Lap Band Surgery

About the Procedure

Lap Band Surgery, short for Laparoscopic Adjustable Gastric Band Surgery, is a weight-loss treatment for morbidly obese people. An inflatable device (the lap) is put around the upper stomach creating a pouch, restricting the amount of food which can be comfortably taken in. The device is routinely adjusted to narrow the opening between the small pouch and the larger stomach. The FDA has now approved this procedure for people with less severe obesity problems and at least one related health issue. Weight-loss surgery is not considered until previous, non-surgical methods to reduce weight have been tried without success and not all patients are eligible for the procedure.

A surgeon trained in bariatrics, laparoscopic techniques, and who has completed an Allergan LAP-BAND® training course as mandated the FDA, performs the procedure in an out-patient facility using general anesthesia. A few tiny incisions are made in the mid-section to insert the laparoscopic instruments and the stomach is accessed. The surgeon slips an adjustable band around the upper part of the stomach creating a pouch-like section. From the band, a tube leads to the chest wall where a small access port is attached under the skin. After the site is closed up, the patient is sent to a recovery area.

What to Know Before the Procedure

Lap band surgery has fewer complications than similar surgeries but it does have some which are significant. One is productive burping, regurgitating swallowed food from the pouch. Another is that food may be caught in the narrow tunnel created by the band. Patients may experience gastrointestinal problems, e.g., ulcers, gastritis. The band can move through the outer stomach to the inside, the lower stomach may prolapse through the band, or it may re-position itself and possibly end up not encircling the stomach at all. For severe instances of these situations, medical intervention is required.

Patients are encouraged to begin a regimen of eating mini-meals throughout the day, and exercise to ease the adjustment to their new lifestyle. Inquiring whether there are any vitamins or minerals which could be taken ahead of time is suggested. The surgeon will go over specific pre-operative instructions including a review of patient medications and pre-admission testing. Some effects of anesthesia, such as grogginess, take a while to completely wear off so it is necessary to have someone else drive at discharge.

What to Know After the Procedure

The procedure takes approximately one hour after which patients spend a few hours in the recovery area where they are assisted with walking around after the anesthesia has worn off. There may be some pain which is usually relieved with over-the-counter medications. A very dry mouth is not uncommon after general anesthesia but patients are restricted to occasional sips of water or sucking an ice cube until the physician permits the slow introduction of food. People who have had an uncomplicated laparoscopic surgery are discharged within 24 hours. Before discharge, an X-ray is performed to see if the surgery has gone well. For a couple of days rest is recommended along with regular walking to help avoid blood clots. Patients with sedentary jobs usually return to work in a week; those with more physical jobs will need extra time. Normal activities can be completely resumed in about six weeks. Adjustments to the lap band can be started around four to six weeks after surgery. The surgeon will inject saline through the access port at each appointment and over time the band tightens, allowing a slow change in the quantity of food intake and dietary recommendations.

If you Need to Travel Outside of your Local Hospital

The cost of laparoscopic adjustable band surgery ranges from about $12,000 to $25,000, depending on location, and routine adjustments run between $35 and $200. If it is covered by the patient's insurance company, a pre-authorization is recommended. Finding a qualified surgeon in the patient's local area may be difficult, although travelling a great distance may not be required. For those who do choose to travel, once the procedure is complete, and the patient returns to their home, it may be possible to find a local physician to do the routine band adjustments. Researching this information ahead of time will be helpful in making a final decision on where to have this procedure done.