Last Updated October 30th, 2023
What is a laparoscopic adjustable gastric band?
A laparoscopic adjustable gastric band (LAGB) is a weight-loss or bariatric procedure.
Your surgeon will probably recommend a LAP-Band procedure if you have used other methods to lose weight such as dieting and exercise and they have failed.
During a LAGB surgery, the surgeon will place a restrictive band (silicone ring) around your upper stomach. This creates a small pouch with a narrow opening to the lower stomach.
The surgeon will also place an access port that is linked to the band under the skin. A restrictive band retains food in your upper stomach for longer. That means your stomach feels full more quickly.
You will have regular appointments with your surgeon to allow him to adjust the band as may be necessary. In case the band is very tight, this can cause nausea, vomiting, and reflux.
A loose band is not effective because it means you will end up eating more than is necessary. Your surgeon will regularly adjust the band until the ideal fit level is attained.
Why you might need LAGB
LAGB is most suitable for severely obese individuals. These are people who have a body mass index (BMI) above 40.
Unlike other bariatric surgeries, LAGB is less invasive. The procedure also has the lowest post-surgical complications because it does not involve dividing the intensities or stomach.
With LAGB surgery, however, it means you will have more follow-up appointments with your surgeon to adjust the band, partially in the first 12 months.
The weight loss achievable through LAGB is also less compared to other bariatric surgeries.
Preparing for LAGB
Before LAGB, your healthcare provider will make sure you have met certain specific requirements.
A team of bariatric specialists will work with you to make sure you have met the following requirements:
- You are at least 18 years old
- You should not be pregnant
- Your obesity should not have been caused by an underlying health issue
- There must be evidence of you trying to lose weight through other ways like dieting or exercise with no success
- You should be ready to make drastic changes to your lifestyle, including dietary modification
- You will be assessed to determine that you are physically and emotionally prepared for LAGB
- Your BMI should be within a specific range that is above 40 or between 35 and 40 with a preexisting chronic health condition like type 2 diabetes or high blood pressure
The bariatric specialist team will enroll you in an education program so that you are prepared mentally for life after this procedure.
During the bariatric surgery education program, you will receive nutritional counseling. The bariatric team will also conduct a psychological assessment to make sure you are prepared for the surgery.
The bariatric surgeon will also order the following tests:
- Physical exams
- Blood tests
Your surgeon may also order imaging tests such as an upper endoscopy.
During the bariatric surgery education program, patients who smoke will get the help that they need to quit the habit a few months before the procedure.
You will also be encouraged to shed some weight before LAGB. Losing weight reduces the size of your liver. It contributes to safer surgery.
If you have been taking blood-thinning medication, aspirin, or ibuprofen, your surgeon will ask you to stop a few days before the procedure.
Your surgeon will ask you to fast after midnight before LAGB.
Before LAGB, your surgeon will request you to sign a consent form that gives the bariatric team the go-ahead for surgery.
Make sure you have read the consent form carefully. If anything is not clear, ask the surgical team to explain it to you. Only sign the form once you are content.
LAGB is a quick procedure that takes between 30 and 60 minutes.
LAGB is administered under general anesthesia. The anesthesia will put you to sleep throughout the procedure.
You will also not feel pain during the LAGB surgery.
The surgeon makes several small incisions into your upper abdomen. These incisions allow the surgeon to insert the surgical instruments, including a laparoscope.
Your surgeon inserts an adjustable gastric band around your upper stomach, separating it from the lower section.
The surgeon creates a small pouch by tightening the adjustable gastric band.
The surgeon will attach the gastric band to a small plastic tube that runs along the length of your skin and is attached to a port.
Once the procedure is complete, your surgeon can access this port using a special fine needle. He can then extract or inject fluid into the port as may be required.
If you are suffering from a hiatal hernia, your surgeon can decide to correct it as well as part of your LAGB surgery
You will be allowed to go home on the same day of the LAGB procedure.
During the first two weeks after LAGB, you will be asked to stick to a liquid diet.
Your nutritionist/dietician will give you a list of the kinds of meals you should be eating during this period.
You will start with liquids, then pureed foods before slowly graduating to soft foods, and finally, regular foods.
You will be cautioned to ensure the portion sizes of your meals remain very small. Make sure you eat slowly and chew each bite thoroughly.
Avoid moving to regular food too fast as it can induce vomiting and pain. Liaise with your bariatric team to identify a diet plan that works for you.
After LAGB, you may not get sufficient minerals and vitamins from your meals.
