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Laparoscopic adjustable gastric banding is
surgery to make the stomach smaller. It is done to help people lose weight. The
surgery limits the amount of food the stomach can hold. This helps you eat less
and feel full more quickly.
Adjustable gastric banding is done through
several small cuts, called incisions, in the belly. The doctor will place small
surgical tools and a camera through the incisions. The doctor will then wrap a
device around the upper part of your stomach to form a ring. Attached to the
ring is a thin tube leading to an access port that is left under the skin. The
access port is the place where the doctor puts in a needle to add or take away
saline. Adding saline tightens the band and makes the stomach smaller. The
doctor can take away saline if the ring is too tight.
During surgery, the band is not inflated. You will need to recover from surgery before the band is adjusted for weight loss. This is usually 4 to 6 weeks after surgery.
Another name for this surgery is gastric banding. Sometimes people refer to it by brand names, for example the Lap-Band System or the Realize Band.
After surgery, you may need pain medicine to help with discomfort and soreness. You'll be encouraged to start moving around to help your body heal. You may have an X-ray the day after surgery to see that everything is working correctly.
Your doctor will
give you specific instructions about what to eat after the surgery. For the
first 2 weeks, your stomach can only handle small amounts of liquids while you are healing. Some people feel full after just a few sips of water or other liquid. Other people won't notice much difference. It is important to
try to sip water throughout the day to avoid becoming dehydrated. You may
notice that your bowel movements are not regular right after your surgery. This
is common. Try to avoid constipation and straining with bowel movements.
Bit by bit, you will be able to add solid foods back into your diet. You
must be careful to chew food well and to stop eating when you feel full. This
can take some getting used to, because you will feel full after eating much
less food than you are used to eating. If you do not chew your food well or do
not stop eating soon enough, you may feel discomfort or nausea and may
Your doctor may recommend that you work with a
dietitian to plan healthy meals that give you enough protein, vitamins, and
minerals while you are losing weight. Even with a healthy diet, you probably
will need to take vitamin and mineral supplements for the rest of your life.
After you can eat solid food again, your doctor will adjust the band around your stomach by inserting saline into your port, which will inflate the band and cause it to tighten. You will probably have many adjustments to the band in the first year to find the right size that helps you lose weight, feel full at the right time, and not vomit. You'll need to visit doctor each time you need the band adjusted.
After this surgery,
weight loss is usually gradual but steady. You will have regular visits with
your doctor to check how you are doing. The doctor can adjust the band if you
are not losing weight as expected or if you have problems with the band. Some
people continue to lose weight for up to 3 years after surgery.
It is common to have many
emotions after this surgery. You may feel happy or excited as you
begin to lose weight. But you may also feel overwhelmed or frustrated by the
changes that you have to make in your diet, activity, and lifestyle. Talk with
your doctor if you have concerns or questions.
Weight-loss surgery is suitable for people who are severely
overweight and who have not been able to lose weight with diet, exercise, or
Surgery is typically considered when your
body mass index (BMI) is 40 or higher. Surgery may
also be an option when your BMI is 35 or higher and you have a life-threatening
or disabling problem that is related to your weight.
It is important to think of this surgery as a tool to
help you lose weight. It is not an instant fix. You will still need to eat a
healthy diet and get regular exercise. This will help you reach your weight
goal and avoid regaining the weight you lose.
Weight loss is usually slower and less with adjustable gastric banding than with gastric bypass.
Risks common to all surgeries for weight loss
include an infection in the incision, bleeding, and a blood clot in the legs (deep vein thrombosis, or DVT) or lung (pulmonary embolism). Some people develop
gallstones or a nutritional deficiency condition such
Although adjustable gastric banding is considered the least
invasive of the weight-loss surgeries, problems can occur. They include:
Weight-loss surgery does not remove fatty tissue. It is not cosmetic surgery.
Some studies show that people who have
weight-loss surgery are less likely to die from heart problems, diabetes,
or cancer compared to obese people who did not have the surgery.footnote 1
Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.
Adams TD, et al. (2007). Long-term mortality after gastric bypass surgery. New England Journal of Medicine, 357(8): 753–761.
Other Works Consulted
Arterburn D, et al. (2014). Comparative effectiveness of laparoscopic adjustable gastric banding vs laparoscopic gastric bypass. JAMA Surgery, 149(12): 1279–1287. DOI:10/1001/jamasurge2014.1674. Accessed November 11, 2014.
Colquitt JL, et al. (2009) Surgery for Obesity. Cochrane Database of Systematic Reviews (2).
Heber D, et al. (2010). Endocrine and nutritional management of the post-bariatric surgery patient: An Endocrine Society clinical practice guideline. Journal of Clinical Endocrinology and Metabolism, 95(11): 4823–4843. Available online: http://www.endo-society.org/guidelines/final/upload/FINAL-Standalone-Post-Bariatric-Surgery-Guideline-Color.pdf.
Pories WJ (2008). Bariatric surgery: Risks and rewards. Journal of Clinical Endocrinology and Metabolism, 93(11, Suppl 1): S89–S96. Available online: http://jcem.endojournals.org/cgi/reprint/93/11_Supplement_1/s89.pdf.
ByHealthwise StaffPrimary Medical ReviewerE. Gregory Thompson, MD - Internal MedicineKathleen Romito, MD - Family MedicineSpecialist Medical ReviewerAli Tavakkoli, FACS, FRCS, MD - General Surgery, Bariatric Surgery
Current as ofFebruary 20, 2015
Current as of:
February 20, 2015
E. Gregory Thompson, MD - Internal Medicine & Kathleen Romito, MD - Family Medicine & Ali Tavakkoli, FACS, FRCS, MD - General Surgery, Bariatric Surgery
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