| The lap band has been used in Europe for several
years and has been in FDA trials at 30 centers throughout the
United States. It was
expected to be approved by the FDA one year ago, however, the FDA
required an additional year of testing.
On Tuesday June 8th, 2001 the FDA approved the
use of the lap band, but required that surgeons who insert the
band must go through specialized training.
It is expected that by the end of the year that the lap
band will be available at about 100 centers throughout the United
States.
In the lap band procedure, a silicone band is placed around the
top of the stomach squeezing the stomach to make a small pouch.
There is a narrow opening that allows food to slowly move
from the upper small pouch to the lower stomach.
Because the opening is narrow, food remains in the upper
pouch providing the patient with a sensation of being full and
satisfied.
When the lap band is inserted, there is a port that is also
inserted just under the skin of the abdomen.
This port connects to the lap band by tubing. The band itself has an inner lining that is filled with a
saline solution. Through
the port, the surgeon can inject more saline, which makes the band
tighter if the patient wants to eat less or the surgeon can remove
some of the saline if the patient wants to eat more.
As with any procedures there are advantages and disadvantages.
The following are some to consider:
Advantages
1. The surgery is
less invasive. There
is no cutting of the stomach or intestines so it is a safer
procedure than the RNY.
2. The hospital
stay is shorter, usually 2 days and patients can return to work in
a week or two.
3. Surgeons like
the procedure because it is technically easier to perform and
takes less time to perform the surgery.
4. The pouch can
be customized so that the patient can eat as little or as much as
they want.
5. If the patient
is unhappy with the procedure, the band can be removed and the
stomach generally returns to its original size and shape.
Disadvantages
1. Patients lose weight
more slowly than gastric bypass patients. In
the clinical trials, the average loss of excess weight was 36-38%
which is about half of what is generally lost with the RNY.
2.
Patients need to see their surgeon 4 or 5 times
over the first year to have "fills" done so the band is adjusted
properly
3.
It is a little more difficult to have the
surgery covered by insurance because it is newer.
But now that the lap band is becoming more widely available,
this will be one more option for patients to consider in their
choice of surgeries.
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