What’s an Adjustable Gastric Band?
An adjustable gastric band, also known as a lap band, is a flexible inflatable tube that’s placed around the upper portion of the stomach to create a small pouch. When the tube is inflated with sterile saline, the volume of the pouch becomes smaller. This reduces the amount of food the patient can consume, leading to weight loss. Because the band can be removed at any time, the procedure is reversible. Because the small intestine is not bypassed, there is no risk of malabsorption of nutrients with this procedure.
If you’re considering bariatric surgery, make sure you’re choosing it because you really want it, not to please someone else or to fit an imagined ideal. No one else can make the choice for you; it’s your body, and you’re in charge of it. After you do your research and understand the procedure, if you believe that an adjustable gastric band is right for you, then proceed. To help you in your decision-making process, we have some information about the risks and benefits of getting an adjustable gastric band at Adjustable Gastric Band: Risks and Benefits. For more about the many resources Doctor Review has to offer, you can check out our Bariatric Surgery Overview page.
Please note that this page is for informational purposes only, and is not a substitute for qualified, individualized medical advice. You should discuss your potential elective surgery with your own doctor(s), including your primary care physician and the surgeon who will perform your surgery if you decide to proceed.
How it’s done
This procedure is typically done laparoscopically. That means that there are only a few very small incisions in your abdomen; during surgery, the abdomen is inflated with air, and cameras and instruments are passed through the small openings to perform the surgery. You will not have any large scars from the surgery.
You’ll be under general anesthesia for this surgery. After the anesthetic takes effect, the area is cleaned with liquid (sometimes the liquid used will temporarily stain the skin yellow). The small incisions are made and the abdomen is inflated. The band is then placed around the upper part of the stomach and secured. An opening in the abdominal skin is created, and the end of the band is passed through this opening and secured. The instruments are removed, the abdomen is deflated, and the openings in the skin are closed with fine suture, medical tape, or skin adhesive.
Preparing for the procedure
Choosing your surgeon
When choosing a surgeon, you want a highly-trained professional with experience in this type of surgery. A surgeon who’s a member of the American Society of Metabolic and Bariatric Surgeons (ASMBS) is a well-trained surgeon who regularly performs bariatric surgical procedures; these surgeons are also certified by the American Board of Surgery. Also, choose a surgeon with whom you feel comfortable and safe, and who listens to you and tries to understand your goals. If you have friends who’ve had bariatric surgery, and you like their results, ask for a referral. While cost may be a consideration, don’t allow this to override more important factors in your decision. Your safety and the quality of your results are worth a little extra spending.
For more help in your search for a plastic surgeon, visit our How to Find the Best Bariatric Surgeon page. At Doctor Review, you can also search providers for patient reviews to help you find the very best.
Getting ready for surgery
You will have at least one appointment with your surgeon before your surgery, during which you’ll discuss your options, ask any questions you have, and make the decision about proceeding with the surgery.
The day before your surgery, you should eat and drink enough healthy food and water, and get enough sleep the night before. You will need to stop eating 8 to 12 hours before your surgery. If you smoke, you should stop for at least 24 hours before the surgery. If you take daily medications to prevent blood clots, such as aspirin, you will likely be asked to stop those for 24 to 48 hours before the surgery (proceed as directed by your doctor, and don’t stop any medication without talking to your doctor first).
You will stay at the surgical center in the recovery room for several hours following surgery, for the anesthesia to wear off. Usually, you’ll then spend about a day in the hospital, where you’ll be monitored to ensure your recovery from the surgery, although some surgeons will discharge you directly home from the recovery room. You’ll slowly be able to resume eating and drinking. Your surgeon will discharge you to your home when you are able to eat and drink and when he or she determines that you’re stable enough to go home safely.
You can resume your normal activity at the direction of your surgeon, who will see you for at least one postoperative visit several days after surgery. If you have sutures that weren’t removed before leaving the hospital, they’ll likely be removed at this appointment.
Even after you’re cleared to resume normal activity, you should expect to have some soreness and swelling for around 4-6 weeks after surgery. It may take a year or even longer for the tiny incision marks to fully fade, though they will eventually become nearly invisible in most people.
Your adjustable gastric band will be inflated in small increments in the weeks following the procedure. The first “fill” will not take place until 4 to 6 weeks after surgery. This is because the stomach may swell after surgery, and filling the band could cause it to become too tight. After 4 to 6 weeks, you’ll go in for an evaluation. Your doctor may decide to do a procedure called fluoroscopy, in which you drink a liquid with barium in it, and an X-ray video is taken to show the size and shape of the esophagus and stomach as the liquid flows through. This allows your doctor to determine whether filling the band would be desirable, and by how much. Further fills, or removal of saline from the band if there is too much, will be done as needed, based on how much weight you’re losing and whether you’re having any symptoms, such as acid reflux.