Lapband

This is the simplest and safest of the three surgical procedures and therefore would normally be the first for you to consider.

01
The figure shows a picture of the Lap-Band which consists of a silicone band with an inner balloon. The balloon is connected to an access port.

The band is placed at the very top of the stomach as shown below in figure 2. The port lies about 2 cm under the skin near the navel. By injecting saline into the access port the balloon of the band gently and steadily squeezes the top of the stomach.

02
The Lap-Band is placed around the very top of the stomach as shown.

We add fluid until we are in the Green Zone where there is minimal hunger, good weight loss and no unpleasant symptoms.  If we leave the band too loose, we are in the Yellow Zone where you are hungry and tend to eat too much and you are not losing enough weight.  If we make the band too tight, we are in the Red Zone where you are getting symptoms such as heartburn, reflux and vomiting after eating and you may be putting on weight as you tend to eat the wrong foods.

Placing the band is just the first step in a continuous follow up process. With the band in place we are able to control your appetite, take away the hunger and enable you to eat small amounts of food and be happy.  The adjustments and advice during the follow up process are very important in achieving a good result.

A few worry beforehand about having an adjustment, but it is so minor a procedure and so powerful an effect that this should not be.  Just a quick, almost pain-free injection and the appetite is turned off. With more squeezing by the band of the top of the stomach, nerves in the stomach wall send signals to the appetite centre in the brain and take away the hunger sensations. It is a wonderful exhibition of how our nervous system works.  No one worries about the adjustment after having it done. It is so simple and yet gives such a powerful effect, they look forward to it.

Strengths:

The Lap-Band has a number of important strengths. 

  • Safe

    First, it is safe, very safe, much safer than the stapling procedures. In our clinic at CBS we have treated over 10,000 people with the Lap-Band and never had a death associated with any surgery.

    Second, it is effective. It achieves substantial, long-term weight loss. In addition, it improves health by resolving or improving many of the diseases associated with obesity, including diabetes and other metabolic diseases, hypertension, heartburn, pain in the back, hips and knees and depression. It improves quality of life. We have even demonstrated it improves length of life.

  • Gentle weight loss

    Thirdly, The Lap-Band achieves this in a gentle way. It is usually a day procedure with a two to three hour length of stay. It is adjustable so that we have the option of resetting the “tightness” to achieve optimal control of appetite. It is easily reversible so that you are not stuck with something that you cannot change if something better comes along in the future. But if all is going well it just stays there permanently.

Weaknesses:

The Lap-Band has three features which can be regarded as weaknesses.

 

 

  • Good follow up

    The Lap-Band has three features which can be regarded as weaknesses.
    First, it requires good follow-up. Placing the band just sets the scene. The Aftercare program does the real work. And so if you live somewhere remote and cannot get to one of our aftercare centres, this is not for you. If your life is so busy that you cannot get to 6 to 8 visits in the first year and maybe one to three visits per year after that, this is not for you and you might be better to consider a sleeve.

  • Partnership

    Second, it is a partnership. We must do the right thing and you also must do the right thing. It is not just me placing the band and you lose weight. It just doesn’t work that way. We make sure you know what you are meant to do. The Lap-Band can get bad press at times, particularly in the social media, from people have not achieved the weight loss they expected or are suffering from side effects such as heartburn or reflux or food intolerance . Mostly we can track these problems to the lack of good aftercare, either poor attendance by the person or poor instructions, advice and adjustments by the surgeon. The Lap-Band procedure is very much a partnership, requiring correct actions by both the patient and the surgeon. At CBS we make sure we do our part properly. if you cannot pledge yourself to that partnership, it may be better to consider a sleeve.

  • Revisional Surgery

    Finally, there may be the need for some revisional surgery to correct something that has moved or changed or broken. This is so for all bariatric procedures. We cannot expect to take a chronic disease such as obesity, do something today and never have to fix anything for anybody for the rest of time. It just is not possible. However, the chances of needing revision are now quite low and are linked to how carefully you carry out your part of the partnership. Essentially all problems can be fixed.