Lap Gastric Band

An Overview of Gastric Banding

The Band Itself

• The gastric band is an adjustable circular balloon made of inert silicone which can be placed around the top of the stomach to help induce weight loss in people suffering from obesity
• The most commonly used brands in Australia are the Lap Band ® (Allergan) and the Swedish Band (Ethicon).
• An access port is placed under the skin of the upper abdomen which can be used to inject fluid into the band to increase its effect
• Gastric banding patients are required to eat smaller food portions. Food must be eaten slowly and chewed carefully to avoid regurgitation.

The Surgery

• The vast majority of gastric bands are placed with laparoscopic or keyhole surgery, hence the commonly known phrase “Lap Band”
• Most surgeons use five cuts ranging from 5mm to 15mm in size to insert the band
• Usually it is a one night stay in hospital
• Modern alternatives to gastric banding surgery including the gastric bypass and sleeve gastrectomy operations

The Follow-up

• Follow-up needs to be intensive with both the surgeon and dietician with the band to ensure success
• A number of band fills may be performed over the first year or two so that the band is adjusted perfectly for the individual
• You will be advised to take a multivitamin for the rest of your life with the band to avoid nutritional deficiencies
• Regular contact with your surgeon will enable prompt treatment of technical issues such as band slip, band erosion, port infection, port migration and other problems

The Outcomes

• On average gastric banding achieves a loss of about 50-55% of excess weight lost
• The weight loss from gastric banding surgery is sustained in the vast majority of cases which sets it apart from most commercial diet and exercise programmes where weight loss is often temporary
• In fact the outcomes with the band are quite variable and up to 50% of people may achieve less weight loss than this (which means 50% achieve more!)
• Medical problems related to obesity respond well to gastric banding. Half the diabetics undergoing banding will be able to cease their diabetic medications. Most patients using a CPAP mask for sleep apnoea will be able to discontinue this.
• Quality of life usually improves dramatically for successful gastric banding patients
• Loose skin appearing after weight loss is common and can be treated with abdominoplasty surgery (apronectomy) or brachioplasty (arm reduction)

Am I Eligible?

• Your Body Mass Index (BMI) is the best guide to eligibility for this surgery
• A BMI of over 40 kg/m2 is usually sufficient but if you have a BMI over 35 and diabetes, sleep apnoea or other obesity-related problems you will generally qualify.
• If your BMI falls outside these guidelines it may be possible to undertake surgery if you have a good understanding of all the potential issues involved (pros and cons)

Costs

• The cost of gastric banding depends on whether you have private health insurance or not
• As a rough guide in our clinic you will be out of pocket approximately $4000 if you are insured and $12500 if you are not