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This section contains important information about morbid obesity and the use of the LAP-BAND Adjustable Gastric Banding System as a surgical aid for treatment of this potentially life-threatening condition.
Morbid obesity exists when excess weight is associated with undesirable implications for general health and when:
The above statements provide only a general descrip-tion of morbid obesity. The exact degree of excess weight is determined using the Body Mass Index (BMI), which employs both weight and height to calculate the measurement.
We use the term 'morbid obesity' because this degree of excess weight may considerably reduce life expectancy and is associated with an increased risk of developing conditions or diseases such as:
With sufficient weight loss, your health can be improved, your risk of developing associated conditions or diseases can be reduced, and the quality of your life can be enhanced.
Non-surgical intervention:
Many overweight people have tried and failed to lose
unhealthy excess weight. There are many slimming diets,
“cures” and products that advertise success. However,
numerous studies have demonstrated that diets and
weight-loss aids rarely succeed in helping people achieve
the desired result of long-lasting weight reduction. In fact,
many people have succeeded in losing weight only to
regain it when they stop dieting.
Surgery:
If diets, exercise programs, and other non-surgical methods
have failed to help you achieve long-term weight loss, you
may want to consider an operation to artificially reduce the
capacity of the stomach and to help decrease your appetite.
The
LAP-BAND
System's innovative surgical technology
can help you attain desirable weight-loss results.
The word LAP-BAND is the abbreviated and trademarked combination of two words (LAP from laparoscopic and BAND from gastric band). The LAP-BAND System's silicone elastomer band is placed around the upper part of the stomach to create a small stomach pouch which can hold only a small amount of food. The lower, larger part of the stomach is below the band. These two parts are connected by a small outlet created by the band. Food will pass through the outlet 'stoma' in medical terms) from the upper stomach pouch to the lower part more slowly, and you will feel full longer.
One of the major advantages of the LAP-BAND System is that the diameter of the band outlet is adjustable to meet your individual needs, which can change as you lose weight. The inner surface of the band can be inflated with liquid (saline solution) or deflated to modify the size of the stoma. The band is connected by tubing to a reservoir, which is placed well under the skin during surgery. After the operation, the surgeon can control the amount of saline in the band by entering the reservoir with a fine needle through the skin. The LAP-BAND System is a unique surgical treatment because in many cases the size of the stoma can be customized to accom-modate your changing needs without further surgery.
Patient-friendly technique: Of all the operations for severe obesity, the LAP-BAND System method is considered to be the least traumatic. The operation can usually be performed using laparoscopy (using small incisions and long instru-ments rather than a single large incision). The procedure requires no cutting or stapling of the stomach.
Adjustability: In many cases, no follow-up operation is necessary to modify the diameter of the stoma.
Avoids irreversible damage: If the LAP-BAND System needs to be removed for any reason, the stomach generally returns to its original form.
Reduced hospital stay: Patients normally leave the hospital within two to four days of the laparoscopic operation, or four to eight days if an abdominal incision is required or if complications occur.
Quicker recovery: After the laparoscopic procedure, patients usually resume normal activities within a week or two, and within four weeks if the procedure is not done laparoscopically or if there are complications.
Most people lose between one-third and two-thirds of their excess weight with the help of the LAP-BAND System. It is important to remember that the LAP-BAND System is an aid to support you in achieving lasting results by limiting food intake, reducing appetite and slowing digestion. However, for the ultimate success of the operation it is very important that you play an active part in the effort to lose weight and keep it off by adopt-ing a different lifestyle and eating pattern for the rest of your life.
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Obesity and its associated morbidities are rapidly becoming the nation's major health problems, as has already occurred in the USA. There is considerable evidence to suggest that in normal individuals, appetite regulation is largely an autonomic rather than a voluntary process. Grossly obese patients (BMI 40 or greater) lack the normal appetite suppression experienced when non-obese patients gain weight. Whereas dietetic advice, attempts to lose weight by voluntary dietary restriction and a graduated exercise regime are always encouraged in overweight patients, the fact remains that in the grossly obese group, these mechanisms virtually never succeed in the long-term - sustained weight loss of more then 10kg is rare.
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Surgery aimed at reducing gastric volume or inducing malabsorption has met with some success, and although the evolution of gastric stapling procedures through the 80's and 90's significantly reduced the risk of surgery, failure to lose weight, or side-effects requiring revisional surgery, occured in a significant minority.
These problems led to the development of a laparoscopically-placed adjustable gastric band, which is, in effect, an inflatable collar around the proximal stomach, just below the oesophago-gastric junction. Apart from being laparoscopically introduced (or removed), its major advantage is that the band diameter can be adjusted with a percutaneous needle, via a subcutaneous Port-A-Cath (injection port). This has now been trialed extensively in Australia and overseas, and the
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Any vomiting illness or acute abdominal illness should lead to immediate percutaneous needle deflation of the band, under x-ray control if necessary. This will facilitate ease of vomiting and will reduce the risk of the band slipping distally. Similarily, the band should be deflated during pregnancy.
Laparoscopic banding procedures attract Medicare benefits and private hospital costs are covered by private health insurance.
Although adjustable laparoscopic gastric banding is very low risk surgery, it is not no-risk, and life-threatening complications are a possibility in this as in any sugical procedure
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| The day after Lap-Band Insertion | Two weeks after Lap-Band Insertion |
