Laparoscopic adjustable gastric band (LAGB)
The band is placed at the upper part of the stomach . I t allows people to feel satisfied after eating only a small amount of food. As the size of the inlet to the stomach can be adjusted, food is slowed down on its journey, allowing you to eat small quantities of food over the same time that others will eat a large meal. Vomiting and heartburn can be minimised if this device is used correctly and the patient is correctly instructed and able to adhere to lifestyle changes. The easy adjustability of the band is the key to allowing weight loss without affecting the enjoyment of a reasonable range of foods. Worldwide, the band is used in at least 25 per cent of obesity surgery. If done correctly, it gives weight loss similar to the larger operations , but with reduced risks.
Advantages : Minimal vitamin deficiencies, because no part of the bowel is bypassed. Lap banding is probably no more risky than elective gall bladder surgery (risk to life between 1 in 1000 and 1 in 3000), and is a very good operation for women of childbearing age.
Disadvantages : Some people cannot tolerate the restricted diet and the requirement to eat slowly and plan meals. T he majority can not eat white bread and chicken and sometimes the restriction interferes with the ability to eat other foods that are components of a normal diet (some fruits, vegetables and salads ). It is possible to ‘beat’ the operation by eating sweets, chocolate or ice cream, and some people develop a preference for these foods, leading to failure. These operation s do not work so well for older, larger patients who have diabetes. Because banding seems easy to perform there has been a tendency for people to over – simplify the operation and after – care, and this can lead to bad results. As bad outcomes can generally be avoided, the operation remains a valid option for most patients. Yearly risk of re – operation is 1 – 4 per cent. Patients who use the band to become bulimic will generally run into trouble 3 – 4 years after surger