Alabama Bariatrics & Minimally Invasive Surgery

Bariatric Diet Orbera Gastric Band Sleeve Gastrectomy Gastric Bypass

W. Jay Suggs, MD, FACS, FASMBS
Madison, Huntsville, and Decatur
Phone: (256) 274-4523
Fax: (256) 203-8791

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There are a variety of different gastric bypass procedures. Some of these procedures involve stapling and removing parts of the stomach, and others require the use of an outside tool, such as a balloon in the stomach. However, the one the I am going to be covering is a relatively new and somewhat controversial procedure, the gastric lap band. It is one of the two main procedures that are offered in the Huntsville, Alabama area, and is covered by most insurers in comparison to other procedures. But just what is it, and is there a difference between a procedure done with an adjustable lap band as opposed to a nonadjustable one?

The History of the Lap Band

The first lap band was introduced as a concept by Dr. L.H. Wilkinson in 1976. Around the time when jaw wiring for weight loss was a thing, Dr. Wilkinson proposed the use of gastric wraps in his 1981 publication” Gastric (Reservoir) Reduction for Morbid Obesity”. He came up with the logic that it would be an alternative way to create a pouch in the stomach without causing things like dumping syndrome or other metabolic issues.

The initial testing of the procedure and its outcome was a success, since it greatly reduced the mortality rate of patient in comparison to other weight loss procedures, but there were still a few bumps in the road. There were mass difficulties that contributed to a high failure rate of the procedure. The band could slip, have leaks, and erode into the stomach lining. They were manageable, but it always required some sort of surgical intervention, costing patient and facilities excess time and money.

That was when it was suggested by a Ukrainian -American, Lyubomir Kuzmak, during the 1980’s, suggested that the band should be adjustable. This greatly reduced complication rates of patients and increased the weight loss post-op success. But it was still done through open surgery, increasing the risk of complication on the operating table, and slow recovery time for patients.

In the 1990’s Swedish doctor, Dag Hallberg, perfected the non-invasive laparoscopic approach to gastric bypass surgery. The laparoscopic technique only involved a few incisions that gave doctors enough access to the abdominal cavity with a decreased the effects of surgical pain and scarring. Once he perfected it, he instructed the use of the technique in several workshops.

That was how, Dr. Forsell, the person who owned the patent of the Swedish version of the adjustable lap band at the time, combined the adjustable lap band with the laparoscopic technique.

Since then different countries, doctors and hospitals have been performing the procedure all over the world, including Dr. Suggs, a gastric bypass surgeon in Huntsville, Alabama.

How is the band adjustable?

According to the Washington University School of Medicine, “The adjustable band is a hollow ring made of biocompatible materials (so the body adapts to it without being harmed) and is filled with saline, a salty solution that is much like other fluids in the body. The band controls the size of the opening between the two parts of the stomach.

 

Surgeons can adjust the size of the opening between the upper pouch and rest of the stomach by adding or removing saline from the ring. This process is called inflating or deflating.”

 

Who are Good Candidates for Adjustable Lap Band Surgery?

According to the mayo clinic, weight-loss surgery could be an option for you if:

·         Efforts to lose weight with diet and exercise have been unsuccessful

·         Your body mass index (BMI) is 40 or higher

·         Your BMI is 35 or more and you have a serious weight-related health problem, such as type 2 diabetes, high blood pressure or severe sleep apnea

·         You're a teenager who's gone through puberty, your BMI is 35 or more, and you have serious obesity-related health problems, such as type 2 diabetes or severe sleep apnea

·         I if your BMI is 30 to 34 and you have serious weight-related health problems.

But that only is the tip of the iceberg. You would still have to undergo dietary restrictions, exercise programs and psychological evaluations. If you have done those things successfully for about 3 months, then you are approved for surgery.

And all of that might not even be in the realm of possibility if you don’t have the financial resources or your insurance does not cover it. If the center you are considering getting your procedure done takes payment plans, like Dr. Suggs Clinic in Huntsville, Alabama, then maybe you might be able to get past the financial hurdle.

But the biggest hurdle of all would be you, the patient. If you are not compliant, complications are bound to happen. Remember,” gastric bands have been approved by the FDA and continue to pass rigorous post-approval safety and efficacy studies. However, if patients continue to overeat or fail to follow the indications of the device, it will not be effective. For this reason, patient compliance is critical to the success of the gastric band in obese patients”.