History of the Gastric Band

Restrictive bands around the top of the stomach have been used since the late 70s in an attempt to reduce food intake. The first gastric bands were “fixed” bands made out of Marlex mesh or Dacron graft material. These were not adjustable and placed through open surgery. Kuzmak introduced the first adjustable gastric band in 1986 made out of silastic with connection to a port under the skin which could be used to control the size of the gastric band with saline injection. (Ref: Obesity Surgery (2008) 18:121-128)

In Australia the first gastric band was placed laparoscopically (keyhole surgery) in 1992, although this was a non-adjustable variety of gastric band. Belechew placed the first laparoscopic adjustable gastric band in 1993, a system which would evolve into the well known Lap Band. (Ref: Obesity Surgery 2001, 11. 778). The Lap Band system was approved for use by the FDA in the United States in 2001.

In modern times, gastric bands have been progressively made larger with balloons which can accommodate higher fill volumes. This gives the surgeon more flexibility in terms of the level of restriction that a particular patient may need.

The surgical placement of the gastric band initially was directly onto the stomach wall in the space behind the stomach. This method of placement was found to be associated with an unacceptably high rate of slippage (mal-position) of the bands. In the late 1990s a higher position on the stomach (the so-called “pars flaccida” approach) was found to produce a much lower slippage rate and is now the standard of care for gastric band placement.

These days over 10,000 gastric bands are placed in Australia annually. They can be placed with laparoscopic surgery in about 99% of cases. In 2011 the food and drug administration of America approved the gastric band for use in selected patients with BMI between 30 and 34 kg/m2.