Laparoscopic Adjustable Gastric Band

An effective, completely reversible option, for the right person

LAGB: Who is it for

Based on experience and measuring weight loss outcomes, typically a good LAGB candidate:

  • Is younger; 20s to 40s
  • Has a lower BMI 30s to 40s
  • Can diet well, but not sustain the weight loss.
  • Has good dietary knowledge of carbohydrates, proteins, fats etc
  • Does not graze, eats regularly, but too much
  • Has a savoury tooth, favouring bread, potatoes, cheese, but not chocolate & sweets
  • Is active, exercises regularly with moderate to high, daily calorie expenditure
  • is in good health, other than their weight

LAGB: The procedure and Recovery

  • ​Laparoscopic (Keyhole) surgery: 4 to 5 small incisions
  • General Anaesthetic
  • Daycase or overnight stay
  • One week recovery time
  • LAGB is placed around the upper stomach.
  • As shown in the model, it is critical that there is a small pouch above the LAGB
  • A poorly placed LAGB, too close to the oesophagus, will not work
  • In the UK, LAGBs have been poorly placed, by inexperienced surgeons and do not work.
  • An access port, is placed under the skin, on the left hand side of the abdominal wall

LAGB: Mechanism of Action

The LAGB, when correctly positioned, adjusted and looked after well:

  • Reduces appetite
  • Makes the patient slow down when they eat
  • Makes the patient feel full sooner
  • Reduces portion size
  • Decreases the appetite drive to snack between meals 

A poorly positioned LAGB, that is not adjusted regularly, will not work

LAGB: Maintenance and Aftercare

To work the LAGB needs to be adjusted.

  • In clinic, saline is added to the LAGB via the subcutaneous  access port
  • The saline inflates the reservoir on the inner aspect of the LAGB
  • Inflation, increases pressure on the upper stomach, this
  • Reduces appetite and makes patients slow down, when they eat

The LAGB will not work without

  • Excellent aftercare, with frequent LAGB adjustments
  • In the first year, on average 6-12 adjustments are needed

LAGB: Weight loss

The LAGB can be just as effective as, other forms of WLS

 

A person who is six stone over their ideal weight, can lose 4.5 stone, if

  • They work well, with the LAGB
  • Use it as a tool, to help them diet
  • Keep it optimally adjusted, to the correct pressure
  • Eat well, avoiding high calorie content, sabotaging foods

Failure to work well with the LAGB, will result in disappointing weight loss.

 

LAGB: Diet & Lifestyle

Almost all foods and drinks can be eaten or drunk

  • More textured foods, such as red meat maybe difficult to eat
  • Foods that swell, such as pasta and rice, may be difficult to eat
  • Eating out, can sometimes be challenging, if the menu is restrictive

​It is important to avoid weight loss sabotaging foods

  • High calorie sugar containing drinks and alcohol, will be absorbed normally
  • Chocolate, sweets, crisps, biscuits, cakes, will pass easily through the LAGB
  • These food and drink groups, should be saved for occaisional treats and celebrations

LAGB Risks and complications

The LAGB procedure is very safe, it is unlikely that the operation will cause harm

 

In the longer term, complications can occur, that may need further surgery

  • LAGB slip
  • LAGB erosion
  • Access port problems

The risk of LAGB slip, is reduced by working well with the LAGB, chewing well, not over-eating and not having the LAGB too tight.

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© Guy Slater