Adjustable Gastric Band Bariatric Surgery: What Is It And What Are Its Advantages? - Dr. Johnell

Dr. Johnell:
Many patients still don’t know that adjustable gastric bands exist. Adjustable gastric banding has been around for almost 20 years now in some form or another.

It was begun in the early to mid 1990s as experimental procedures. It was improved upon.

The laparoscopic procedure came into play and by the end of the 1990s and early 2000s, adjustable gastric banding procedures were being done all over this country in various programs.

They are laparoscopic operations, which mean these operations use minimally invasive techniques, small incisions, a camera and a scope to be able to do the operation on a video monitor that’s over the operating room table.

These operations continue to improve, ultimately became FDA-approved in 2001 and has grown tremendously over the years since then.

The first band that was FDA-approved in this country is the LAP-BAND® and the LAP-BAND® is commonly known now although it is a trademark name.

There is another band that became FDA-approved two years ago and that’s the REALIZE® Band.

Both of these bands function the same way. They are both very good quality products and we offer both of these bands to our patients.

What the bands do is actually provide restriction and create a small pouch in the upper part of the stomach. The band is placed in the upper part of the stomach.

And then depending upon how tight that band is we will determine how much restriction there is.

So in essence, it functions like a gastric bypass where it produces a little pouch and then when that pouch gets filled up with food the patient’s hunger goes away and they stop eating.

Depending upon how tight that band is will determine how quickly the food empties from that pouch into the rest of the stomach, and so that’s the key difference between the band and other procedures.

The band is adjustable – that’s the amazing aspect of the band that makes it different from any other operation.

The adjustability is unique and if you think that everybody is the same, well then give them all the same operation.

The thing about the band is that it is adjustable. So essentially it’s a different operation for every individual patient at any particular time.

Somebody comes in. They have an operation. We have patients who don’t even get an adjustment for the first several months because they have all the restriction they need with the initial operation.

We have other patients that come in and get adjustments right away and we get them up to speed quickly with their weight loss.

The adjustability is a very important aspect of how the band works and how well it works. There are other really key important differences as well, particularly in pregnant women.

Women that desire pregnancy after their bariatric surgical procedure often have higher risk when they have other operations, specifically malabsorptive procedures like the biliopancreatic diversion, or BPD as it is known, or the gastric bypass operation that is also malabsorbtive to various really important micronutrients.

The thing about the band is that it is not a malabsorptive procedure; it just provides restriction. However, when a patient gets pregnant one of the problems that they have is sometimes they gain weight too rapidly or they gain too much weight.

We can actually adjust the band so that we can prevent that excessive weight gain during their pregnancy.

Or if their obstetrician feels that they need to gain a little bit more weight to maintain a healthy pregnancy we can actually remove fluid from the band.

So we can actually tailor the band adjustments during the patient’s pregnancy so that it is as safe a pregnancy as possible with their bariatric procedure.

About Dr. Michael W. Johnell, M.D., F.A.C.S.:
Dr. Johnell is an advanced laparoscopic bariatric surgeon, specializing in the Adjustable Gastric Band procedure. Bariatric surgery constitutes 98 percent of his practice. He has 22 years of general surgery experience, 17 years of advanced laparoscopic surgery experience, and 7 years of laparoscopic bariatric surgery experience.

Tags:

• Bariatric Surgery