What is the Adjustable Gastric Band (AGB)?
The LAP-BAND system consists of an adjustable silicon band and a "port" connected by tubing.
The band is placed around the upper part of the stomach and divides the stomach into two parts.
The small upper stomach pouch can only hold a small amount of food. The remainder of the stomach lies below the band. The two parts are connected by means of a small opening called a stoma.
The port, which is placed under the skin, allows the size of the opening to be adjusted. Your surgeon painlessly adjusts the size of the stoma by piercing the port with a fine needle through the skin. The level of restriction is increased by adding fluid - up to the manufacturer's recommended maximum.
If a patient experiences difficulty the level of restriction can be decreased by withdrawing some of the saline fluid currently in the band.
The first is the LAP-BANDŽ system (pictured below). This band is manufactured by BioEnterics Corporation which offers two bands which have a capacity of 5mls or 10mls.
The second is the Swedish Adjustable Gastric Band (SAGB) (pictured below). This band is manufactured by Obtech Medical and has a fluid capacity of 9mls.
A Weight Loss Tool
The Adjustable Gastric Band helps patients to lose weight by reducing the amount, frequency and variety of foods that patients are able to ingest.
The Adjustable Gastric Band reduces the capacity of the stomach so that it holds less food. Most patients find they can only eat a portion of the amount of food they were able to eat prior to surgery.
The Adjustable Gastric Band also slows down the passage of food through to the rest of the stomach. Patients feel full for longer and find that they therefore eat less often.
In many cases the Adjustable Gastric Band appears to reduce the types of food that patients are able to eat. A number of Lapbanders report difficulty ingesting soft breads, red meat and some vegetables.
In addition to the physical reasons for weight-loss, surgeons have observed associated psychological effects that are not yet fully documented or understood. For example, it has been speculated that the presence of the band assists in the functioning of a neurotransmitter which effectively reduces hunger. Studies have suggested that this neurotransmitter is usually absent in obese patients.
Expected Weight loss
Although the Lapband has been shown to be an effective tool for weight loss, the majority of patients are unlikely to reach their "ideal" weight.
On average, patients can only expect to lose up to two thirds of their excess weight. That means if a patient weights 160 kilos, and their ideal weight is 70 kilos, they could expect to lose 60 kilos and reach a weight of 100 kilos.
Only a small perecentage of patients will lose all of their excess weight to reach an "ideal" weight.
Rate of Weight Loss
On average, patients can expect to lose between 2-4 kilos per month.
The studies to date show that most patients will have lost almost all of the weight they are going to lose within 18-24 months of surgery. However, there is no reason why a patient cannot continue to lose weight beyond this point if they still have some capacity in their band.
Maintaining Weight Loss
Most people manage to sustain the majority of their original weight loss.
In a nine-year follow up study, titled "The Swedish Adjustable Gastric Banding (SAGB) for Morbid Obesity: 9-year Experience and a 4-year Follow-up of Patients Operated with a New Adjustable Band", Forsell and Hellers found that the 50 patients in the study lost a mean weight of 54 kgs and managed to keep that weight off for the duration of the study.
The combination of the physical and psychological effects of the band appear capable of bringing patients a sustainable weight loss.
A Lifetime Commitment
It is not intended that the LAP-BAND system should be removed at any time unless the band needs to be replaced.
It is possible that the band may need to be deflated, but it is rarely removed.
According to the research to date, patients would be likely to regain their weight if the band is removed.
