LAP-BAND vs. REALIZE Adjustable Band

Laparoscopic Adjustable Gastric Banding (LAGB) is one of the most frequently performed types of weight loss surgery. This bariatric approach utilizes medical implants (gastric banding systems) to help patients achieve and maintain a healthier weight by limiting meal portions and reducing hunger sensations.

With LAGB, the body's anatomy is not altered. Gastric banding does not involve cutting or stapling of the stomach or intestinal re-routing as with gastric bypass surgery, the gastric sleeve procedure, and duodenal switch surgery. Gastric bands are implanted using minimally invasive methods of surgery, although conversion to open surgery may occur in rare situations. Once the gastric bands are placed in to the body, they can be adjusted to the patient's needs without additional surgery or removed if medically necessary.

There are currently only two LAGB systems approved for use in the United States - the LAP-BAND System and REALIZE Adjustable Gastric Band. Although there are differences in the construction of the gastric bands, both the LAP-BAND and REALIZE Band are considered safe and effective types of weight loss surgery.

Procedure	LAP-BAND System	REALIZE Adjustable Band
Manufacturer	Allergan	Ethicon Endo-Surgery, a division of Johnson & Johnson
Developed/First Used	1993 in Belgium	1985 in Sweden
Date First Marketed Outside USA	1994	1996
US Clinical Trials	Started in 1995	Started in 2003
Date Approved By US FDA	June 2001	September 2007
Surgery Method	Laparoscopic	Laparoscopic
Versions	The most current version is the LAP-BAND Advanced platform (AP) System, a new and improved version of the older LAP-BAND Systems. Three generations of improvements: 2007 - The LAP-BAND AP System 2004 - The LAP-BAND VG System 2001 - The 9.75/10 LAP-BAND System	The REALIZE Band is based on the technology of the Swedish Adjustable Gastric Band (SAGB), the original soft, low-pressure balloon design, with improvements to the gastric band locking mechanism and injection port technology. Three generations of improvements: 2009 - REALIZE Band-C 2007 - REALIZE Band 1996 - SAGB (Outside US)
Gastric Band	LAP BAND AP 360° fill capacity Soft and molded (pre-curved) 7 baffles (mini reservoirs) Low pressure Basal volume of 3-4cc's LAP BAND VG 280-300° fill capacity 6 baffles (mini reservoirs) LAP BAND 9.75/10 260-280° fill capacity One single inner ring	REALIZE Band 360° fill capacity One smooth inner balloon High-volume/Low-pressure REALIZE Band-C Launched April 2009 - Same technology as REALIZE Band but with streamlined design and an expanded adjustment range to accommodate larger patients. Width of 23mm
Product Features	Silicone elastomer structure and patented Omniform technology (soft, precurved, individual pillow-like sections); kink-resistant tubing.	Strong, flexible silicone structure with a wide and soft inner balloon; puncture-resistant protection near tubing connection; REALIZE injection port and port anchoring system.
Band Sizes	AP Standard AP Large	Both the REALIZE Band and REALIZE Band-C are One Size Fits All
Adjustable	Yes	Yes
Fill Volume	AP Standard, 10cc AP Large, 14cc VG, 10cc 9.75/10, 4cc	REALIZE Band 9cc REALIZE Band-C 11cc
Access Port	Two access ports: Standard (14.7 mm) and Low-profile (11.9 mm) Port anchored with stitches and/or mesh to muscle wall	Low-profile (1/2" or 11.6mm) Self-clamping system attaches port to muscle wall
Adjustment Method	Saline added/removed with special needle via port	Saline added/removed with special needle via port
First Adjustment	4-6 weeks after surgery	4-6 weeks after surgery
Approximate Adjustments	5-8, first two years	Average of 4, first year Average of 2, second year Average of 2, third year
Weight Loss	At 1 year: 40-50% excess weight loss At 5 years: 55% excess weight loss	At 3 years: 83% of patients lost 42.8% of their excess weight 35% of patients lost 50% of their excess weight 10.5% of patients lost 75% or more of their excess weight
Promotion	Free LAP-BAND® System Information Kit can be sent via mail delivery or by e-mail	REALIZE Patient Guide and Other Resources Available Free Online to Download, View, and Print
Patient Support Program	My LAP-BAND Journey
Website	www.lapband.com	www.realizeband.com

According to the results of a recently completed systematic review and meta-analysis comparing the LAP-BAND and REALIZE Band, the two LAGB systems showed basically equivalent excess weight loss, body mass index reduction, resolution of diabetes and hypertension, and rate of complications.

To date, there have been no side-by-side studies comparing the two newest bands and it is too early to determine if the differences significantly affect the long term results. Ultimately, it is likely that a patient's success will have more to do with their behavior than with the specific medical device.

Most bariatric surgeons consider the two systems to be comparable products and will often decide which band is best for the patient based on the patient's anatomy. Overall, bariatric patients in the United States will benefit from having two options for laparoscopic adjustable gastric banding and the ability to choose the system that is the best fit for them.

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