The Advantages

Advantages of the Lap-Band

1.

The Lap-Band is adjustable.

The Lap-Band’s ability to be adjusted is critical to the success of the procedure. We can tighten (fill), or loosen (de-fill) the Lap-Band during a simple office visit. This allows us to control the rate at which food goes across the band. This adjusts how soon and how long you have a sense of fullness after a meal. Adjusting the amount of fluid in the band is a regular part of follow-up care. The amount of food that can be eaten before feeling satiated or full at each meal can be changed with simple inflation or deflation of the Lap-Band via the access port.

2.

The Lap-Band is reversible. However, the Lap-Band should be considered a permanent implant.

Only in the rare instance where there is a problem with the band would removal be necessary. Removing the Lap-Band will restore the stomach to its original form and function and the patient would be at risk of regaining the weight that had been lost.

3.

Weight loss is gradual, maintaining muscle mass and skin elasticity.

Weight loss is more rapid with gastric bypass, but studies have shown that bypass patients may lose muscle mass in addition to losing fat. Loss of muscle mass is not a desired result. The ideal weight loss with Lap-Band surgery is one to two pounds per week with a goal of sustained loss of 60% to 80% of excess body weight. Studies have shown (J Gastro Surg, 2005) that the weight loss achieved with Lap-Band surgery is equivalent to gastric bypass at two to three years. However, gastric bypass patients have a tendency to begin to regain weight after three years. The weight loss with Lap-Band surgery is much more likely to be sustained.

4.

The procedure is performed with minimally invasive surgical techniques (laparoscopic surgery) avoiding the need for large incisions and can usually be performed on an outpatient basis.

By avoiding large incisions, most patients are able to recover quickly with minimal pain and discomfort. Patients normally leave the clinic or hospital about two hours after their surgery. In the rare case where a large incision is required or if there have been other significant medical problems, admission to a hospital may be required. After the procedure, patients usually get back to their normal activities in about 7 to 10 days.

5.

There is no stapling of the stomach.

The Lap-Band does not involve stapling or diversion of the gastrointestinal tract. There are no permanent changes to the stomach and gastrointestinal tract. Lap-Band surgery is minimally invasive and easy to adjust or reverse. Operations that rely on stapling have a higher rate of complication due to problems with poor healing of the stapled area leading to leakage and serious infection.

6.

No special diets or nutritional supplements are required after surgery.

Lap-Band surgery changes how much you eat, rather than what you eat. It simply reduces portion size and gives you a sense of being full with a much smaller meal. Some foods, such as white bread and pasta can be troublesome if not chewed well enough and many patients will avoid them. Beef and pork must also be well chewed in order to pass across the restriction caused by the band. Generally all other foods can be eaten without difficulty. All food must be chewed well and we encourage patients to eat slowly to avoid feeling uncomfortable. We recommend a daily multi-vitamin with minerals, but no other supplements are necessary.

7.

The Lap-Band does not rely on malabsorption.

Other surgical weight loss procedures (such as gastric bypass) achieve results by relying on malabsorption of ingested nutrients. Long-term follow-up of patients who have had malabsorption procedures show a higher risk of nutritional complications such as liver disease and osteoporosis that may not be reversible. Since there is no malabsorption, the Lap-Band is safe for mothers and their babies.

How much weight can you expect to lose?

At the Surgical Weight Loss Centre, we work closely with you to achieve the best results possible and to meet realistic expectations. We will help you define a goal weight prior to surgery and we will track your progress. We use a comprehensive database to track the details of surgery, weight loss progress and to record the adjustments of the Lap-Band for all of our patients

For most patients the goal is a sustained loss of 60%-80% of excess body weight. For example, an individual whose height is 5 feet, 5 inches, for example, and whose weight is 300 pounds, the calculated BMI would be 50. This individual’s body weight based on a BMI of 25 would be 150 pounds. This means that the excess weight is 150 pounds. Thus the goal would be for a weight loss of 70% of 150 pounds, which equals 112.5 pounds. Therefore the goal weight would be in the range of 185 pounds or less.

The rate of weight loss with Lap-Band surgery is approximately one to two pounds per week or 10 pounds per month. Thus, to lose 100 pounds would normally take at least one year. Studies (Am J Surg, 2005) show that weight loss with Lap-Band surgery is sustainable and rarely will patients regain the weight they have lost.

