Lap banding, also referred to as 'Laparoscopic Adjustable Gastric Banding' (LAGB) is a minimally invasive/keyhole surgical technique to assist seriously obese patients (those with a BMI of 35+) lose weight.
More than 10,000 lap banding procedures have taken place every year in Australia, with the technique being in use since the 1970s. The procedure is a lot less common now than it was five years ago.
The procedure involves the placement of a specially designed silicone 'belt' around the upper section of the stomach and then tightening this band by introducing saline solution into it. The net effect of this is to reduce the stomach size, which both reduces the amount of food that can be contained in the stomach and slows down the movement of food from the stomach into the intestine. This then sends a signal to the brain from the stomach that it is 'full' and significantly reduces appetite.
The procedure itself generally takes up to two hours and the patient is under a general anaesthetic for the entire time. As a minimally invasive procedure, only 3-5 2.5cm incisions are required to allow the instruments to be inserted into the abdominal cavity. The gastric band is fixed in place using sutures and a 'gastric band port' is positioned just under the skin so that the band itself can be adjusted as necessary by injecting or removing saline solution from the band via this port.
After the procedure, most patients are able to return home and go back to work a week later and resume all normal activity at the six-week mark.
Prior to the surgery it is recommended that patients start to adapt to more frequent smaller meals to adjust to the effect of the lap banding ahead of time.
Approximately 6-8 weeks after the surgery the gastric band is adjusted in a process known as a 'lap band fill', after the post-operative healing process in the body has completed. It may only be after the lap band fill that the patient notices any change in appetite. The lap band may also need to be adjusted where the patient has any side effects from the procedure, such as nausea or vomiting.
Weight loss after lap band surgery tends to be steady and gradual and generally occurs over an 18-month timeframe, after which weight often remains constant. Patients generally experience a loss of around 40% of their excess weight in the first year, with an additional 10%-20% in the second year.
Not all patients are suitable for the lap banding, with the procedure being an option for patients who have not been able to lose weight using non-surgical treatment and showing a clear commitment to the lifestyle changes involved after surgery. The procedure is not offered to anyone younger than 18.