Candidates tend to have a BMI over 40, or a BMI between 35 and 40 also with accompanying diseases such as diabetes, sleep apnea, cardiomyopathy (heart damage) or severe joint degeneration and pain. They should have a long record of failed previous non-surgical weight loss interventions (diet, exercise) before considering the gastric lap band.
Patients who have current drug and alcohol abuse, a history of binge eating, untreated major depression or psychosis, severe cardiac disease, or disorders that interfere with healing such as blood clot disorders are not good candidates for the gastric lap band. Gastric lap band surgery should not be considered a first-line option for weight loss and should be considered only after exhausting non-surgical weight loss options.
You may be asked to change your diet, lose or maintain a stable weight, or alter your dietary habits (e.g. eating smaller meals throughout the day) before surgery. This increases the probability of successful, sustained weight loss after the surgery. Like other surgeries, gastric lap band may require you to undergo certain general surgery procedures such as preoperative blood testing, medications, and cessation of smoking or use of pain relievers and anti-inflammatory drugs.
Recovery is a slow and gradual healing and readjustment process as you learn how to eat smaller portions of food. Pain in the first 2-3 days after surgery in the upper left part of the abdomen is common, but can be managed with pain relievers. Pain should be minimal to nonexistent by 2-3 weeks after the surgery. Although light walking is suggested soon after surgery, strenuous exercise should be avoided for the first few weeks.
Patients should stick to an all-liquid diet for the first week, before gradually easing onto soft foods and eventually back to a normal diet. However, portion sizes should be heavily restricted and patients should eat slowly so they can properly gauge their satiety and fullness. Lifestyle changes implemented before the surgery should be maintained in the long run as patients adjust to eating smaller portions.
As with any surgery, there are risks of complications related to infection or the potential of adverse reactions to anesthesia, such as deep vein thrombosis or pulmonary embolism. Scarring will occur, as with all surgical procedures.
Gastric lap bands carry risks of their own, such as obstruction, band slippage, access port problems, gastroesophageal reflux disease (GERD), esophageal dilation, and poor nutrition due to restriction of food intake. These issues are relatively rare, but can result in infection, lowered quality of life, or need for revision surgery (removal or replacement of lap band). However, gastric lap bands are considered among the most non-invasive methods of achieving weight loss through surgery.