| Procedures |
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LAP-BAND® System
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Gastric Bypass
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| Description | A
restrictive procedure, during which an inflatable band is placed
around the upper part of the stomach. This creates a smaller stomach
pouch, which restricts the amount of food that can be consumed
at one time and increases the time it takes for the stomach to
empty. As a result, a patient achieves sustained weight loss by
limiting food intake, reducing appetite, and slowing digestion. |
A
combination procedure that uses both restrictive and malabsorptive
elements. First the stomach is stapled to make a smaller pouch.
Then most of the stomach and part of the intestines are bypassed
by attaching (usually stapling) a part of the intestine to the
small stomach pouch. As a result, a patient cannot eat as much
and absorbs fewer nutrients and calories. |
| Advantages | • Lowest
mortality rate1 • Least invasive surgical approach • No stomach stapling or cutting, or intestinal re-routing • Adjustable • Reversible • Lowest operative complication rate • Low malnutrition risk |
• Rapid
initial weight loss • Minimally invasive approach is common • Longer clinical experience in the U.S. • Slightly higher total average weight loss reported than with purely restrictive procedures |
| Disadvantages | • Slower
initial weight loss • Regular follow-up critical for optimal results • Requires an implanted medical device • In some cases, effectiveness can be reduced due to band slippage • In some cases, the access port may leak and require minor revisional surgery |
• Cutting
and stapling of stomach and bowel are required • More operative complications • Portion of digestive tract is bypassed, reducing absorption of essential nutrients • Medical complications due to nutritional deficiencies • "Dumping syndrome2" can occur • Non-adjustable • Extremely difficult to reverse • Higher mortality rate |
| Results | Although during the first year after surgery, weight loss
with the gastric bypass is greater than with the LAP-BAND® System,
surgeons report that at 5 years many LAP-BAND® and gastric bypass
patients achieve comparable weight loss (55% for LAP-BAND® and
59% for Gastric Bypass).3 |
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| Risks | Mortality rate: 0.05% Total complications: 9% Major complications: 0.2% Most common include: • Standard risks associated with major surgery • Nausea and vomiting • Band slippage (minor revisional surgery) • Band erosion (minor revisional surgery) • Access port problems (minor revisional surgery) |
Mortality rate: 0.5-2% Total complications: 23% Major complications: 2.1% Most common include: • Standard risks associated with major surgery • Nausea and vomiting • Separation of stapled areas (major revisional surgery) • Leaks from staple lines (major revisional surgery) • Nutritional deficiencies |
| Costs and Insurance |
Generally speaking, both procedures will be covered by insurance,
but check with your employer or your surgeons office for specific
information about your policy. Costs of LAP-BAND® surgery and
Gastric Bypass surgery will vary depending upon the site where
the surgery occurs (in-patient or out-patient), the type of bypass
procedure (laparoscopic or open) and how long you are required
to stay in the hospital. One survey of cash prices for both procedures
showed the average charge for a LAP-BAND® procedure of $17,500
while the average charge for a laparoscopic gastric bypass was
$22,500. The survey did not find any program that offered a cash
price for open gastric bypass. |
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| Recovery Timeline |
• Hospital
stay is usually less than 24 hours • Most patients return to normal activity within 1 week • Full surgical recovery usually occurs within about 2 weeks |
With
a laparoscopic approach: • Hospital stay is usually 48-72 hours • Many patients return to normal activity within 2.5 weeks • Full surgical recovery usually occurs within about 3 weeks |
