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Bariatric Surgery

Laparoscopic Gastric Banding (Lap Band or Realise Band)

Laparoscopic adjustable gastric banding (LAGB) or Laparoscopic Gastric banding is one of the least invasive weight loss treatments available for obesity. It’s done with a few tiny abdominal cuts, instead of with one large cut. The surgeon puts instruments through the cuts. One of those instruments is a laparoscope, a tool with a tiny camera. Using this, a silastic band is placed around the stomach just below the junction of oesophagus (food pipe). This forms a small pouch thus creating an hour-glass effect. The silicon ring passes around the stomach, thus giving a small outlet, that allows only as much food as the size of an eraser, to enter the distal stomach. The reservoir is placed under the skin in the midline just below the chest such that it can easily be felt while lying down. A needle can be injected through the skin into the reservoir and to add or remove fluid to adjust the size of the stomach outlet.

The hour glass configuration only constricts the upper stomach thus acting as a pure restrictive operation. Since the outlet is small, food stays in the pouch longer and one also feels satiated for a longer time. The small pouch ensures that the patient feels full after eating only small amounts of food, which causes weight loss.

This is a new procedure, specifically designed for patients with Diabetes Mellitus with or without obesity.

This combines the restrictive effect of a vertical sleeve gastrectomy, and also the malabsorptive effect of upper small intestinal bypass, thus leading to weight reduction.

The advantage of this procedure is that the chances of frequent stools and esophageal reflux are less. Also, since it is a lap procedure, a single anastomosis is made, which can be examined via endoscopy.

It is a partially reversible procedure, which works to its advantage in selecting this surgery especially for resolution of type II diabetes mellitus.

Advantages

  • Very successful (50-70% of excess weight loss) as a primary weight loss procedure especially in type II DM
  • Operation for patients who failed restrictive procedures like balloon, banding and sleeve gastrectomies
  • Faster recovery < 48 hours
  • Band is inflatable and can be adjusted over time
  • Improvement in associated co-morbidities & quality of life

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