Gastric Lap Band Procedure: 2 Types of Systems, Which Is Best & Why
The gastric lap band procedure, or “Laparoscopic Adjustable Gastric Banding” (LAGB), is a relatively safe procedure that often takes less than an hour to complete. But did you know that your doctor has two LAGB systems to choose from?
- The Lap Band Procedure
- Lap Band Myths
- How does the lap band procedure compare to other types of bariatric surgery?
- Comparing the 2 types of gastric banding
Gastric Lap Band Procedure
Regardless of which gastric banding system you choose – LAP-BAND® or REALIZE™ Band – the procedure works by wrapping a silicone and Silastic band around the top part of the stomach and sewing it into place. There are two techniques your surgeon can use to place the band…
- Perigastric Technique (PGT)
- Pars Flaccida Technique (PFT)
We won’t get into the technical details of each, but talk with your surgeon about which technique they will use. Three separate studies have confirmed that the pars flaccida technique (PFT) is safer and results in a lower rate of band slippage.1,2,3
The inner surface of the band has a balloon attached (imagine the inside of a bicycle tire) which is connected to a tube that leads to a half-dollar-sized port above the abdominal muscles but below the skin. This balloon is where saline solution will be “filled” and “unfilled” during the recovery period until your ideal band tightness is found.
Gastric banding works by making you feel full sooner (so it is know as a “restrictive” procedure), and the entire gastric lap band procedure usually takes about one hour to complete.
Take a look at the following computer animated videos for a better understanding of your two gastric banding options, the LAP-BAND® and the REALIZE™ Band, and notice how similar they are (turn on your sound!)…
YOUR Weight Loss Journey
Help visitors like you by sharing your advice related to this page or other topics...
Rather share later? Set up a reminder email.
(click here to jump past the videos)
LAP-BAND®
REALIZE™ Band
(click here to skip past the actual procedure video)
Actual Gastric Banding Procedure Being Performed
And click the following for a real-life gastric lap band procedure being performed…
Gastric Lap Band Procedure Myths – Fact or Fiction
- “There’s little to no follow-up care required” – FICTION - in fact, gastric banding may require more follow-up care than all other types of bariatric surgery. You’ll need to see your surgeon up to 10 or more times during the 2 years following surgery to adjust the fill amount in your band.
- “The access port can set off airport metal detectors” – DEPENDS - this can happen, but not usually. It depends on the sensitivity of the metal detectors and how much other metal you are carrying with you (since the detectors will only go off if the total metal you are carrying exceeds a certain amount). However, a metal wand will detect your port, so play it on the safe side and carry a note or card from your doctor identifying you as a lap band patient.
- “You can’t get an MRI” – FICTION - the gastric lap band systems contain nothing that will prevent the safe use of an MRI.
- “The super-obese (BMI at or above 40) shouldn’t consider it” – DEPENDS - some say gastric banding is not good for the super obese since it may result in less weight loss. But patients with a higher BMI have a higher risk of complications, and lap band surgery is statistically safer than other procedures.
- “Lap band is better than other surgeries because you don’t have to change your lifestyle” – FICTION – as with all other procedures, if you want to have successful long-term results a lot will need to change after surgery. See our Life after Weight Loss Surgery page for the details.
Gastric
Lap Band Bariatric Surgery vs
Other Bariatric Surgery Procedures
Our Types of Bariatric Surgery page provides a comparison of all major bariatric surgery procedures, but here’s a quick summary of how each procedure’s results directly compare to the gastric lap band procedure (click on the following procedure names for more information)…
- Laparoscopic Gastric Bypass Surgery – gastric lap band bariatric surgery is reversible and safer in terms of complications, but Roux-en-Y gastric bypass results in greater weight loss, lower reoperation rates and lower feelings of hunger following surgery. See our Lap Band vs Gastric Bypass page for a complete analysis.
- Vertical Banded Gastroplasty (VBG) - While in some cases the restrictive VBG procedure may be recommended, on average, gastric lap band bariatric surgery is preferred due to similar long-term weight loss, much fewer complications and a shorter hospital stay.
- Gastric Sleeve Surgery – The gastric sleeve is better than gastric banding in a number of ways… more weight loss, lower feelings of hunger after surgery and less long term incidents of gastroesophageal reflux disease (GERD). However, the gastric sleeve has more severe complications associated with it. In addition, the gastric sleeve needs more long-term research in order to solidify its position as a recommended bariatric procedure.
