Lap-Band Surgery

Reviewed by Tim Ehrlich, MD

Here you'll find information on:

• What is the Lap-Band System?
• Best candidates for Lap-Band surgery
• Lap-Band placement
• How the port works
• Recovery and aftercare
• Possible complications
• Consult a qualified surgeon
• Cost of Lap-Band surgery

Lap-Band surgery is a type of weight loss surgery that, like gastric bypass, alters the anatomy of the stomach to help you reduce food intake.

What Is a Lap-Band?

"Lap-Band System" is the brand name of the FDA-approved, adjustable gastric band used in the procedure. Most simply, a Lap-Band is a silicone belt that goes around the top of the stomach. This results in the ability to control your hunger and achieve a "feeling of fullness," or satiety. Ultimately, you eat much less and should feel full sooner.

A key component of the Lap-Band System is its adjustability. The band is connected to a port, which enables the device to be inflated over time to expedite the weight loss.

Who Are Candidates for the Lap-Band System?

The NIH (National Institutes of Health) requirements for Lap-Band surgery are the same as for any other weight loss surgery. These criteria were originally set in the early 1990s and have not changed. If your BMI, or body mass index, is between 35 and 39, then you must also have associated severe medical problems, or co-morbid conditions, in order to be a candidate for the Lap-Band. These conditions usually include diabetes, hypertension, or high cholesterol. But if your BMI is greater than 40, then it is not required that there be any associated medical problems.

Most insurance companies also require a history of previous attempts at weight loss. How stringent these requirements are can differ from one insurance company to another.

Many people do not meet the NIH requirements or do not have the insurance benefit for weight loss surgery, but they may still be able to pursue the procedure by paying for it themselves.

How the Lap-Band Is Placed in the Body

After performing a series of small incisions, your surgeon would use a small camera, called a laparoscope, to visualize placement of the Lap-Band. The Lap-Band is placed around the top of the stomach and secured in place with sutures. The port is then placed underneath the skin on the top part of the abdomen. Surgery should take only about an hour, and an overnight stay in the hospital may or may not be required.

How the Port Works

Injecting saline into the port inflates the band, making the passage to the lower part of the stomach smaller, which further restricts food intake. Fluid can easily be removed in the doctor's office if it is too tight.

After Lap-Band Surgery: Recovery and Aftercare

Following surgery, you should be able to return to work within a week, with minimal discomfort. You will need to follow a nutrition plan (which may include vitamin supplements) prescribed by your surgeon and/or nutritionist. The nutrition plan will likely include a liquid diet for a few weeks, until you can tolerate soft foods, and later solid foods. A specific exercise program, as well as behavioral-modification therapy, may also be recommended.

Frequent office visits are mandatory to adjust the band. Your surgeon or his assistant will be able to inject the port in the office. On average, patients require six to eight adjustments of the band during the first 18 months following Lap-Band surgery.

Patients typically lose 50% to 60% of their excess body weight within two years after the procedure. Additional plastic surgery may be indicated, depending on how much weight is lost.

Lap-Band System Complications

As with any surgical procedure, there are known risks. Besides the standard risks of most procedures, including bleeding and infection, there are complications specific to Lap-Band surgery. Slippage of the band can occur as you lose weight and the stomach goes above the band, causing heartburn or vomiting. This can usually be fixed laparoscopically. Rarely, the band may erode into the inside of the stomach.

Laparoscopic surgery is not always possible. Your surgeon may need to use an "open" method. This happened in about 5% of the cases in the U.S. clinical study. Other problems can occur that are directly related to the Lap-Band System:

• The band can spontaneously deflate because of leakage. That leakage can come from the band, the reservoir, or the tubing that connects them.
• The stomach pouch can enlarge.
• The stoma (stomach outlet) can be blocked.

For Lap-Band Surgery, Consult a Qualified Surgeon

Using a qualified surgeon will be critical to your success as a Lap-Band patient. Not only will this reduce your risk of complications, but also it will ensure that you lose as much weight as you can. Be sure to verify the number of procedures your surgeon has done, and find out about his office support for Lap-Band patients.

Cost of Lap-Band Surgery

The cost of Lap-Band surgery varies from about $17,000 to $30,000, depending on where you live. In the past, insurance companies did not cover this procedure, but increasingly they are paying for all or part of it if medical necessity is established by your doctor and if you meet the NIH requirements described above.

For financing options and tips, please read about patient financing.

Related Topics

• Realize Band surgery
• Gastric bypass surgery
• Duodenal switch surgery
• Gastric sleeve
• Weight loss surgery for adolescents
• Weight loss trends
• Surgeons discuss obesity and plastic surgery
• Weight loss surgery home page

About the Reviewer of This Article

Dr. Tim Ehrlich is the director of bariatric surgery at St. Vincent's Medical Center in Bridgeport, Conn. and a member of the American Society for Bariatric Surgery and The Society of American Gastrointestinal and Endoscopic Surgeons.

[Page updated April 2008]