This operation started in the mid-nineties with the appearance of two types of bands in the market: The American (Lap-band) and the Swedish (SAGB). More than 90,000 cases were done so far. Most surgeons performing the procedure are new to morbid obesity surgery. The procedure is very attractive to surgeons because it is very easy to perform. The principle of the operation is through placing a band around the upper stomach, that band is lined with an inflatable balloon that is connected with a tube to a metallic reservoir that is placed under the skin. Later on the skin is pierced with a long needle to access the metal reservoir and inflate the balloon and thus control the diameter of the band. The operation is done laparoscopically using 4-5 small incisions and with a one day hospital stay. The operation has the same principle as stomach stapling giving satiety after eating a small amount of food and it also has the same week point of inability to control sweet or high calorie fluid intake so that a sweet consuming individual can fail the operation and gain weight despite having the band in place. Results of the band are very controversial were there are many reports of good results (these usually are reported by band only surgeons) and also there are many bad results for the band (these are usually reported by surgeons who perform other forms of obesity surgery). The United States experience with the band reported poor weight loss as compared to the stomach bypass procedure and also reported an unacceptably high rate of complications and band removal. In our experience in Egypt we compared the 4 types of obesity operations and we were surprised to see very slow and poor weight loss with the adjustable band as compared to the stomach stapling, bypass or BPD operations. Also the incidence of complications with banding tends to increase with time.
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Frequently Asked Questions
Is it true that banding is the easiest operation to undo or cancel?
Banding is easy to undo if the patient has no side effects or complications. But in the presence of complications (as when the band penetrates into the inside of the stomach) undoing is then very difficult.
The metal part that is placed under the skin: is it visible and how do we deal with it?
Yes, you can feel it as a hard lump under the skin. It becomes more visible as you lose weight and that is sometimes annoying especially for girls.
Is there an estimated life span for the balloon lining the band?
The band has been in the market for only 7 years. No body knows how long will it function but it will definitely not function for ever. If the balloon stops functioning the patient will then rapidly gain the lost weight back. Then he will need a second surgery either to place another band or to have a more effective obesity operation as the stomach bypass.
What are the chances for weight regain?
As mentioned before if the patient takes sweets excessively he will gain the lost weight back. Studies have shown high incidence of weight regain with banding after 5 years.