The LAP-BAND® System is one of the most successful surgical systems ever designed for weight loss. A small prosthetic device made out of plastic, it was first approved to help in the treatment of excess weight in America in 2001. Dr. Brian Quebbemann of The N.E.W. Program was one of the original surgeons involved with the FDA testing of the LAP-BAND® System and he has been performing the procedure to help patients achieve successful weight loss ever since, making The N.E.W. Program one of the most experienced LAP-BAND® centers in the United States. (In fact, Dr. Quebbemann's father has had the LAP-BAND® and has used it to succeed at weight loss.)
The LAP-BAND® System involves the placement of a small, adjustable ring over the upper stomach to create a small stomach pouch. The ring is attached to tubing which itself is attached to a small port that lies under the skin. The tightness of the ring can be adjusted during routine office visits. If a patient does not experience adequate weight loss, fluid is added through the port and the band tightens, resulting in an earlier sense of fullness during meals. If too much fluid is present, or the band is too tight, fluid can be removed from the band allowing the patient to eat more. Using these adjustments, the band can be fine-tuned for each patient. This ability to adjust the system after surgery is a unique feature of gastric band systems.
How many band adjustments are necessary before I start losing weight?
Because of the special diet we place patients on immediately before and after all of our weight loss operations, many patients will lose some weight even without any adjustments. However, we want the band to heal in place before we perform adjustments, so we don't do the first adjustment until 6 weeks after surgery. On average, 3 - 4 adjustments are necessary in the first year to fine tune the system for each patient; however, the number of adjustments needed can vary quite a bit. We try to see every patient frequently at first in order to adjust the band system and start each patient losing weight as soon as possible.
How are the band adjustments performed?
In the office, your surgeon or his assistant will clean the skin above the port and then inject a small amount of saline (like water) through the skin and into the port. This generally feels like a small pin prick and doesn't leave a scar. If a patient desires, a small amount of local anesthesia, lidocaine, can be placed in the skin prior to an adjustment to numb the sensation. Generally, there is so little discomfort with an adjustment that patients do not need the lidocaine. The procedure is done in the clinic and takes about 5 minutes.
When do I know that I need a band adjustment?
Patients should be able to eat normal food if they chew well, eat slowly, and generally follow our simple basic nutritional guidelines. If they do this, we expect to see an average of 1-2 pounds of weight lost per week during the first year. Patients should feel full after eating a small portion of solid foods. If the band is too tight, patients will often experience heartburn or difficulty eating and the band will need to be loosened. Success with the Lap-Band System (and also with the Realize Band System which works in the same way) depends on good communication and follow-up with our program, adherence to our basic nutritional guidelines, and a regular exercise. Our Lifestyle Management Program is designed to support our patients success with the gastric band process.
What are some of the unique aspects of the Gastric Bands?
- Gastric banding can be done as an outpatient procedure.
- Gastric banding is reversible.
- Gastric banding allows patients to fully digest vitamins and minerals.
- Gastric banding can be performed as a single incision procedure in certain patients.
- Gastric banding is not only effective for patients with a high BMI, it is also safe and effective for patients with lower amounts of excess weight. (see our Low BMI Program)
What should be my weight loss expectation with the LAP-BAND® System?
Surgeons at The N.E.W. Program are experts in the LAP-BAND® System and we find that patients will lose an average of 50% of their excess weight, although many patients lose substantially more weight, especially if they follow an exercise program. This weight loss typically occurs over a period of 2-3 years, with the majority of weight loss in the first year. Excess weight is defined as a person's current weight minus their ideal body weight (which is generally quite thin). All experienced centers in America and the world have found that patients will lose about 50% of their excess weight with this system, but patients will not be successful if they do not adhere to a recommended eating and exercise pattern (statistically studied data). As you can see below, weight loss with the LAP-BAND® System has been shown to be much greater than weight loss with a traditional diet.
Other post-operative aspects of the LAP-BAND® System.
The LAP-BAND® System is a fairly simple procedure and, because of this, there are few potential complications immediately after placement of the band. However, some long-term complications are unique to gastric banding (LAP-BAND®, REALIZE® Band). First, any gastric band can "slip." That is, the band can twist out of position and cause reflux and difficultly with foods, or worse. Weight loss will be affected when this happens, and a patient that feels they have a band slip will often need to undergo surgery to reposition the band. A band slip is best diagnosed by an X-ray --- however, only an experienced band surgeon will be able to diagnose this problem accurately and correct it. Band slips have been reported to occur in about 5 percent or more of patients during the first 5 years after the band is inserted, but at The N.E.W. Program only about 2 percent of our patients have been found to have slipped bands requiring an operation. There are other, more rare potential complications that can occur with gastric banding procedures. The most common complaint, however, with the LAP-BAND® System is heartburn which is generally a result of the band being too tight, and is corrected with a simple adjustment.