The surgeons fit the Inamed LAP-BAND® System. This is the least invasive and only adjustable surgical weight-loss option available. It helps achieve sustained weight loss by placing an adjustable band around the upper part of the stomach to reduce its capacity. FDA approved over 300,000 which have been fitted since 1990. Careful consideration is required before deciding on which type of surgery is best for you. Please be aware that the adjustable gastric band can be costly in terms of time and money required for adjustments in the long term. It also has the most eating complications associated with it when compared with the gastric bypass, sleeve gastrectomy, or Mac Lean surgeries. A higher level of aftercare is required, with the need for several refills in the first year. It is considered the least invasive procedure and is inserted using Laparoscopic surgery. Statistics show that 50% of candidates opt to have their band removed after a few years and have further surgery for weight loss. This is usually because the candidate fails to reduce weight over a sustained period of time (over 6 years) or has problems with food intake. However many candidates have had their bands for longer periods. Our experiences go back over 30 years and many candidates are perfectly satisfied and happy with their adjustable gastric bands.
How the Gastric Band works: The band is adjusted by adding or removing fluid (water) using a syringe injected into a “port”. This subcutaneous port is located just to the left of the navel and a bit lower down. It can be felt underneath the surface of the skin and sits comfortably in its place. It won’t interfere or cause irritation. The fluid inflates the Band surrounding the top of the stomach limiting the amount of food intake. Strict aftercare and monitoring is required for this system to be effective.
The Lap-Band subcutaneous injection port: This consists of a subcutaneous injection port attached to the tube connecting the Lap-Band (see picture). The port is placed, under the skin below the navel. Access to these ports requires the use of a non-coring needle known as a Huber needle. A non-coring needle will minimise the damage to the silicon rubber covering of the port and therefore reduce the risk of leakage from the port.
Filling the Adjustable Gastric Lap Band: Please note that with Adjustable Gastric Lap Banding further adjustments to the lap-band are required; the first being 4 – 6 weeks after the band is fitted with approximately 3 further visits in the first year. Providing the candidate loses weight satisfactorily, further adjustments can normally be reduced to yearly adjustments.
The Lap-Band Fill or Adjustment: The Lap Band is filled or adjusted by access from the port. Normally a syringe with a Huber needle is used to fully withdraw all the fluid in the Lap-Band. This is then measured and if the band needs tightening then slightly more fluid is pumped back into the port. A Lap-Band can normally be filled until slight resistance is felt this is then the optimum fill level. For example if 3 cc’s of fluid is removed and the band needs tightening then 3.5 cc’s may be put back in.
When filling the band it is important not to overfill the lap-band as this will cause a blockage or restriction preventing the candidate from eating our taking fluids. If such a restriction occurs the band should be deflated immediately and half the fluid placed back in. Frequent adjustments of lap-bands are necessary. A lap band candidate should be familiar with their refill centre and visit as often as necessary to be sure that all is going well and they are losing weight satisfactorily. Lap-band candidates should be aware that air travel can adversely affect the band creating a blockage. Pressurisation and depressurisation of the aircraft can cause air bubbles to occur within the lap-band, leading to a restriction. If this situation occurs and the candidate cannot take on fluids then the lap-band must be deflated immediately. Once the band has been deflated half the fluid can be put back in. The candidate will need to return for a fill and adjustment after a few days.
Complications and Problems associated with the Adjustable Gastric Band: Sometimes Adjustable Laparoscopic Bands can be problematical. All bands are fixed in place with stitches low on the oesophagus on the top of the stomach. However in some cases the band can slip. This usually occurs when the candidate has tried to force too much food down. If you think the gastric band has moved out of place an X-Ray with a contract injection into the port may be required along with a Barium Swallow gastrointestinal examination to determine its position. Another problem associated with long haul flights is where air bubbles may occur causing restriction. This may lead to the candidate not keeping down food and fluids. Dr Dillemans recommends deflating the band by half before undertaking flights longer than 3 hours and refill on return. In certain circumstances the adjustable gastric Laparoscopic band can leak, this is usually occurs at the joint or connection to the subcutaneous port. This is corrected by a minor surgical procedure. If you are experiencing problems or are unable to keep down fluids or food, seek immediate assistance! It is extremely unlikely that a gastric band will have been fitted incorrectly. In our experience of 6,000 adjustable gastric bands fitted over 30 years, none have been found to have been fitted incorrectly.