Saturday December 20, 2014
Increase in the Number of Weight Loss Surgeries
According to the American Society for Bariatric Surgery (ASBS), the number of weight loss surgeries performed in the United States increased from about 16,000 in 1992 to about 220,000 in 2008.

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
  Lap-Band Gastric Bypass
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.

Consumer Guide to WLS

Weight Loss Surgery

How Gastric Bands Work

Gastric banding involves wrapping an adjustable silicone band around the upper part of the stomach to create a small upper stomach pouch with a narrow opening to the lower stomach.

  • Smaller stomach pouch only holds about 1/2 cup of food, limiting food intake.
  • Narrowed food passage slows digestion, helping patients feel full faster and longer after eating a meal.

The band can be adjusted by adding or removing saline solution via an injection port that is placed within the patient.

Adjustments are made by the doctor during a quick, in-office visit. They are easily done by inserting a needle into the port, without additional surgery.

What is the Sweet Spot?

The "sweet spot" in adjustments is where the band is tight enough to keep solid food above the band for several hours after eating but loose enough for food to pass through.

Getting the appropriate band adjustment usually takes several adjustments and careful monitoring of weight loss progress because it takes different amounts of saline for each patient.

  • On average, weight loss surgery patients are able to achieve and maintain a long term weight reduction of 50% or more.
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