Gastric banding (LAGB) comprises 10-20 percent of bariatric operations performed in the US. Gastric banding was introduced in the US in 2001, but has been performed in Europe and Australia for at least 5 years before 2001. We therefore have more than 15 years of follow-up data in patients who have undergone gastric banding.
A primary advantage of gastric banding is its lower risk of complications in comparison to sleeve gastrectomy or gastric bypass. Disadvantages of gastric banding include a failure rate that may lead to band removal in 10-20 percent of patients over many years. Despite these issues, gastric banding remains a good choice of operation for the right patient. Your surgeon will help you decide if this is the right operation for you.
How does it work?
LAGB involves placement of a silicone band around the upper stomach, which effectively creates a small gastric pouch much like a gastric bypass, but without the need to cut across the stomach or rearrange intestinal anatomy. LAGB thus restricts the amount of food a person can eat and provides a feeling of fullness. The band is attached via a long stretch of tubing to an access port; the access port is in turn implanted under the skin of the abdominal wall. This allows your surgeon to inflate the band to an appropriate tightness by simply numbing the skin over the port in clinic with numbing medicine (similar to that used at the dentist), accessing the port with a needle, and injecting sterile saline (salt water). The band is removable, if necessary and studies so far indicate that the intestinal tract returns to normal after removal.
What are the risks?
Gastric banding is a simpler operation than gastric bypass, and as a result, avoids some of the rare complications associated with gastric bypass. No stomach or intestines are cut, removed, or bypassed. Because of this, no vitamin or mineral deficiencies are expected after LAGB. Rare complications include bleeding, infection, and slippage of the band.
What are the benefits?
Weight loss after gastric banding ranges from 40-60 percent of excess weight in most patients. More than 80 percent of patients will experience marked improvement in related diseases such as diabetes, sleep apnea, high blood pressure, fatty liver disease and osteoarthritis .