Your food intake will have reduced considerably, and that means a reduction in the level of nutrients getting absorbed. For that reason, your surgeon will put you daily multivitamin.
Your surgeon can also prescribe vitamin D and calcium supplements. In case the medical team determines that you need extra nutrients like iron or vitamin B-12, these will be prescribed to you as well.
You will experience changes in your bowel habits including constipation and diarrhea. Talk to your surgeon about the changes that you may experience and what to do about it.
You will require regular appointments with your surgeon in the first 12 months after surgery. During such appointments, your doctor will order blood tests to check for blood glucose, iron, vitamin D, and calcium levels.
In case of heartburn, your surgeon will recommend medication to minimize stomach acid.
Some people who have had LAGB procedure regain the lost weight. To avoid this, you will need to be very disciplined by partaking in regular exercise and observing a healthy diet.
In case the gastric pouch dilates over time, you will feel like eating more food. Regular adjusting of the gastric pouch helps to correct this problem.
Benefits of LAGB
- LAGB carries a reduced risk of developing complications after the procedure
- LAGB does not divide your intestines or stomach
- The gastric band can be removed if need be
- The procedure may be customized to fulfill your individual health needs
- There is no need to open up your gastrointestinal tract thus minimizing the risk of infection
- The procedure is widely applied and suitable for individuals of different ages and physical conditions
Risks and Complications
LAGB surgery carries the following risks:
- Breathing problems
- Blood loss
- Allergic reactions to anesthesia
- Infection of the lungs, incision site, or bladder
- Blood clots in the legs
LAGB surgery may also present with the following complications:
With a gastric band, your intake of fluids is limited. It is also difficult to hold sufficient fluids in your stomach all at once. This can cause constipation.
Nausea and vomiting
You will experience these symptoms a few days after the procedure. It will resolve after some time as you get used to new ways of eating.
You may experience a port malfunction. Your surgeon may not easily access the port from outside because it got dislodged from the initial position.
A leaking tube o port means your surgeon can not fill the gastric band. There is also the risk of the port protruding on the skin especially if you lose a lot of weight drastically. Such malfunctions will necessitate port replacement or fixing.
If the band is too tight, you will have problems swallowing the food. This can be remedied by eating slowly and chewing your food.
Loosening the band is also helpful. If these practices do not resolve the problem, this may be a sign of band intolerance.
In case the band slips from its secured position, the stomach pouch increases in size. This can trigger reflux or stomach necrosis. When this happens, your stomach tissue begins to die. Band slippage calls for an emergency procedure to relieve the band.
If the band is too tight, this can lead to heartburn through acid reflux. Band loosening will stop the gastroesophageal acid reflux but may affect weight loss.
If not addressed, acid reflux may lead to acid erosion on the walls of your esophagus. Your surgeon will prescribe medication to treat acid reflux. If it is a severe case of acid reflux, it may be necessary to have the gastric band removed.
Some people will experience discomfort or persistent nausea after LAGB surgery. This is because their bodies adversely react to the band which is treated as a foreign implant. With such reactions, your surgeon will recommend another procedure to remove the band.
Cost of LAGB in India
The cost of LAGB in India ranges from Rs. 2,80,000 and Rs. 4,40,000 depending on various factors:
Elderly patients are more likely to present with complications during the procedure. In addition, they are more likely to have chronic conditions such as type 2 diabetes and heart diseases that increase their risk for LAGB.
Type of hospital
Private hospitals will charge more for LAGB compared to government hospitals. This is because public hospitals receive financial assistance from the government and this will reduce their operational costs.
In case of post-surgical complications such as band intolerance or problems with the port, you may have to undergo another procedure to correct the problem. This also affects the cost of surgery.
The fee that your surgeon charges will depend on their years of experience and skill level. If they are more experienced and skilled in administering LAGB, you will probably pay more.
Room category opted
If you choose a shared recovery room, you will pay less compared to someone who opts for a deluxe room.
Why choose India for your LAGB surgery?
The cost of LAGB in India is a fraction of what you would pay in any Western country where this surgery is offered.
In the United States, for example, it costs between 10,800 USD and 25,000 USD for the same procedure.
If you choose to have LAGB in Mexico, you will pay about $ 5,250.
As an international patient, you will benefit from:
- Access to a large pool of skilled and experienced surgeons
- Many clinics and healthcare facilities that have invested in state-of-the-art equipment for administering LAGB
- Significant cost reductions for the procedure
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