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 Realize Band
Company Apollo Endosurgery (Purchased from Allergan) Ethicon US, a Johnson & Johnson Company
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
  • 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)
Features LAP BAND AP
  • 360° fill capacity
  • Soft and molded (pre-curved)
  • 7 baffles (mini reservoirs)
  • Low pressure
  • Basal volume of 3-4cc's
  • 280-300° fill capacity
  • 6 baffles (mini reservoirs)
LAP BAND 9.75/10
  • 260-280° fill capacity
  • One single inner ring
  • 360° fill capacity
  • One smooth inner balloon
  • High-volume/Low-pressure
  • Launched April 2009 - Same technology as REALIZE Band but with streamlined design and an expanded adjustment range to accommodate larger patients.
  • Width of 23mm
  • 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
  • Yes
  • Yes
Fill Volume
  • AP Standard, 0-10cc
  • AP Large, 0-14cc
  • REALIZE Band, 9cc
  • REALIZE Band-C, 11cc
Access Port
  • 3 ports: Standard (14.7 mm), Rapidport EZ (11.6mm), 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 access port needle
  • Saline added/removed with special access port needle
Adjustment Schedule
  • Initial adjustment 6 weeks or more after placement
  • Patient reviewed every 4-6 weeks, fill may be indicated if less than 2 pound weight per week
  • First band adjustment about 1 week after begin to eat solid food (4-6 weeks after surgery)
  • No set adjustment schedule, based on weight loss
Weight Loss At 1 year:
  • range of 38-65% excess weight loss
At 5 years:
  • average of 60% 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
Patient Resources
  • Free e-mail program with information on LAP-BAND, weight loss tips, healthy lifestyle content.
  • Online support; diet and exercise tips, recipes, trackers, patient guide.
  • visit
  • call 1-800-LAP-BAND
  • visit
  • call 1-855-2-REALIZE (1-855-273-2549)

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 types of gastric bands and it is not known 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.