Laparoscopic Adjustable Gastric Banding

The Bariatric Surgery Program at UT Southwestern Medical Center has been making pioneering advancements in weight-loss surgery for more than two decades.

We offer laparoscopic adjustable gastric banding as a minimally invasive bariatric option for treating obesity and related health complications.

A Popular Choice for Safe, Effective Weight Loss

Laparoscopic adjustable gastric banding involves placing an inflatable balloon-type device around the upper portion of the stomach. This device is connected to a port placed underneath the skin that allows inflation or deflation of the band. One of the most commonly used gastric bands is the LAP-BAND®.

A bariatric specialist adjusts the gastric band by adding water to the port once every eight weeks in the first post-operative year until steady weight loss is established.

Laparoscopic adjustable gastric banding is the safest bariatric procedure – and it can be reversed – but it’s also the weight-loss operation that requires the most patient compliance. It’s crucial to have expert supervision and care in managing gastric band adjustments – both to lose weight properly and to avoid band-related complications.

What to Expect with Laparoscopic Adjustable Gastric Banding

People considering laparoscopic adjustable gastric banding are encouraged to speak with others who have undergone the same procedure to better understand the benefits and long-term lifestyle changes that must be made. Patients are also encouraged to attend a monthly support group before and after surgery.

Preparing for the surgery

Prior to the procedure, patients will:

• Meet with our bariatric specialists to discuss pre- and post-operative details
• Meet with a psychologist for an evaluation and testing to prepare for the diet and exercise requirements that are essential to successful weight-loss management
• Be required for two weeks before surgery to drink only high-protein shakes and eat one sensible meal daily
• Be on a liquid diet the day before surgery, drinking only high-protein shakes and zero-calorie beverages
• Be encouraged to exercise in the weeks leading up to the procedure

It’s essential to carefully follow diet and exercise guidelines before surgery and to prepare for a regimented diet after surgery. Our registered dietitians work with patients to develop individual meal plans and fitness goals before and after surgery.

About the surgery

A bariatric surgeon performs laparoscopic adjustable gastric banding by making five or six small abdominal incisions and inserting a tiny camera and long instruments through the incisions.

The surgeon places a band around the upper part of the stomach, separating it from the lower part. This creates a small pouch with a narrow opening that goes into the larger, bottom portion of the stomach.

The surgery does not require any cutting or stapling inside the abdomen. Many gastric-banding surgeries take less than an hour.

Recovery
Patients who undergo laparoscopic adjustable gastric banding usually spend one night in the hospital after the band is placed. Depending on their condition and medical history, most people can return to work within one to two weeks.

Life After Surgery

Post-operative diet
As with all types of bariatric surgery, patients must immediately follow a special diet for the rest of their lives after undergoing laparoscopic adjustable gastric banding.

After the surgery, patients must eat smaller portions and chew each bite more than 20 times before swallowing. Patients with a LAP-BAND who eat too much or too fast will vomit, which can damage the stomach and esophagus.

It generally takes six weeks after the procedure to “retrain” the stomach to eat. The first two weeks consist of consuming only liquids. During a six-week transition period, foods are gradually reintroduced to the altered “new” stomach and remaining gastrointestinal system. Our bariatric surgery team supervises this process.

Post-operative exercise
As soon as the bariatric surgeon says it’s time, patients can begin a rigorous exercise program to help them lose weight and avoid regaining it. Data shows that exercise helps patients lose more weight more quickly while increasing their aerobic fitness.

We recommend 150 minutes of moderate physical activity (such as brisk walking) or 75 minutes of vigorous physical activity (such as jogging or swimming laps) per week.

Post-operative care
All bariatric surgery patients are required to have regular follow-up appointments. These visits ensure that weight loss occurs in a healthy, consistent manner and help prevent minor complications from turning into major ones. The bariatric surgery team will also regularly monitor patients’ vitamin and mineral levels.

Most patients who have had laparoscopic adjustable gastric banding have their bands adjusted every eight weeks during the first post-surgical year, then twice yearly during the second year, then annually.

At follow-up appointments, patients also may meet with a registered dietitian, a bariatric advanced practice provider, or a bariatric surgeon.

It can take two to five years for patients to reach their desired weight after a LAP-BAND placement.