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THE NEXT STEP:  Treatment of Morbid Obesity

 

The medical treatment of morbid obesity has been shown to be ineffective for the majority of people. Studies have shown that greater than 90% of patients managed medically, and have lost weight, return to their original weight. Because there are a few patients that can lose weight and keep it off, medical management is always the first choice

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What are the criteria for surgery?

• BMI > 40 or BMI > 35 with co-morbid illnesses 

• History of failed weight loss on supervised weight reduction programs. 

• No substance abuse, psychoses, or uncontrolled depression

 

What are the attributes of an Ideal Bariatric Operation?

• Least invasive surgical option 

• Safe 

• Effective

– weight loss, improvement of co-morbid illnesses, improved quality of life 

• Effective over time 

• Low re-operation/revision rate 

• Minimal Side Effects 

• Adjustable 

• Reversible 

 

The Lap–Band System has all of these attributes.

The laparoscopic gastric band is an inflatable silicone band placed around the upper part of the stomach. It is designed to create a small pouch that holds less food, and induces a feeling of satiety.  The band is placed laparoscopically and is a same-day surgical procedure for most patients. 

 

What are the advantages of Laparoscopic Gastric Banding?

• 10 times safer that Gastric Bypass 

• Adjustable-customized per patient 

• Least invasive option 

• No stomach stapling, cutting, or intestinal re-routing 

• Reversible 

• Lowest operative complication rate-no leaks 

• Low malnutrition risk 

• Satiety-inducing procedure

 

What are the steps in the Lap-Banding Program?

• Patients must first register and attend a Laparoscopic Gastric Banding Informational Seminar. 

• Medical records are reviewed and if patient meets criteria necessary appointments are scheduled. 

• Upon approval, patient is scheduled for surgery. 

• Patients usually go home the same day of surgery and are seen 1 week after surgery then monthly for the first year. After the first year patients are seen at least quarterly. 

• Adjustments to the band are performed in the office on an individualized basis. Support groups are available

 

Summary: 

The Lap-Banding Program is a safer alternative to the more traditional and higher risk gastric bypass procedures commonly performed. The weight loss is more gradual but the end-point weight loss is similar. The close follow-up and adjustability of the band provides for individual weight loss and is the key to success. The reversibility is important for many people. Weight loss and better health because hunger is no longer a driving force in life. 

Proctored by: Jeff Allen, M.D.  Certified 12/2004 

Lap Band Certification Training - Chicago 02/2004 

Contemporary Bariatric Surgery Course 10/2005 

Member - American Society for Bariatric Surgery

 

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