to slowly wiggle its way through that narrow channel to get through the pouch and move downstream. Once food gets past the lap band, it goes where food usually goes.  Digestion proceeds as normal.

The idea is that while those little bites of food are waiting in the pouch for their turn to "squeeze" through, they are hopefully distending it, or tensing its walls slightly. That tension activates the stomach's special nerves that create the sensation of satisfaction. With the band’s help, you can activate those nerves and enjoy that really full feeling with a much smaller amount of food than you would otherwise need.

Types of Adjustable Gastric Band

The LAP-BAND™ has been available in the United States for over a decade. The other band that one can get in the U.S., the Realize™ band, was approved by the F.D.A. in 2007. These two bands look slightly different, but neither has convincingly proven itself superior over the other. Dr. Fitzer is qualified to do both types of gastric bands.

Making Adjustments to the Band

Gastric banding usually takes about 30 minutes, and most patients leave the hospital the same day. The rate of serious complications is the lowest of all of the popular bariatric surgery procedures, which is nice, but revisional surgery for problems down the road are more common than with other bariatric operations. Weight loss averages 45% of excess weight.

The band needs to be adjusted periodically for life. In the beginning, though, it requires frequent adjustments – maybe every six weeks – so it’s extremely helpful if you don’t live too far from your bariatric surgeon.

Filling the Gastric Band

Filling the band is not something that anybody with a needle can do for you. A good band adjustment “manager” is also your eating coach. The skill level of this individual, whether he/she is a doctor, nurse, or P.A., is much more important to your success with a gastric band than is the skill level of the surgeon who installed it. Signing on to have a band placed by a bariatric surgeon far away (i.e. Mexico) without first ensuring that you have skilled follow-up is a surefire recipe for disappointment.

To discuss adjustable gastric banding as an option for your weight loss, give us a call at 703.709.9771 or visit our Contact Us page for our email address and online form.