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 Treatment

Non-Surgical Treatment
Dieting, exercise, and medication have long been regarded as the conventional methods to achieve weight loss. Sometimes, these efforts are successful in the short term. However, for people who are morbidly obese, the results rarely last. For many, this can translate into what's called the "yo-yo syndrome," where patients continually gain and lose weight with the possibility of serious psychological and health consequences.

Recent research reveals that conventional methods of weight loss generally fail to produce permanent weight loss. Several studies have shown that patients on diets, exercise programs, or medication are able to lose approximately 10% of their body weight but tend to regain two-thirds of it within one year, and almost all of it within five years.1 Another study found that less than 5% of patients in weight loss programs were able to maintain their reduced weight after five years.2

 

Surgical Treatment
Over the years, weight-loss surgery has proven to be a successful method for the treatment of morbid obesity.3 Surgical options have continued to evolve and Surgical Weight Control Center is pleased to be able to offer patients the BioEnterics® LAP-BAND® ® System surgery. The “Laparoscopic” approach is the least traumatic and recovery time is a lot less. These procedures are unique tool that can help you achieve and maintain significant weight loss, improve your health, and enhance your quality of life.

LAP-BAND® System Overview

Approved by the FDA in June 2001, the BioEnterics® LAP-BAND® Adjustable Gastric Banding System is the newest and the only adjustable surgical treatment for morbid obesity in the United States. It induces weight loss by reducing the capacity of the stomach, which restricts the amount of food that can be consumed. Since its clinical introduction in 1993, more than 100,000 LAP-BAND® procedures have been performed around the world.

Minimally Invasive Approach
During the procedure, surgeons usually use laparoscopic techniques (using small incisions and long-shafted instruments), to implant an inflatable silicone band into the patient's abdomen. Like a wristwatch, the band is fastened around the upper stomach to create a new, tiny stomach pouch that limits and controls the amount of food you eat. It also creates a small outlet that slows the emptying process into the stomach and the intestines. As a result, patients experience an earlier sensation of fullness and are satisfied with smaller amounts of food. In turn, this results in weight loss. click to watch animation



Watch an animation of the LAP-BAND® installation click on the image>>

Least Traumatic Procedure
Since there is no cutting, stapling or stomach re-routing involved in the LAP-BAND® System procedure, it is considered the least traumatic of all weight loss surgeries. The laparoscopic approach to the surgery also offers the advantages of reduced post-operative pain, shortened hospital stay and quicker recovery. If for any reason the LAP-BAND® System needs to be removed, the stomach generally returns to its original form.

Adjustable Treatment
The LAP-BAND® System is also the only adjustable weight loss surgery.The diameter of the band is adjustable for a customized weight-loss rate. Your individual needs can change as you lose weight. For example, pregnant patients can expand their band to accommodate a growing fetus, while patients who aren't experiencing significant weight loss can have their bands tightened.click to watch animation
 

Watch an animation of the LAP-BAND being adjusted
<<click on the image

 

 

To modify the size of the band, its inner surface can be inflated or deflated with a saline solution. The band is connected by tubing to an access port, which is placed well below the skin during surgery. After the operation, the surgeon can control the amount of saline in the band by entering the port with a fine needle through the skin.

LAP-BAND® Candidates

The BioEnterics® LAP-BAND® System is not right for everyone. Here are some of the things we will consider when evaluating your candidacy for obesity surgery.

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Indications
The LAP-BAND® System may be right for you if:

  • You are at least 18 years old.
  • Your BMI is 40 or higher or you weigh at least twice your ideal weight or you weigh at least 100 pounds more than your ideal weight. (BMI is calculated by dividing body weight (lbs.) by height in inches squared (in2) and multiplying that amount by 704.5). [insert link to BMI Calculator or BMI Chart if you create one]

  • You have been overweight for more than 5 years.
  • Your serious attempts to lose weight have had only short-term success.
  • You do not have any other disease that may have caused your obesity.
  • You are prepared to make substantial changes in your eating habits and lifestyle.
  • You are willing to continue being monitored by the specialist who is treating you.
  • You do not drink alcohol in excess.

If you do not meet the BMI or weight criteria, you still may be considered for surgery if your BMI is over 35 and you are suffering from serious health problems related to obesity.

Contraindications
The LAP-BAND® System is not right for you if:

  • You have an inflammatory disease or condition of the gastrointestinal tract, such as ulcers, severe esophagitis, or Crohn's disease.
  • You have severe heart or lung disease that makes you a poor candidate for surgery.
  • You have some other disease that makes you a poor candidate for surgery.

  • You have a problem that could cause bleeding in the esophagus or stomach. This might include esophageal or gastric varices (a dilated vein). It might also be something such as congenital or acquired intestinal telangiectasia (dilation of a small blood vessel).

