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LAP-BAND® System |
Gastric Bypass |
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| Description |
A
restrictive procedure, during which an inflatable band is placed around the upper part of the stomach. This creates a smaller stomach pouch, which restricts the amount of food that can be Consumed at one time and increases the time it takes for the stomach to empty. As a result, a
patient achieves sustained weight loss by limiting food intake, reducing appetite, and slowing digestion. |
A combination procedure that uses both restrictive and
malabsorptive
elements. First the stomach is stapled to make a smaller pouch. Then most of the stomach and part of the
intestines are bypassed
by attaching (usually
stapling) a part of the intestine to the small stomach pouch. As a result, a patient cannot eat as much and
absorbs fewer nutrients
and calories. |
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| Advantages |
* Lowest mortality rate1
* Least invasive surgical approach
* No stomach stapling or cutting, or intestinal re-routing
* Adjustable
* Reversible
* Lowest operative complication rate
* Low malnutrition risk
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* Rapid initial weight loss
* Minimally invasive approach is common
* Longer clinical experience in the U.S.
* Slightly higher total average weight loss reported than with purely restrictive procedures
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| Disadvantages |
* Slower initial weight loss
* Regular follow-up critical for optimal results
* Requires an implanted medical device
* In some cases, effectiveness can be reduced due to band slippage
* In some cases, the access port may leak and require minor revisional surgery
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* Cutting and stapling of stomach and bowel are required
* More operative complications
* Portion of digestive tract is bypassed, reducing absorption of essential nutrients
* Medical complications due to nutritional deficiencies
* "Dumping syndrome2" can occur
* Non-adjustable
* Extremely difficult to reverse
* Higher mortality rate
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| Results |
Although during the first year after surgery, weight loss with the gastric bypass is greater than with the LAP-BAND® System, surgeons report that at 5 years many LAP-BAND® and gastric bypass patients achieve comparable weight loss (55% for LAP-BAND® and 59% for Gastric Bypass). |
| Risks |
Mortality rate: 0.05%
Total complications: 9%
Major complications: 0.2%
Most common include:
* Standard risks associated with major surgery
* Nausea and vomiting
* Band slippage (minor revisional surgery)
* Band erosion (minor revisional surgery)
* Access port problems (minor revisional surgery)
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Mortality rate: 0.5-2%
Total complications: 23%
Major complications: 2.1%
Most common include:
* Standard risks associated with major surgery
* Nausea and vomiting
* Separation of stapled areas (major revisional surgery)
* Leaks from staple lines (major revisional surgery)
* Nutritional deficiencies
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| Costs and Insurance |
Generally speaking, both procedures will be covered by insurance, but check with your employer or your surgeons office for specific information about your policy. Costs of LAP-BAND® surgery and Gastric Bypass surgery will vary depending upon the site where the surgery occurs (in-patient or out-patient), the type of bypass procedure (laparoscopic or open) and how long you are required to stay in the hospital. One survey of cash prices for both procedures showed the average charge for a LAP-BAND® procedure of $17,500 while the average charge for a laparoscopic gastric bypass was $22,500. The survey did not find any program that offered a cash price for open gastric bypass. |
| Recovery Timeline |
* Hospital stay is usually less than 24 hours
* Most patients return to normal activity within 1 week
* Full surgical recovery usually occurs within about 2 weeks
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With a laparoscopic approach:
* Hospital stay is usually 48-72 hours
* Many patients return to normal activity within 2.5 weeks
* Full surgical recovery usually occurs within about 3 weeks
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1. Executive summary: Laparoscopic adjustable gastric banding for the treatment of obesity (Update and Re-appraisal). The Australian Safety and Efficacy Register of New Interventional Procedures - Surgical (ASERNIPS) 2002; 1. (Laparoscopic adjustable gastric banding surgery, like the LAP-BAND surgery, is associated with a mean short-term mortality rate of around 0.05% compared to 0.50% for Gastric Bypass and 0.31% for Vertical Banded Gastroplasty.)
2. “Dumping syndrome” is a physiological reaction frequently seen following gastric bypass surgery, which is designed to alter anatomy and interrupt normal digestion. Whenever patients eat foods such as sugar and sweets, they may experience symptoms of nausea, flushing and sweating, light-headedness, and watery diarrhea.
3. O’Brien P, Dixon J, LAP-BAND®: Outcomes and Results, J of Laparoend & Adv Surg Techniques, 13(4), 2003, 265-270.
4. Parikh M, Laker S, Weiner M, Hajiseyedjavadi O, Ren CJ, Objective Comparison of Complications Resulting from Laparoscopic Bariatric Procedures, J Am Coll Surg, 2006;202:252–261. For detailed LAP-BAND® System risk information, please visit the Risk Information page.
5. Fisher B. Comparison of Recovery Time after Open and Laparoscopic Gastric Bypass and Laparoscopic Adjustable Banding, Obes Surg, 14, 2004, 67-72.
Disclaimer:
As with any surgery, there are specific risks and possible complications associated with the LAP-BAND® System surgery. Talk to your doctor to determine if you are a candidate for the LAP-BAND® System.
M898-10 06/07
To receive more information on the LAP-Band® System or other weight-loss options offered by Tri-City Reigional Medical Center Bariatric Program please call
1-877-4OBESITY.
Weight-Loss Options • Comparison of Surgical Options • Obesity Defined |
