Stomach Stapling vs. Lap Band2018-09-04T16:22:42+00:00

Stomach Stapling vs. Lap Band

Stomach Stapling (Vertical Banded Gastrectomy)

A Lighter Me does not recommend the stomach stapling procedure. A gastric sleeve operation is more affordable and often has less complications.

Overview

Vertical banded gastrectomy is one of the oldest forms of surgery for weight loss. It is used to limit the amount of food that can be eaten. It does not alter any part of the digestive process, and none of the stomach is removed. During this procedure, the upper part of the stomach near the esophagus is stapled vertically. This creates a small pouch. The rest of the stomach is then banded, leaving a small opening at the bottom of the small pouch, which opens into the larger portion of the stomach. A mesh or plastic tissue is placed around the small opening to prevent stretching. This process is known as a restrictive surgery because it limits the amount of food that can be consumed at one time, which causes patients to feel fuller faster. After surgery, most meals must be limited to approximately one ounce. This surgery does not typically cause malnutrition or dumping syndrome. The entire procedure typically lasts between 3 and 4 hours. Vertical banded gastrectomy surgery is reversible, but the procedure to do so is quite complex.

Patient Eligibility

In general, candidates for this procedure will either have a BMI over 40 or a BMI between 35 and 40 plus weight-related health problems. Women who are 80 pounds over their goal weight and men who are 100 pounds over their goal weight are also good candidates for this surgery.

Average Weight Loss Results

On average, most patients are able to lose approximately 50 to 60 percent of their excess body weight after one year. Weight gain can happen easily if the patient does not adhere to consuming very small portions of food and drinks.

Recovery Time

If the surgery is performed laparoscopically, the patient will need to remain in the hospital for 2 or 3 days. If it is performed in an open surgery, then the hospital stay is longer, usually 4 or 5 days. Patients will initially need to follow a liquid diet and gradually move onto thicker liquids and soft foods. After about one month, most patients are able to eat solid foods and return to normal activities.

Common Side Effects

Patients may experience side effects such as reflux, stomal stenosis, incisional hernia, staple-line disruption, intolerance to the band, gastric leak, bleeding, fistulas, pulmonary embolus, and peritonitis. More commonly, side effects such as vomiting can occur if a strict diet is not followed, if food is not chewed properly, or if food is eaten too quickly.

Cost

The average cost of this procedure is $20,000 to $25,000. Insurance may cover a portion of the cost.\

References:
https://obesitynewstoday.com/vertical-banded-gastroplasty/
https://www.hopkinsmedicine.org/healthlibrary/test_procedures/gastroenterology/gastric_stapling_restrictive_surgery_procedure_92,p07989

Lap Band (Adjustable Gastric Band)

A Lighter Me does not recommend the lap band procedure. A gastric sleeve operation is more affordable and often provides better results.

Overview

Adjustable gastric band surgery is done laparoscopically. It is considered one of the least invasive weight loss surgeries. During the procedure, the surgeon makes small incisions in the upper abdomen and then places a soft silicone ring with an expandable balloon around the top of the stomach. The silicone ring, or band, creates a small stomach pouch, which causes the patient to feel full after eating only a small amount of food. The band is adjustable; fluid can be added to or removed from the balloon through a port that is placed under the skin. The reduction in the intake of food, due to the patient feeling fuller more quickly, can result in significant weight loss.

Patient Eligibility

Individuals who have certain stomach or intestinal disorders, take aspirin frequently, or are addicted to alcohol or drugs are not eligible for this procedure. This procedure is only performed on individuals who are 18 or older.

Average Weight Loss Results

Weight loss results vary widely based on patient motivation and compliance. On average, most patients lose approximately 40 to 60 percent of their excess body weight after this procedure. Initially, most patients can expect to lose about 2 or 3 pounds per week, and then their weight loss will drop to about one pound per week. Adjustments to the band can be made if necessary.

Recovery Time

Most people are able to return to work one week after the procedure, and they can resume normal activities after 6 weeks.

Common Side Effects

This procedure has a moderate risk of long-term complications. Between 15 and 60 percent of patients end up needing to have the procedure completed again due to implant malposition, erosion, frequent vomiting, or lack of weight loss. Common side effects include nausea, vomiting, constipation, indigestion, ulceration at the band site, dehydration, and weight regain.

Cost

The cost of this procedure varies, but on average it costs approximately $3,500 with insurance and $15,000 without insurance.

References:
https://www.medicinenet.com/lap_band_surgery_gastric_banding/article.htm#who_are_candidates_for_the_lap_band_system
https://www.hopkinsmedicine.org/healthlibrary/test_procedures/gastroenterology/laparoscopic_adjustable_gastric_banding_135,63