The photo shows a standard LapBand made by Inamed Health. It consists of a ring of silicone which is placed around the very top of the stomach. On the inner surface of the ring is a balloon which is connected via a long thin tube to an access port which is buried deep under the skin just above and to the left of the umbilicus. If we pass a fine needle through the skin into the access port we can inject saline into the balloon causing it to swell up and thus tighten on the stomach wall. This will give the patient a sense of satiety or lack of hunger. Even if they have not been eating they will feel less hunger and less interest in food. If the band is adjusted optimally, there is almost no interest in food or appetite for eating. When they do eat they quickly get a sense of fullness and do not feel inclined to eat more. The net result is that they eat 3 or less very small meals per day and feel quite satisfied with that.

These four pictures show two of the Lap Band models – the 10cm band and the VG or Vanguard band. They show them without additional saline and with added saline so that you can see the effect of adding saline has on the space available in the middle.

• adjusting-the-lapband.mpg  (9Mb movie file)
• placing-the-lapband.mpg  (4.8Mb movie file)
• the-lap-band.mpg  (720k movie file)

These three graphics have been developed to help illustrate how the band works, how it is placed and how the adjustments work. To look at each, simply click on the image. Note that the Lap Band is placed laparoscopically – keyhole surgery. Thin tubes are passed through the skin into the abdominal cavity. A telescope is passed down one of these tubes. It has a very high definition camera attached and the surgeon can see what he is doing by looking at the image on a television monitor rather than looking directly inside the patient.

The adjustments are performed in the office and generally only take a few minutes. Apart from a quick jab of the needle through the skin there is no particular discomfort.