Laparoscopic adjustable gastric banding is a restrictive procedure that connects a balloon to a band around the upper part of the stomach. A reservoir is placed under the skin and is used to inflate the balloon and adjust the gastric band. With the inflation of the balloon the gastric band tightens and decreases the amount of food passing through at the given time. When the balloon is deflated the band loosens and the weight loss begins to be reduced. The LAP-BAND ® System, Swedish Adjustable Band and the Mid-Band are the different types of bands for the procedure.
Unlike the other restrictive procedures, LAGB does not permanently alter the anatomy of the stomach or small intestines. LAGB can be a reversible procedure and it produces no risk of severe nutritional deficiencies. Based on these facts, LAGB may be considered to be a safer procedure than the gastric bypass or malabsorptive procedures. However, weight loss induced by LAGB is lower. Weight-related problems have improved with LAGB such as sleep apnea, type II diabetes asthma, and hypertension, but the amount remains less that of gastric bypass procedures.
While some studies have documented weight loss equal to RYGBP with fewer complications, other groups have had disappointing outcomes. Some studies document a substantial number of patients who have required re-operation for long-term complications of the adjustable band (such as for port problems, erosions and slippage, or inadequate weight loss). In addition, conversion of a failed LAGB to another bariatric procedure may be technically more difficult and associated with more complications than with a first time operation.