Weight Loss Surgery – Understanding the Minimally Invasive Laparoscopic Adjustable Band

Since FDA approval in 2001 the Laparoscopic Adjustable Band for weight loss surgery has become the second leading surgical treatment for morbid obesity in the United States. Commonly called “lap-band surgery” this bariatric procedure is less invasive than the more commonly performed gastric bypass, is customized to the patient, offers low risk of malnutrition, requires short hospital stay and is less costly and produces fewer side effects than other gastric weight loss surgeries.

The Lap Band is a hollow silicone tube that is wrapped around the upper portion of the stomach and then attached to a small port buried beneath the skin and adipose tissue on the abdominal wall. Once the Band is secured in the correct position, food intake is restricted. The band is adjusted with fills to increase or decrease the amount of restriction a patient feels when eating. A well adjusted band will provide a sense of satiety (satisfaction) with small portions and facilitates a weight loss of 2 pounds per week with diet and exercise.

Lap-Band Vocabulary:

Patients of lap-band surgery benefit from learning the language spoken by medical providers and fellow patients as they share their experience in the weight loss journey. The following are commonly used terms unique to the lap-band patient:

Adjustable Gastric Banding (AGB) – This is the generic term for the banding process.

Band – The generic term for the actual band used in the AGB process.

Bandster or Bandit – A person who has undergone minimally invasive laparoscopic adjustable band surgery for the purpose of weight loss and weight management.

Fill – A syringe injection of saline into the sub-muscular port in order to increase the pressure of the band around the stomach. This process adjusts the pressure of the band, thus affecting the amount of food patients are able to eat and how quickly their food drops into the lower stoma. Fills are usually first given 6-8 weeks post-op. Most patients find that they need several fills before feeling a significant level of restriction.

Leak – A leak in the band can either be small or dramatic and treatments can range from more frequent fills to removal and replacement of the band. A leak is rarely dangerous, but it can decrease the efficacy of the band.

Migration – A more serious, but rare, complication where the band cuts into the wall of the stomach. Often this can be attributed to the band placing too much pressure on the stomach and cutting off circulation in the affected areas. The usual remedy is releasing all pressure on the band to allow the stomach to heal. Removal of the band may also be necessary.

Productive Burping (PBs) – This is a ‘bandster’ term that refers to the regurgitation that most bandsters will experience at least once after eating food or larger pieces of food than than can be passed through the stoma. Since the food has not been digested, there is no odor, stomach acid, or retching involved but there may be a varying degree of phlegm that accompanies it. PB episodes may last anywhere from 1 minute to two hours, depending on the individual and circumstances. After a PB episode, under most circumstances, it’s best to refrain from eating at that meal and let the stoma rest.

Plateau – A period of time, at least 2 to 4 weeks, whereby a patient maintains (instead of losing) weight. It is common for post-op patients who are 4-10 weeks out to experience a plateau before getting their first fill.

Port – The subtanceous dongle at the end of the tube connected to the band. This is where the surgeon will inject fluid in order to increase pressure on the band. Many people can feel their ports under the skin, more so as they lose weight. The area around the port is often tender for several weeks post-op and can become sore if the surrounding muscle is stretched or worked too vigorously.

Posterior stitch – The surgeon stitches the band around the back of the stomach. This technique reduces slippage rates and is the standard operating procedure for Lap-Band insertions.

Pouch – This is the “upper stomach” that is created when the band draws the entire stomach into an hourglass shape. Food is held here before passing slowly through the stoma into the lower stomach and through the digestive tract.

Restriction – This is the feeling of being able to eat only small amounts of food. As the band is filled, the tighter the restriction should feel. Many patients report that it takes 2-4 fills before feeling restricted enough to lose weight at an appropriate rate.

Slippage – This is where the band moves down the stomach, often causing significant pain to the patient. Slippage usually occurs if the band is too tight or if the patient frequently challenges the band with excessive vomiting.

Stoma – Artificial openings between two cavities or canals. In this case, it is the passage from the upper pouch and the rest of the stomach.



Source by Kaye Bailey



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