We often get questions from patients about surgical bariatric procedures and how they compare to what we offer here at Batash Endoscopic Weight Loss Center. There is a world of difference between surgery and endoscopic procedures, including the level of risk involved, the possible complications, how long recovery takes, and the amount of weight you can expect to lose.

Today, we are going to provide an overview of one surgical procedure known as lap band surgery, which is also called gastric banding. We are going to answer some frequently asked questions about the lap band procedure to give you a solid understanding of this weight loss option.

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What Is Lap Band Surgery?

The first instance of lap band surgery was done in 1978 and was placed through an “open” surgical procedure, as this predated laparoscopic techniques. Since then, there have been several changes and improvements made to the types of bands and the techniques used to place them.

The band is placed around the stomach to temporarily divide it into two sections, with one being substantially smaller. This restricts the individual’s portions to very small amounts and causes them to lose weight. The band can be removed or adjusted if necessary, but it can also stay in place long-term if the patient is not experiencing any issues.

What Are Gastric Lap Bands Made Of?

Over the years, Lap bands have been constructed out of many different materials, including titanium, stainless steel, different types of plastic mesh, and silicone. Because of the many issues experienced by patients over the years, the only material used today is silicone rubber.

How Is A Lap Band Installed?

• I do laparoscopic gastric banding surgery while the patient is asleep under general anesthesia and it takes between an hour and two hours to complete;
• Several small cuts are made in the abdominal area, and the entire surgery is done through these openings;
• A small pump is placed through one incision and used to fill the abdomen with gas to give the surgeon access to the procedure site;
• A tiny camera-equipped surgical tool called a laparoscope is inserted into one of the openings, and the lap band is inserted through another;
• While visualizing what they are doing on a video screen, the surgeon uses the camera's live video feed to wrap the lap band around the upper portion of the stomach (like a belt). The band is then inflated with sterile saline solution to create a smaller section and restrict the flow of ingested food;
• The surgeon also installs a port just under the skin that you cannot see but can feel from the outside using pressure from your fingers. This port is used by the doctor during future visits to add or remove some of the sterile saline solution that the band is filled with;
• Then the surgeon removes the tools from the abdominal openings and closes up the incisions.

Who Is Eligible For Lap Band Surgery?

Lap band surgery is intended for people who have not been able to reach or maintain a healthy weight using traditional methods that do not involve previous surgery. They must have reached the unhealthy BMI level of at least 35 or have a BMI of 30 or more and be suffering from a condition that is weight-related. (high blood pressure, diabetes type II, etc.)

How Long Is Recovery From Lap Band Surgery?

Everyone recovers in their own timeframe, but on average, it takes about 6 to 8 weeks to recover after having lap band surgery. You will be encouraged to walk as much as you can beginning the day of your procedure, but you will have other activity restrictions such as no pushing and pulling things (such as a vacuum cleaner) for several weeks, no heavy lifting for a few months, no bathing or swimming for several weeks, and you will be on a liquid diet for at least two weeks and then gradually working your way back up to eating solid food over the next few months.

You will have several follow-up appointments over the first year to monitor your progress and watch for any adverse activity.

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What Are The Benefits And Drawbacks Of Laparoscopic Gastric Banding?

Benefits

• Short procedure time;
• The band can be removed at any time, and the surgery does not involve removing any part of the stomach or making additional alterations to the digestive system.

Drawbacks

• Individuals lose fewer pounds than with other types of bariatric surgery;
• It can require frequent adjustments;
• The rate of failure is higher than with any other type of bariatric surgery;
• The gastric lap band has a high complication rate (over 50%).

Complications Of Laparoscopic Gastric Banding Surgery

Initial complications include:

• Diarrea;
• Excess gas and discomfort;
• Weakness and fatigue;
• Náuseas;
• Vómitos;
• Issues with sleeping;
• Constipation.

Long-Range Or Ongoing Complications

• Swallowing problems;
• Persistent GERD (chronic acid reflux);
• Obstructions (food can become lodged in the passageway between the two halves of the stomach and create a blockage that may require surgery to fix);
• Issues with dilation of the esophagus or stomach pouch (these areas widen, which allows more food to pass through and at a faster pace, promoting weight gain).
• Band issues
  • Slippage: The lap band can slip or migrate to a different place on the stomach, which can cause problems such as weight gain, reflux, or necrosis requiring emergency surgery;
  • Erosion: The band can rub against the tissue of the stomach and irritate the location enough to cause an infection or create a hole in the stomach;
  • Intolerance: Sometimes the individual's body has an adverse reaction and rejects the band, causing chronic nausea or the build-up of scar tissue.
• Issues with the port
  • The implanted port can become loose from its location or flip over, making it impossible to access;
  • If a large amount of weight is lost rapidly, the port may protrude out of the skin;
  • The port tubing can leak;
  • Surgery or antibiotics may be required.

Is Lap Band Surgery Covered By Insurance?

Yes, most major insurance carriers that offer coverage for bariatric surgery include lap band surgery coverage in their policies. Each company will use the same laparoscopic gastric banding CPT codes (current procedural terminology) to differentiate between the different lap band procedures.

Several CPT codes help describe a particular segment of lap band surgery. The following CPT codes are used for laparoscopic gastric banding:

• 43771 The lap band alone is adjusted;
• 43772 The lap band alone is removed;
• 43773 The lap band alone is removed and replaced with a new band;
• 43774 The lap band and port are removed.

How Popular Is Lap Band Surgery?

There is currently only one type of gastric lap band that is FDA-approved in the United States, and this procedure is rarely done today because of its high rate of failure and numerous complications. More than 50% of all patients experience some complications, and the weight loss results are substandard. In 2021, only a little over 1,000 lap band procedures were performed, compared to the 153,000 gastric sleeve surgeries that were done that year.

What Is A Better Way To Lose Weight Than Gastric Lap Band Surgery?

Frankly, pretty much any other bariatric surgery would be more effective than the lap band. Some may argue that this surgery is less invasive than the other types of bariatric surgery and may be a good option for those who are not able to withstand another type of surgery; however, we recommend a better alternative.

At Batash Endoscopic Weight Loss Center, we offer Suture Sculpt endoscopic sleeve gastroplasty (ESG), which is a non-surgical weight loss procedure that offers amazing weight loss results with no incisions. Patients can go home the same day as their procedure and be back to their normal activities in a day or two. The procedure itself takes about an hour to perform and is done endoscopically, which means the doctor does it from the inside without using any cuts at all. The stomach is accessed via the patient's esophagus and is reshaped into a small tube-like pouch using a special suturing tool. The risk profile is less than 2% and there are no activity restrictions.

Check out some of our Suture Sculpt ESG patient victories to see the weight loss potential for yourself, and then set up an appointment to come learn more. Start your journey to better health today and shed those excess pounds without surgery.

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