The LAP-BAND® is a restrictive operation used for weight loss. The LAP-BAND® is made
of silicone and is placed around the stomach near the upper end, creating a small
upper pouch and a narrow passage into the larger lower portion of the stomach. The
LAP-BAND® has an adjustable inner-collar that can be inflated or deflated depending
on a number of factors. The LAP-BAND® is connected through a tube to a port (reservoir),
which is placed under the skin of the upper abdomen. The collar around the stomach
outlet is adjusted by adding or removing small amounts of saline solution by inserting
a needle into the injection port. The adjustment is performed under x-ray control
or in the physician’s office. This technique leaves the digestive tract in the normal
sequence for digestion and absorption. The only intended effect is a reduction in
capacity for a meal. Small pouch volume and correct outlet diameter are very important
for the success of this operation.
One advantage of
gastric banding is that the stomach is not cut, stapled, or entered. Thus, the risk
of infection is less and there is no possibility of staple-line disruption. However,
there is always a risk of injuring the esophagus or stomach when placing the band.
Other important advantages are that the operation can be revised and is the only
completely reversible technique if a need arises. In such a case, the band is removed
and the stomach recovers its normal anatomy, without sequelae.
After gastric banding, the stomach can slip under the band, causing distention of
the pouch and poor emptying. The band can cause scar tissue to build up and reduce
the outlet, or it can loosen and no longer restrict eating, or it may rarely penetrate
into the stomach. These problems can result in repeated vomiting or failure to lose
weight, and may require another operation for correction.
|