Laparoscopic Adjustable Gastric Banding (LAGB)

ROBOTIC, LAPAROSCOPIC ADJUSTABLE GASTRIC BANDING (LAGB)

– Once popular for the treatment of severe obesity and severe diabetes, it became outdated and numbers declined worldwide because of less efficacy and availability of better surgeries.

– Procedure:

  1. Performed by robotic or laparoscopic method (By putting small holes over the tummy) using advanced high quality imported laparoscopic equipment and instruments.
  2. An inflatable silicon band is wrapped around the upper part of the stomach.
  3. Capacity of stomach above this band will be < 20 ml.
  4. Individuals can’t take large quantity of food at a time.
  5. This band has a balloon which is connected through a tube to an access port fixed outside abdominal muscles.
  6. By injecting or withdrawing saline from the access port, opening between the pouch and remaining stomach can be adjusted there by controlling the food intake.

– In India and Asia,

  1. Individuals suffering from severe obesity with the body mass index is ≥ 32.5 kg/m2 with co-morbid medical conditions such as type 2 diabetes.
  2. Individuals suffering from severe obesity with the body mass index is ≥ 37.5 kg/m2 even without any co-morbid medical conditions.

– In Western countries

  1. Individuals suffering from severe obesity with the body mass index is ≥ 35 kg/m2 with co-morbid medical conditions such as type 2 diabetes.
  2. Individuals suffering from severe obesity with the body mass index is ≥ 40 kg/m2 even without any co-morbid medical conditions.

– Gastric banding is purely a restrictive procedure.

– It acts mainly by limiting calorie intake.

– Physiological changes responsible for weight loss after gastric banding are negligible unlike other bariatric and metabolic surgeries.

– Average excess weight loss is < 50%.

– Some may lose above average, even 100% of the excess weight loss but that number is less.

– For Example – If you are 50 kg excess weight, you lose approximately < 25 kg on average. Some may lose all the extra 50 kg but that number is less.

– Generally if your weight burden is less, you lose more percentage of excess weight and if your weight burden is more you lose less percentage of excess weight.

– Total weight loss percentage is ~ 15 to 20%.

– Average diabetes remission < 50%.

– It is necessary to follow lifestyle modifications to improve weight loss and diabetes remission and to prevent weight regain and diabetes recurrence.

– It is easy to perform.

– Complications are few

– Hospital stay is short (less than 1 day).

– Since there are negligible physiological changes after LAGB, weight loss and diabetes remission are inadequate.

– Weight regain chances are very high.

– Majority of patients want to get band removed because of intolerance and increased hunger.

– There is a need for regular visits to the doctor for repeated adjustments of the band.

– After this operation food intolerance, band slippage, band erosion, pouch dilatation or gastric prolapse can occur.

– It is very very safe procedure.

– It is a life saving surgery.

– Severe obesity and severe diabetes are dangerous.

– Bariatric and Metabolic surgeries are very safe.

– Complications are very rare. Even if they occur, they can be rectified.

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