  • You have portal hypertension.
  • Your esophagus, stomach, or intestine is not normal (congenital or acquired). For instance you might have a narrowed opening.
  • You have or have experienced an intra-operative gastric injury, such as a gastric perforation at or near the location of the intended band placement.
  • You have cirrhosis.
  • You have chronic pancreatitis.
  • You are pregnant. (If you become pregnant after the BioEnterics LAP-BAND® System has been placed, the band may need to be deflated. The same is true if you need more nutrition for any other reason, such as becoming seriously ill. In rare cases, removal may be needed.)

  • You are addicted to alcohol or drugs.
  • You are under 18 years of age.
  • You have an infection anywhere in your body or one that could contaminate the surgical area.
  • You are on chronic, long-term steroid treatment.
  • You cannot or do not want to follow the dietary rules that come with this procedure.
  • You might be allergic to materials in the device.
  • You cannot tolerate pain from an implanted device.
  • You or someone in your family has an autoimmune connective tissue disease. That might be a disease such as systemic lupus erythematosus or scleroderma. The same is true if you have symptoms of one of these diseases.

Your Motivation

While the LAP-BAND® System is an effective treatment for morbid obesity, the pounds do not come off by themselves. The LAP-BAND® System is an aid to support you in achieving lasting results by limiting food intake, reducing appetite and slowing digestion. However, your motivation and commitment to adopt a new lifestyle are extremely important for long-term weight loss. New eating habits must be adhered to for the rest of your life. Exercise is an equally important component of a changed lifestyle. For more information, please see the frequently asked questions page.

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Risks Associated with the LAP-BAND® System

Indications: The LAP-BAND® System is indicated for use in weight reduction for severely obese patients with a Body Mass Index (BMI) of at least 40 or a BMI of at least 35 with one or more severe co-morbid conditions, or those who are 100 lbs. or more over their estimated ideal weight.

Contraindications: The LAP-BAND® System is not recommended for non-adult patients, patients with conditions that may make them poor surgical candidates or increase the risk of poor results, who are unwilling or unable to comply with the required dietary restrictions, or who currently are or may be pregnant.

Warnings: The LAP-BAND® System is a long-term implant. Explant and replacement surgery may be required at some time. Patients who become pregnant or severely ill, or who require more extensive nutrition may require deflation of their bands. Patients should not expect to lose weight as fast as gastric bypass patients, and band inflation should proceed in small increments. Anti-inflammatory agents, such as aspirin, should be used with caution and may contribute to an increased risk of band erosion.

Adverse Events: Placement of the LAP-BAND® System is major surgery and, like any surgery, death can occur. Possible complications include the risks associated with the medications and methods used during surgery, the risks associated with any surgical procedure, and the patient's ability to tolerate a foreign object implanted in the body.

Talk to your doctor about all of the following risks and complications:
        . Ulceration
        . Gastritis (irritated stomach tissue)
        . Gastroesophageal reflux (regurgitation)
        . Heartburn
        . Gas bloat
        . Dysphagia (difficulty swallowing)
        . Dehydration
        . Constipation
        . Weight regain
        . Infection
        . Death

Other problems which may occur are:
        . The band can spontaneously deflate because of leakage. That leakage can come
           from the band, the reservoir, or the tubing that connects them.
        . The band can slip.
        . There can be stomach slippage.
        . The stomach pouch can enlarge.
        . The stoma (stomach outlet) can be blocked.
        . The band can erode into the stomach

Obstruction of the stoma can be caused by:
        . Food
        . Swelling
        . Improper placement of the band
        . The band being over-inflated
        . Band or stomach slippage
        . Stomach pouch twisting
        . Stomach pouch enlargement

Weight loss with the band is typically slower and more gradual than with some other weight-loss surgeries. Tightening the band too fast or too much to try to speed up the weight loss process should be avoided. The stomach pouch and/or esophagus can become enlarged as a result. You need to learn how to use your band as a tool that can help you reduce the amount you eat.

Complications can cause reduced weight loss. They can also cause weight gain. Certain complications may require that you return to surgery to remove, reposition, or replace the band.

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1. American Association of Clinical Endocrinologists (AACE) / American College of Endocrinology (ACE) Statement on the Prevention, Diagnosis, and Treatment of Obesity (1998 Revision). AACE/ACE Obesity Task Force. Endocr Pract. 1998; Vol. 4 No. 5: 297-330.
2. Kramer FM et al. Long-term follow-up of behavioral treatment for obesity: patterns of weight regain among men and women. Int J Obes 1989; 13:123-136.

3. SAGES/ASMBS Guidelines for Laparoscopic and Conventional Surgical Treatment of Morbid Obesity. American Society for Bariatric Surgery. http://asbs.org/html/guidelines.html

  
Home
Overview
ADA's Man of the Year
Lap Band Treatment
Patient Information
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