The pattern of weight loss with Lap-Band surgery is gradual and steady. You may notice that your weight loss will sometimes plateau for a few weeks. This usually corresponds with an increase in hunger and a feeling that you can eat more than you should. These signs indicate that you may benefit from a fill or adjustment of the band. Once the band has been adjusted, you will likely notice that hunger subsides and weight loss resumes.

There are many benefits of sustained weight loss that are not proportional to the amount of weight that is lost. The major goal of Lap-Band surgery is to improve overall physical and emotional health. Our team of professionals will work with you to focus on the non-weight-loss benefits or “Non Scale Victories”, as we have found that these are also an important part of our patient’s success.

How effective is the Lap-Band?

The Lap-Band is a tool designed to achieve weight loss by restricting the amount of food an individual can consume and by inducing a feeling of early satiety, or fullness. Published literature reports sustained weight loss and associated health benefits for more than ten years in Lap-Band patients. To date, there are no publications noting any average weight regain. New studies are published regularly around the world reiterating the safety and effectiveness of a Lap-Band procedure.

Health benefits

Obesity is a chronic disease associated with serious medical problems. Studies indicate that even a mild reduction (10%) in weight produces an improvement in blood sugar control and a reduction in blood pressure and cholesterol levels. Many studies have been published that establish the improvement in co-morbidities associated with weight loss through use of the Lap-Band. A recent study in the Journal of the American Medical Association (JAMA Jan 08) showed that 73% of patients with Type II diabetes will experience remission of their diabetes after Lap-Band surgery.

Ponce, et al, studied 402 patients who were at least one-year post Lap-Band procedure. Resolution of diabetes occurred in 66% at one year and 80% at two-year follow-ups. Hypertension resolved in 60% at one year and 74% at two years after surgery1.

Alvarez-Cordero, et al, report the following improvement in co-morbidities related to weight loss after Lap-Band surgery2:

Disease	Improved	Resolved
Arthritis	47%	41%
High cholesterol	33%	63%
Heartburn	24%	72%
Hypertension	18%	70%
Sleep apnea	19%	74%
Depression	47%	8%
Urinary incontinence	39%	44%
Asthma	69%	13%
Diabetes	18%	82%
Headaches	29%	57%
Gout	14%	72%

Success rate

As mentioned above, the goal of Lap-Band surgery is to achieve and maintain a weight loss of 60% to 80% of excess body weight at the rate of one to two pounds per week. However, patients may have their own unique definition of success. Published reports indicate that fewer than 10% of Lap-Band patients will lose less than 25% of their excess weight within three years of surgery.

The majority of patients who have Lap-Band surgery are successful in achieving significant, sustained weight loss. Studies (Dixon, et al, SOARD, 2006) have shown that any significant degree of sustained weight loss is of benefit to obesity-related health problems, such as diabetes, hypertension, sleep apnea, high cholesterol and arthritis.

Three main reasons why patients may fail to reach their goal after a Lap-Band procedure:

1.

Patients do not have the Lap-Band adjusted as needed

Approximately 10% of Lap-Band patients never require an adjustment or fill of their band and yet they achieve adequate weight loss. However, the majority of patients require adjustments to allow the band to be effective. The number and timing of adjustments needed to obtain the desired weight loss of one to two pounds per week is unpredictable. Unlimited Lap-Band adjustments are included if the adjustment is done at our clinic. Long distance and out-of-province patients can access adjustments closer to home for a small fee.

2.

Consuming high-calorie liquids

The Lap-Band does not produce restriction to the flow of liquids. If a patient chooses to consume high-calorie liquids such as ice cream, milk shakes, chocolate, fruit juice, soft drinks or alcohol, these fluids will go across the band without restriction and will not result in a feeling of fullness or satiety. These high-calorie liquids may make it more difficult to achieve the desired weight loss and may even result in weight gain.

3.

Eating between meals

Constant grazing or snacking between meals does not lead to distension of the pouch above the band. In this case food moves across the Lap-Band continuously and can lead to excessive calorie intake. Occasional, small healthy snacks such as fruit or raw vegetables are good choices.