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Laparoscopic Adjustable Gastric Banding (LAP-BAND)
The LAP-BAND® is a device that is surgically applied to the upper part of the stomach in order to restrict the amount of food entering the stomach. Using a minimally invasive approach, five (5) small incisions are made to allow for surgical instruments to be introduced into the abdominal cavity.
The goal is to allow individuals to feel fuller faster in order to lose weight and to reduce or resolve the health conditions associated with being overweight or obese, otherwise known as co-morbidities, that negatively impact your quality of life. On average, patients lose 1-2 pounds per week over a 2-3 year period (or approximately 30-40% of excess body weight). Patients are advised to follow a healthy diet and to lead an active lifestyle.
LAP-BAND® Surgery Process:
Patients are admitted the same day of surgery and usually discharged the following day. The Lap-Band® is placed around the upper part of the stomach under general anesthesia. Five (5) small incisions are made for the laparoscopic equipment. A laparoscope is introduced into the abdomen in order for the stomach, and other organs in the abdominal cavity can be seen. Once the Band is placed and the port is placed for access after surgery, the incisions are closed and the patient goes to recovery. If the patient is being treated for sleep apnea, it is important that the patient bring the equipment (i.e. CPAP machine) to the hospital on the day of surgery so that it can be used while in the hospital.
Diet/Nutrition Guidelines:
After LAP-BAND placement, patients can no longer eat or drink foods containing sugar. Patients who drink any liquids containing sugar (e.g. milk shakes, ice cream, etc.) will have difficulty losing the weight to resolve their associated health conditions. As a result, wellness will not be achieved and weight gain may occur.
Patients will have a stomach pouch holding approximately (1) one ounce of food. With a stomach pouch this size, patients are expected to eat 2-3 tablespoons of food at each meal. People eat three meals a day.
See Post-Op diet for diet after LAP BAND® surgery.
After LAP-BAND® surgery:
Refer to LAP-BAND® Discharge brochure (PDF)
Patients will be seen frequently in the first year of surgery and then routinely for life.
Patients will have office visits with Dr. Tishler 2 weeks after surgery to check wounds and overall assessment and then at:
6 weeks, 10 weeks, and then monthly for one year. After the first year, patients are advised to return to the office for yearly visits.
Patients are assessed to determine whether the adjustment of their Band is needed at their 6-week visit.
Goals include:
Average 1-2lbs weight loss/per week for the first year after surgery
Decreased appetite
Increased activity
Monthly support group attendance
Decrease/loss of comorbidities
Risks and/or possible complications include:
Band Erosion: is rare, but can occur if the material the band is made from starts to break down or erode
Band Leak: can occur if there is an opening in the band or port connection causing the saline to leak into the abdominal cavity. This is not life threatening, but the band or port would need to be replaced.
Band "Slippage"/Prolapse of the Pouch: can occur if the stomach pouch comes up through the band
Death: the mortality rate for the Lap-Band is currently one out of 2000 cases.
Flipping of Port: can occur if one of the sutures holding the port in place comes undone or breaks loose; this would require a same day procedure to re-stitch the port back into place.
Infection: as with any operation, an over abundance of bacteria on the skin or internally can create an infection. Because the Lap-Band is introduced as a foreign object to the body, the body can...
Resources:
www.lapband.com
www.orlive.com: Watch Dr. Tishler perform the Lap-Band® procedure LIVE (occurred May 10, 2005) at Hartford Hospital.
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