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Gastric Banding – A Note From Dr. Jacobs

I was part of the FDA studies for both gastric band systems approved in this country – the LAP-BAND® and the Realize® band – and performed a large number of cases between 1999 and 2004. In our series, the average weight loss for the adjustable gastric banding system was approximately 40 pounds and a significant portion of the weight loss that was achieved was due to vomiting. In my experience, approximately at 3 years after the Adjustable Gastric Band has been placed, the complication rate ranges between 25-30%. Ultimately various studies have shown a large proportion of the adjustable gastric bands have to be removed. In fact, one recent study showed that 80% of the adjustable gastric banding systems are removed due to many complications.The complications I have seen include a tremendous amount of reflux, esophageal dilatation, band slippage, creation of hiatal hernias, esophageal dysmotility, and band erosions.

Removal of the adjustable gastric band and conversion to gastric sleeve is the most common revisional bariatric procedure I perform today. Because of the scar tissue and inflammation created by the band, repair of a hiatal hernia with conversion to a gastric sleeve or conversion to a fundoplication and a greater curvature plication is a technically demanding operation that should be performed by experienced surgeons.

I believe the adjustable gastric band causes these problems because it is placed horizontally, not vertically (see our logo-vertical weight loss solutions), and doesn’t restrict, but obstructs (chokes) the stomach. It is for these reasons that I haven’t placed an adjustable gastric band in over 8 years, and can’t recommend it as a bariatric procedure.

Only for educational purposes, do I still keep this category in our website.

Gastric Banding

Gastric BandingThere are two providers of gastric bands, the Realize Band® and the Lap-band®. During the gastric banding procedure a silicone band and an injection port are placed in the patient’s abdomen. The silicone band fits around the upper stomach and creates two connected chambers. The injection port is then attached to the abdominal wall, underneath the skin and serves to adjust the band in the future.

The band is adjustable and removable. Adjustments are made periodically using a needle to inject saline solution into the band through the injection port. Adding the saline solution increases the amount of restriction and thus giving the patient a full feeling sooner.

Expected Health Benefits

Conditions associated with morbid obesity (often referred to as co morbidities) include:

  • High Blood Pressure
  • Type II Diabetes Mellitus
  • High Cholesterol or Triglycerides
  • Obstructive Sleep Apnea
  • Gastric Reflux
  • Obesity Hypoventillation Syndrome
  • Fatty Liver Disease
  • Heart Disease
  • Congestive Heart Failure
  • Urinary Stress Incontinence
  • Metabolic Syndrome
  • Most patients will experience full remission or significant improvement in their obesity-related medical problems.

Recovery

Recovery times vary, but many patients can be back to light work in as little as a week.

Potential Concerns of Gastric Banding

  • Gastric banding will not eliminate the desire to eat. You will have specific dietary and exercise guidelines.
  • Gastric banding requires intensive follow-up care – more than most other bariatric surgeries. Even after reaching a desired weight, adjustments will still be made periodically.
  • Although rare, complications may require additional surgical procedure or removal of the gastric band.


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