Adjustable Gastric Banding with the REALIZE BAND and LapBand

Laparoscopic Adjustable Gastric Banding or LAGB is a restrictive bariatric surgical procedure using a medical device consisting of an adjustable silicone ring placed around the top of the stomach to make a small pouch that slows the passage of food into the main body of the stomach. The adjustable ring is attached to a reservoir (called the port) located under your skin. The band can be adjusted for the correct amount of tightness by your surgeon injecting saline water into the port during follow-up office visits. These injections are called "adjustments" or "fills".There are two bands available in the United States. They are the LapBand and the REALIZE band. Both bands have similarities and differences. Both can be placed laparoscopically under general anesthesia using 5 small incisions. Surgery generally takes between 30 minutes and 1 hour. The band is placed in a relatively deflated state. You are usually discharged from the hospital either the same day of surgery or the day after the operation. After surgery, you are on a liquid diet for 2 weeks, then pureed food (nothing thicker than applesauce) for another 2 weeks, and then on mechanically soft foods which can be crushed with the back of a fork for 2 more weeks. Six weeks after surgery you are seen by your surgeon for your first adjustment.

Risks of LAGB

Laparoscopic Adjustable Gastric Banding is the safest weight loss surgery procedure with the easiest recovery. But no matter how safe and how carefully your surgery is performed, there is always the possibility of complications. The following table gives estimates for the risks associated with LAGB.

Risk of complications after LAGB

Complication	Risk of occurrence
Death within 30 days after surgery	0.1%
Conversion to open surgery	<1%
Need for second operation for any reason	~5%

Specific risks and complications of the operation include:

Blood clots (called deep vein thrombosis or DVT) can form in the veins during any surgery. Pulmonary embolus (or PE) is when they break lose and go to your lungs. The risk of this occurring is less than 1%.
.Bleeding which requires blood transfusion, conversion to open surgery, or even removal of the spleen. The risk of this occurring is less than 1%.
General risks of laparoscopic surgery which include unexpected heart or lung problems, injury to other organs or need for conversion to open surgery

Complications that can arise during long term follow-up include:

band slippage which requires an operation to reposition or remove the band
port or tube problems which may require a superficial operation to reposition or replace the port
esophageal dilatation with associated swallowing problems or GERD
erosion of the band into the stomach or infection of the band

Most other complications can be prevented by appropriate nutritional and medical follow-up along with proper eating and drinking habits. These include any vitamin and mineral deficiency, hair loss, constipation and vomiting.

Lap Adjustable Gastric Band

follow-up

As well as seeing our own patients in follow-up for adjustments, we often see patients who have had their LAGB surgery elsewhere, both in the US and outside the US. For patients who have had surgery elsewhere, we begin with an initial consultation, a review of an upper GI barium x-ray study and nutritional labs, followed by adjustments. If health insurance covered the placement of your LAGB, it usually covers the expense of follow-up.

If you are a LAGB patient whose health insurance doesn't cover your follow-up adjustments, you can click here to see our fees or call (425) 453-7888 for more information.