Gastric band surgery is one type of bariatric surgery procedure that’s adjustable and reversible. It involves placing a silicone band called the Lap-Band around your stomach. The gastric band reduces your stomach capacity and slows the passage of food through your stomach. This can retrain you to eat less.
The adjustable gastric band is a surgically implanted device to help people with obesity lose weight. It’s one of several types of bariatric surgery that restrict how much you can eat at one time (restrictive weight loss surgery). The adjustable gastric band reduces the size of your stomach without permanently dividing it as other surgeries do. The “Lap-Band” is the only brand of gastric band that is currently available in the U.S. It was approved by the FDA in 2001.
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The gastric band is an adjustable, inflatable tube made of soft silicone. It’s placed around the upper portion of your stomach to form a ring. This inflatable ring is connected to a port that is placed underneath your skin. Your surgeon can tighten the fit of the band by accessing the skin port and injecting with saline fluid, enough to allow a small outlet between the upper portion of your stomach and the lower part. When you eat, this upper stomach pouch will fill up quickly, making you feel fuller faster.
In general, you may be a candidate for bariatric surgery if you’re suffering from health conditions related to obesity and if other methods of weight loss haven’t worked for you. Your healthcare provider may suggest the Lap-Band if you’re looking for an intervention that’s less invasive and less permanent than other weight-loss surgeries.
Compared to other bariatric procedures, the gastric band has the lowest complication rate after surgery, and there is no division of stomach or intestines. It can also be removed if needed. However, the Lap-Band leads to less weight loss than other bariatric procedures. It also requires several frequent follow-up office visits and adjustments, especially over the first year.
Currently, other bariatric surgery procedures, like the sleeve gastrectomy and the roux-en-Y gastric bypass, are more widely used. As of 2019, the rate of gastric band surgery was estimated to be 0.9% of all bariatric procedures performed in the United States.
The average weight loss with Lap-Band is about 40% of excess weight over two years. That means if you were 100 lbs. overweight, you’d lose 40 lbs. Results can vary, depending on how much you change your habits after surgery. Weight loss with the gastric band is typically less than with other bariatric surgeries.
Just losing weight can do a lot to improve obesity-related health conditions, including:
The gastric band doesn’t have the same effects on metabolism and hormones as other weight-loss surgeries. It’s considered a purely “restrictive” procedure, meaning that it works primarily by limiting the amount of food you can eat at one time.
Your healthcare provider may recommend bariatric surgery if you have:
You’ll also have to undergo medical screening to make sure you’re healthy enough for surgery. You may have physical exams, blood tests, or imaging tests of your abdomen. If you smoke or overuse alcohol or opioids, you’ll have to quit before qualifying for surgery.
This is a subjective question. However, the procedure and recovery time are relatively short, and like most bariatric surgeries, you can have the adjustable gastric band installed by minimally-invasive surgery methods (laparoscopic surgery). This means that instead of one large incision across your abdomen, your surgeon can perform the entire operation through a few small “keyhole” incisions.
Your healthcare provider will give you specific dietary instructions. You’ll be on a liquid diet for the first several weeks, gradually progressing from pureed foods to soft foods and finally, solid foods. This is to give your stomach time to heal. When you do return to solid foods, you’ll have to limit your portions to fit your new stomach pouch. Overeating will likely cause nausea and vomiting. You’ll have to choose high-quality foods to make sure you get enough nutrients and chew your food well.
You'll visit your healthcare provider often in the first year after surgery to make adjustments to your gastric band. As you lose weight, your Lap-Band may need to be tightened in order for you to sustain your weight loss. You’ll also have regular blood tests to make sure you’re getting enough nutrients on your new diet. You may have nutritional counseling to help you learn new ways of eating. If necessary, your healthcare provider may prescribe supplements.
The Lap-Band is designed to last a lifetime, but whether it does isn’t yet proven. Studies show that 35% to 40% of people may have their gastric bands removed after 10 years.
There are many reasons why the gastric band may be removed, including:
Some people eventually move on to a more permanent bariatric surgery with a higher success rate.
The main advantage of the adjustable gastric band is that it has a lower risk of complications immediately after surgery. While sleeve gastrectomy and gastric bypass are both considered very safe, the gastric band is estimated to have an even lower risk of complications. There’s no division of your stomach or intestines involved. Additionally, it can be removed if necessary.
There are several disadvantages to gastric band surgery. First, it leads to less weight loss than the other bariatric surgeries. It also may require frequent adjustments, especially during the first year after placement.
Over time, there may be additional issues that arise. For example:
Many people lose weight with the gastric band in the first year or two after surgery. The gastric band placement itself rarely causes complications immediately after surgery, but some complications may develop down the road. Complications may require reoperation or removal of the Lap-Band. Some people decide after removal that they desire another bariatric procedure.
A note from Cleveland Clinic
Any bariatric surgery is a major commitment with important pros and cons to consider. Gastric band surgery is no exception. As a reversible and removable option that doesn’t require cutting your organs, the Lap-Band may be an easier commitment up front. It also means more follow-up care, however, including frequent adjustments in the first year or two and possible revision surgeries later on. And it will require lifelong changes to your eating habits.
For some people, this is the option they need to take the next big step toward significant weight loss and lifelong change. Depending on how it works for you, it might be the end of your weight loss journey, or a step along the way. Some people use the Lap-Band to effectively retrain themselves to change the ways that they eat and live. Others may fail to lose enough weight or maintain their weight loss over time. If this happens, you’ll have other treatment options.
Last reviewed by a Cleveland Clinic medical professional on 04/26/2022.
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