Lap-Band® and Adjustment Schedule

In June 2001, the Lap-Band® System (Allergan, Inc., Irvine, CA) became the first FDA-approved laparoscopic adjustable gastric band (LAGB) for patients 18 years and older in the United States. Indications for LAGB placement are the same for any bariatric procedure (BMI > 35 with one or more obesity-related comorbidity or BMI > 40). LAGB is a restrictive procedure in which an infl atable silicone band is placed around the upper part of the stomach. The band is placed just below the gastroesophageal junction and secured with sutures. The adjustment port is then tunneled through the abdominal wall and secured to the anterior abdominal wall fascia. The creation of a smaller stomach pouch results in restriction of the amount of food that can be consumed at one time. LAGB increases the time it takes for the stomach to empty. Weight loss is achieved by limiting food intake, reducing appetite, and slowing digestion. There are currently three Lap-Band sizes (Fig. 13.1) available in the United States: 9.75/10, VG, and the AP.