Laparoscopic adjustable gastric banding

Illustration showing laparoscopic adjustable gastric bandingA laparoscopic adjustable gastric band (LAGB) is a silicone band placed around the upper part of your stomach. It helps you feel full after eating a smaller amount of food, which can help you reduce your portion sizes.

The pressure of the band on the stomach sends signals to the brain which contribute to the feeling of fullness. The band is connected to a small port placed under the skin on the left side of your abdomen.

Fluid can be added to the band through the port to make it tighter or removed to loosen it. Fluid can also be removed during pregnancy if necessary.

No part of your stomach or intestines is cut, stapled or removed during the procedure, so digestion and nutrient absorption are not altered in the same way as with some other types of weight loss surgery. The gastric band is safe for MRI scans.

Band adjustments

The band does not usually contain any fluid when it is first inserted. Your first adjustment, sometimes called a ‘fill’, will usually take place around six weeks after surgery. You may need several adjustments to achieve the right level of restriction.

Your bariatric nurse or dietitian will discuss how much you should be eating and advise you about any dietary changes you need to make.

Expected weight loss

Weight loss following gastric band surgery tends to be gradual and may continue for two to three years.

On average, people lose around 40–50% of their excess body weight, equivalent to approximately 15–20% of their total body weight. Weight loss is generally slower than following gastric bypass, OAGB or sleeve gastrectomy.

There is considerable variation in the amount of weight people lose and weight loss is not guaranteed. Following your diet and activity plan is important in helping you achieve the best possible result.

Advantages

Possible advantages include:

  • you may feel full more quickly and stay full for longer
  • the tightness of the band can be adjusted
  • the stomach and intestines are not cut or removed
  • food continues to be digested and absorbed through the normal route
  • the operation carries a lower surgical risk than some other weight loss procedures because it is usually shorter and does not involve cutting or removing parts of the stomach or intestine
  • the band can be removed if necessary, although weight may be regained afterwards

Disadvantages and possible side effects

These can include:

  • slower weight loss than gastric bypass, OAGB or sleeve gastrectomy
  • weight loss may not begin immediately because the band needs to be adjusted gradually
  • the band may not always create the expected feeling of fullness
  • the access port can move or twist, which may make it difficult to adjust the band
  • the band or port can leak or deflate
  • the band can move or slip. This happens in around 2–5% of cases and may require the fluid to be removed temporarily or further surgery
  • in rare cases, around 1%, the band can erode into the stomach wall and may need to be removed
  • the band or port can become infected and may need to be removed
  • reflux, stomach irritation, bloating, difficulty swallowing, dehydration or constipation
  • nausea and vomiting, particularly soon after surgery or if you eat too quickly or too much
  • around 10% of people may not lose the expected amount of weight

If you need another operation in the future, you should always tell the surgical team that you have a gastric band.