Why the Lap Band is No Longer the Favored Option.

When considering gastric surgery for weight loss, one must factor in effectiveness, maintenance, and longevity. Seeing as there are several options available in bariatric surgery, one has to think about what would be most suitable for his or her individual needs and concerns.

There are two main categories of weight-loss surgeries; restrictive and malabsorptive. Restrictive procedures limit the amount of food one can eat by making the stomach smaller, while malabsorptive procedures, such as the Roux-en-Y Gastric Bypass, also reduce the body’s ability to absorb calories by circumventing part of the small intestine (combined with the restrictive intervention). This article will focus on the simpler and more common of the two, restrictive surgeries. These include the Adjustable Gastric Band (Lap Band) and the Vertical Sleeve Gastrectomy (Gastric Sleeve).

Gastric Surgery Options

When the Lap Band was first introduced, it quickly became the go-to solution for people who couldn’t lose weight no matter what they tried to do in terms of diet, exercise, and other lifestyle modifications. It works by reducing the stomach’s volume by placing a ring around it, slowing and limiting the amount of food a patient is able to consume at a time. While its results are undeniable, the test of time has revealed some of its shortcomings.

Regular "Fills"

Firstly, it requires regular tune-ups known as “fills” where liquid is injected into the ring to modulate how much of the stomach is being restricted. This adjustability is sensible in theory, but at the tune of around $200 every month or two, this extra cost takes a considerable bite out of the monthly budget. 

Lap Band Migration

Secondly, while the band’s biggest supporters laud its non-invasiveness, it is a foreign body that is not always as sturdy as one would hope. Many patients have had to undergo revision surgery due to its unintended slippage (migration). Any time a second surgery becomes necessary on the same site, it becomes a more invasive procedure.

The Gastric Sleeve surgery, on the other hand, has become the new favorite, and will likely keep that title for the long haul. It limits the amount of food one can consume, much like the Lap Band, but once it is set into place there are no adjustments or maintenance measures with which to be concerned. Rather than placing a ring around the organ, a portion of its volume is simply removed and the stomach stapled together, never needing to be altered again. In addition, the portion removed includes the gland that secretes grehlin, a hunger stimulant, which makes eating sensible portions much easier and more satisfying.

An astoundingly positive set of side-effects of both surgeries includes the reversal of several co-morbidities such as high cholesterol, hypertension, type-II diabetes, and sleep apnea. The Gastric Sleeve, however, is more effective on all counts.