Approved by the FDA in June 2001, the LAP-BAND® Adjustable Gastric Banding system is named by the FDA Office of Device Evaluation as “One of the Significant device Breakthroughs” which is the preferred choice for the minimally-invasive surgical treatment of morbid obesity in the United States. It induces weight loss by reducing the capacity of the stomach (without cutting of intestines or stapling of the stomach), which restricts the amount of food that can be consumed. Since its clinical introduction in 1993, more than 600,000 LAP-BAND procedures have been performed around the world. In the Philippines, LAP-BAND® surgery started in 2004.

During the procedure, surgeons usually use laparoscopic techniques (using small incisions and long-shafted instruments), to implant an inflatable silicone band into the patient's abdomen. Like a wristwatch, the band is fastened around the upper stomach to create a new, tiny stomach pouch that limits and controls the amount of food you eat. It also creates a small outlet that slows the emptying process into the stomach and the intestines. As a result, patients experience an earlier sensation of fullness and are satisfied with smaller amounts of food. In turn, this results in weight loss.

Since there is no cutting, stapling or stomach re-routing involved in the LAP-BAND procedure, it is considered the least traumatic of all weight loss surgeries. The laparoscopic approach to the surgery also offers the advantages of reduced post-operative pain, shortened hospital stay and quicker recovery. If for any reason the LAP-BAND needs to be removed, the stomach generally returns to its original form.

As opposed to other types of weight loss surgery the LAP-BAND is adjustable and can be easily adjusted after surgery to meet patient’s requirements. The diameter of the band is adjustable for a customized weight-loss rate. Your individual needs can change as you lose weight. For example, pregnant patients can expand their band to accommodate a growing fetus, while patients who aren't experiencing significant weight loss can have their bands tightened.

To modify the size of the band, its inner surface can be inflated or deflated with a saline solution. The band is connected by tubing to an access port, which is placed well below the skin during surgery. After the operation, the surgeon can control the amount of saline in the band by entering the port with a fine needle through the skin.

Minimal Trauma

• Least invasive surgical option
• No intestinal re-routing
• No cutting or stapling of the stomach wall or bowel
• Reduced patient pain, hospital length-of-stay and recovery period

Fewer Risks and Side Effects

• Significantly lower mortality risk than other obesity surgery procedures
• Low risk of nutritional deficiencies associated with gastric bypass
• Reduced risk of hair loss
• No "dumping syndrome" related to dietary intake restrictions

Adjustable

• Allows individualized degree of restriction for ideal, long-term weight loss.
• Adjustments performed without additional surgery
• Supports pregnancy by allowing stomach outlet size to be opened for increased nutritional needs

Reversible

• Removable at any time
• Stomach and other anatomy are generally restored to their original forms and functions

Effective Long-Term Weight Loss

• More than 600,000 LAP-BAND procedures have been performed around the world (as of July 2008, with the U.S. performing close to 4,000 procedures a month).
• For the BIB, More than 100,000 procedures performed
• Standard of care for hundreds of practices around the world
• More than 1600 scientific publications with more than 10 years follow up

The LAP-BAND System is usually placed laparoscopically while you are under general anesthesia. While you may be in the operating room for two to three hours, the surgery itself typically takes about an hour. First, the surgeon makes a few very small incisions in the abdominal wall and secures "ports" in these incisions to accommodate long, thin surgical instruments. A narrow camera is also passed through one of these ports so that the surgeon can view the operative site on a nearby video monitor. A small tunnel is made behind the top of the stomach to let the LAP-BAND System device through and allow it to be wrapped around the upper part of the stomach, like a wristwatch. The LAP-BAND System is then locked securely in a ring around the stomach. This creates your new, smaller stomach pouch. Also, to help hold the LAP-BAND in place, stomach tissue is folded over it and stitched together. The rest of the lower stomach will stay in its normal position. Then, the small access port, which is used for LAP-BAND adjustments, is fixed just underneath the skin. The access port is used by the surgeon to inject saline (sterile salt water) into the LAP-BAND when you have an adjustment. The LAP-BAND System is usually left empty for the first 4 to 6 weeks after surgery.

Although it's normal to be nervous, the day of your weight loss surgery is really an exciting day because it's a major milestone on your road to a healthier, happier life. Here is a general overview of how to get ready for your LAP-BAND surgery, and what to expect that day.

• Preparing for Surgery
• What to Expect on Surgery Day
• Post Surgery FAQs

Before your surgery, your surgeon will discuss your procedure in detail with you. It is also very important to discuss your overall health and your health history. You need to let your surgeon know if you have any current/past health conditions, are allergic to any drugs, or have ever had a bad reaction to anesthesia. In addition, make a list of all the medications that you take, including aspirin, injections, all prescription and over-the-counter drugs, herbal supplements, vitamins, and recreational drugs, and give it to your surgeon.

Your doctor may also want you to meet with other medical experts, such as a dietitian and/or psychologist, to help you understand what will happen during and after the LAP-BAND surgery process. They will help you make certain that you are mentally and emotionally prepared for surgery and your new life with the LAP-BAND^®System. Additionally, you will have a number of tests before your surgery to evaluate your general state of health.

On the day before your procedure, you will need to follow specific instructions to ensure all goes well the next day. Your surgeon and medical team will provide you with a complete list of instructions on how to prepare for the surgery. Here are two general guidelines:

• Do not eat or drink anything after midnight.Your stomach must be empty for surgery to minimize risks during the operation.
• Ask a friend or a family member to be at the hospital with you for comfort and support and to drive you home after the surgery. You may also want him or her to help you get settled at home.

Please note that although this experience is typical, the routine at your healthcare facility may be different. You will be admitted to the hospital either the day before, or on the morning of your surgery. You may be in the operating room for two or three hours, but the actual procedure typically takes about one hour. Then you will spend a few hours in the recovery room. Once the anesthesia has worn off, you may feel some pain or discomfort, which can usually be treated with ordinary pain relievers. The hospital staff will help you get out of bed and start moving as soon as possible to help prevent blood clots, respiratory problems, and bedsores.

On the day after the surgery, you will likely have an X-ray. This allows your health team to see that the LAP-BAND is in the right place and that the new stomach outlet is open. You may be asked to swallow a liquid that can be seen on X-ray.

For LAP-BAND surgery, hospitalization is usually less than 24 hours. The hospital stay may be longer if there are complications or if the surgeon has to change to an "open" surgical procedure.