What is lap band surgery?

Lap band surgery, also known as gastric banding, is used to aid weight loss in obese patients who have failed to lose weight by conventional means.

During lap band surgery, a physical barrier is put in place around your stomach, three-quarters of the way up, to create a small pouch. The food you eat fills this pouch much quicker than it would fill your whole stomach so you feel fuller sooner and eat less. The food then passes through the small opening left by the gastric band and continues along the normal digestive process.

Risks of the operation

As with all operations that involve having a general anaesthetic, lap band surgery carries a small but significant risk, and can be fatal. Although this is extremely rare and occurs in less than 1% of cases, the fact that patients undergoing this procedure are normally significantly overweight increases this risk. If your weight problems have also lead to diabetes, breathing or heart problems, or other associated conditions these will increase the risk further.

This article on lap band surgery is written by Jackie Griffiths, a freelance journalist who writes health, medical, biological, and pharmaceutical articles for national and international journals, newsletters and web sites.

Although lap band surgery is done laparoscopically (keyhole surgery), through a small incision in the abdomen, there are still a range of complications which can occur during the surgery itself, including:

  • Perforation of the stomach or oesophagus
  • Damage to major blood vessels
  • Spleen or liver damage
  • Blood clots

In around one in twenty cases, the laparoscopic procedure will need to advance to a full ‘open’ surgery as a result of complications. In around 10% of procedures, a second operation is needed to fix a problem and this should be considered when making your decision. However, the more experienced your surgeon the lower the risks have been shown to be.

Common complications

There are a range of post-operative problems reported with gastric bands, and over 80% of patients will experience one or more of the following symptoms:

  • Nausea and vomiting (50%)
  • Reflux or regurgitation of food (35%)
  • Slipped band (25%)
  • Obstruction or blockage (15%)
  • Constipation
  • Diarrhoea
  • Difficulty swallowing

If these complications cause you serious discomfort your band may need to be adjusted or removed. This involves further surgery, exposing you to all the associated risks once again.

Problems with the band

As well as the medical complications described above, there can also be physical problems with the band itself. In rare cases, the band can erode into the stomach wall and migrate inside the stomach.

Alternatively, the band can slip, causing the lower part of the stomach to swell over the band and become an obstruction. There can also be mechanical problems, such as leakage of the saline that fills the band, or cracking of the tube between the band and the reservoir. Once again, in these cases the band will need to be removed and replaced, involving further surgery.

Management problems

Your surgeon or consultant will instruct you on how to manage your gastric band. If it becomes over or under inflated, this can cause problems and will lead to the band not serving its proper function as part of your weight loss regime.

Generally, the gastric band is highly effective as a way of losing weight, but it is a “slow but sure” method compared to other weight loss surgery. Some patients are tempted to tighten the band too much to try and speed up weight loss, but this should be strictly avoided as it can lead to problems with the oesophagus. What’s more, losing weight too rapidly can lead to complications such as malnutrition, vitamin deficiency, and anaemia.

So, is it safe?

Despite all the potential complications discussed above, lap band surgery remains one of the safest weight loss procedures available, particularly when undertaken by an experienced surgeon.

Compared to the health risks of remaining seriously overweight, the risks of lap band surgery may be considered worth taking. However, as with any surgery, you should discuss your treatment in depth, and weigh up the risks and rewards carefully with your consultant before you go ahead.

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