- Duodenal Switch (BPD/DS or DS) is far better than gastric banding in terms of weight loss, but since the duodenal switch is the most complicated weight loss surgery to perform, it carries with it one of the highest complication rates and longest hospital stays. As a result, duodenal switch surgery may be a more serious consideration for the super obese (body mass index 40 or above), but the morbidly obese (BMI from 35 to 39.9) may be better off choosing a procedure with lower complication rates such as the gastric lap band.
- Mini Gastric Bypass Surgery (MGBP) – many surgeons write MGBP off as “gimmicky”, partly due to the emerging number of inexperienced surgeons offering to conduct this toned-down version of the Roux-en-Y gastric bypass. But in the hands of a good surgeon, research is emerging that suggests mini gastric bypass surgery provides the results of Roux-en-Y with the low complications of the lap band. Time and additional research will tell.
The 2 Types of
Gastric Lap Band Systems &
Which Is
Best
3rd Gastric Banding Option: Realize Band C
The Realize Band C has recently been introduced and has had some positive results, but for now we are leaving it off of the list.
Initial research suggests it may not be as effective as the Lap Band AP or Realize Band systems.
The actual equipment used in the gastric lap band procedure is made by one of two companies:
- Allergan, Inc. makes the LAP-BAND AP®
- Ethicon Endo-Surgery, Inc. (a Johnson & Johnson company) makes the REALIZE™ Band
So how do they compare and which is better?
First, we’ll give each company a chance to make its own case. The following links will open a new browser window and take you to each company’s web page that compares its product to the other:
Both present very compelling differentiators, so how do you decide?
As always, we turn to the research…
Data was pulled together and analyzed from multiple separate studies from 1998 to 2006.4 The analyses included 4,273 Swedish Adjustable Gastric Band (now the REALIZE™ Band) patients and 24,707 LAP-BAND® patients. Here are the results…
| Swedish Adjustable Gastric Band (now the REALIZE™ Band) |
LAP-BAND® | |
|---|---|---|
| 3-Year Mean Excess Weight Loss | 56.36% | 50.20% |
| Resolution of Type 2 Diabetes | 61.45% | 60.29% |
| Resolution of Hypertension | 62.95% | 43.58% |
| Early mortality rates | Equal to or less than 0.1% |
Equal to or less than 0.1% |
Both companies continue to improve their products, so the percentages are likely to be even more appealing in future studies.
The bottom line is that…
- Despite the percentages above giving the slight edge to the Swedish Adjustable Gastric Band, the percentages are so close as to be almost statistically insignificant. In other words, it’s a virtual draw.
- You should let your surgeon be the deciding factor. If you move forward with gastric lap band surgery, focus your attention on which surgeon is best for you. Then go with whichever product he or she is most familiar with.
Go to our Bariatric Doctors page to learn how to find, evaluate and choose the right surgeon for you.
For additional research, search for your topic of interest...
Also see...
Back to Bariatric Surgery Source Home Page from Gastric Lap Band Procedure
References
- Bueter M, Maroske J, Thalheimer A, Gasser M, Stingl T, Heimbucher J, Meyer D, Fuchs KH, Fein M (2008) Short- and long-term results of laparoscopic gastric banding for morbid obesity. Langenbecks Arch Surg 393:199–205
- Wolnerhanssen B, Kern B, Peters T et al (2005) Reduction in slippage with 11-cm LAP-BAND® and change of gastric banding technique. Obes Surg 15:1050–1054
- O’Brien PE, Dixon JB, Laurie C et al. A prospective randomized trial of placement of the laparoscoic adjustable gastric band: comparison of the perigastric and pars flaccida pathways. Obes Surg 2005; 15: 820–6.
- Scott A. Cunneen. Review of meta-analytic comparisons of bariatric surgery with a focus on laparoscopic adjustable gastric banding. Surgery for Obesity and Related Diseases - May 2008 (Vol. 4, Issue 3, Supplement, Pages S47-S55, DOI: 10.1016/j.soard.2008.04.007)
In the spirit of full disclosure: We proudly support this website through advertising and affiliate marketing. In other words, when you click on a link that takes you outside of this website, we sometimes earn a small commission. These small commissions allow us to keep the site up and running and to continue offering it completely free of charge to you. Rest assured that all content, recommendations and advice are created before, and are independent of, any sponsorship or affiliate relationship. Click here for more info.
