Laparoscopic Adjustable Gastric Banding Surgery: Costs of Lap-Band

LAGB limits your food intake after an inflatable tube is placed around your stomach directly below the gastroesophageal junction. This placement allows the physician to adjust the outlets size by adding or removing saline through a port just beneath the skin.

Ultimately, this procedure restricts the size of your stomach and how much food it can hold. It also slows down the amount of time it takes for the food to reach your intestine. By doing this, signals are sent to the brain to make you feel full and satisfied.

The LAGB Surgical Procedure

A laparoscopic technique is utilized to perform this surgical procedure. It takes about two hours to perform this surgery. The surgeon will make three to five tiny incisions. These incisions will only be about an inch in length. A small camera will be attached to a tube and then inserted into one of the previously made incisions. This camera allows the surgeon to view the procedure on a screen. The band is put around the upper portion of the stomach and kept in position with sutures. The port that will be used for adjusting the band will be placed in the abdomen’s wall and then sutured in place.

Are You a Good Candidate for Gastric Banding?

If you are considering gastric banding to lose weight, there are several questions you should ask yourself. The answers to these questions should assist you in determining if gastric banding is the right procedure for you.

  1. Have you tried other methods to lose weight, such as diet and exercise that did not work? Have you attempted these methods more than once? This is an important question to ask yourself. Bariatric surgery is only considered as a last-resort and is for individuals who have tried every other option to no avail.
  2. Is your BMI (body mass index) above 40? A BMI higher than 40 is considered ‘extreme obesity.’ Sometimes, bariatric surgery will be considered for individuals with a BMI in the 35 to 40 range if they have certain health problems
  3. Do you have any other serious medical conditions to take into consideration? Some people who have serious lung or heart conditions may not be considered a good candidate for this type of surgery.

Once you have decided that gastric banding is the answer for you, you need to learn more about what lifestyle changes you may need to make following your surgery.

Lifestyle Changes Following Gastric Banding Surgery

Immediately after your surgery, you will have some discomfort and pain. These issues can be dealt with quite easily with the use of medication. This is a usual occurrence during the recovery phase following the gastric banding surgery.

You can typically return to your normal activities after about six weeks. Your weight loss will be gradual. Initially, your weight loss could be more dramatic at two or three pounds weekly. After the initial weight loss, you will most likely lose about four pounds a month. Obviously, the food choices you make will determine your rate of weight loss.

After about a year and a half, your weight loss may slow. Within the first year and individual usually loses 40% of her excess body weight, 10% to 20% during the second year. Patients need to keep in touch with their surgeon. Band adjustments may be necessary.

Adjusting Your Gastric Band

Generally, your first fill will take place approximately six to eight weeks following your surgery.

The surgeon who performed your surgery will usually fill your band for you. The filling process is painless and very easy; all it involves is the injection of saline into the port that is just beneath your skin. This port is connected to your gastric band. Before your first fill, there may not be much change in your appetite.

These adjustments are done to enhance your weight loss, especially if you experience a plateau phase in your weight loss. Sometimes adjustments may be made to loosen your band. Loosening the band helps individuals to overcome some side effects they are experiencing. These side effects are vomiting and nausea.

Side Effects Related to the Gastric Band Surgery

Some of the side effects related to this surgery include:

  • Vomiting
  • Nausea
  • Band site ulceration
  • Dehydration
  • Indigestion/esophageal reflux
  • Weight regain
  • Constipation

This kind of surgery does not typically cause the individual malabsorption of nutrients that cause vitamin deficiencies. Even so, many bariatric centers do recommend a multivitamin supplement be taken on a daily basis.

The Cost of Gastric Banding Surgery & Adjustments

The cost of gastric banding will vary depending on the area where you reside. The price usually ranges from $12,000 to $25,000 depending. The adjustments or fills for the gastric banding can cost anywhere from $35 to $200.

The majority of insurance companies will not pay for the gastric banding surgery until you have attempted to lose weight through diet, exercise and even medications. Always check with your insurance company about your policy prior to agreeing to have the gastric banding surgery.

Study Proves Gastric Banding Will Pay for Itself within 4 Years

In June of 2011, a study found that a patient recovers the cost of his surgery within a relatively short amount of time. This is true especially for the obese patients that have diabetes, according to lead author Eric A. Finkelstein, Ph.D., of Duke University & Duke-NUS Graduate Medical School/Singapore.

Clinical Trials

There were 14 comparative studies identified (one randomized trial). These studies were found in several different databases. The databases included Cochrane clinical trials, Medline database dates ranging from 1966 to 2007, Database of Abstracts of Reviews of Effects and the Cochrane reviews database. The majority of the studies did not report any of the outcomes beyond one year. The excess body weight loss at one year was reliably greater with the Roux-en-Y gastric bypass than with the laparoscopic gastric banding (the median difference, 26% range, 19% to 34%:P ,<.001). The resolution of multiple illnesses was greater following a Rouex-en-Y gastric bypass. Considering the highest-quality study, with the bypass, the excess body weight loss was 76%, the gastric banding, 48%. Diabetes resolved in 78% of the bypass patients and 50% of the banding patients.

Average Weight Lost Comparison

The amount of weight lost following a bariatric surgery will depend on several factors. The kind of procedure that was performed, the health and weight of the patient (heavier patients typically lose more weight), how faithful the patient is at following the diet and exercise plan the physician has recommended.

Gastric bypass-Patients lose about 60% (around 140 pounds) of their excess body weight within approximately 14months.

Gastric banding-The weight loss after a Lap Band procedure is about 50% of the patient’s excess weight (around 80 pounds). This weight loss generally occurs over two or three years.

Gastric sleeve- Because this is a relatively new bariatric procedure, data is limited. However, early studies indicate average weight loss falls in between the losses that are seen with the gastric bypass and the gastric banding procedures.

An individual patient may lose less or more weight that is indicated by the national averages. The weight loss will depend largely on the patient’s post op diet and his physical activity level.

Gastric Sleeve

The gastric sleeve surgery works by making you feel full faster than you would have prior to the surgery. It will usually be performed laparoscopically. On average, the procedure will take about two hours to complete.

Gastric Sleeve vs. Gastric Banding

After one year and three years, weight loss and the loss of feeling hungry are better with the gastric sleeve than with the gastric banding surgery. GERD is more frequent one year after the gastric sleeve surgery and at three years following gastric banding surgery. The severity of complications does appear higher in the gastric sleeve procedure than the gastric banding.

Comparing Gastric Sleeve to Bypass & Banding

The hunger feeling is lower following the Gastric Sleeve procedure that it is with the gastric band or the gastric bypass.

Weight loss that is as good as or better than the gastric bypass and the gastric sleeve surgery may be less risky.

Long-term research needs to be done to confirm that Gastric sleeve is effective on its own.

GERD could be worse than banding following the Gastric sleeve surgery in the first year; however, the reverse could be true three years post-op.

Gastric Banding in the Initial 12 Months Following Surgery

The mean EWL (Excess Weight Loss) was almost 65%.

The mean reduction in the circumference of the waist for women was 5.9” and for men was 6.1”.

The mean reduction in the BMI (Body Mass Index) was 6.5 points.

Average Weight Loss with the Gastric Sleeve

In the first year, patients lost between 33% and 70% of their excess body weight. Over the longer term of up to three years, the excess body weight lost was between 64% and 75%.