If you're thinking about undergoing weight loss surgery, it's not only an important medical decision but a significant financial decision too. Lap band surgery or adjustable gastric band procedure is usually used in dire circumstances and is performed with laparoscopic instruments, which means the surgery is minimally invasive and has a short time for recovery. The American company, INAMED Health, designed the BioEnterics LAP-BAND Adjustable Gastric Banding System, which was first introduced in Europe back in 1993.

Gastric banding, including the Lap Band procedure and weight loss system is usually indicated for people whose Body Mass Index is above 40. Or for those people who are 100 pounds (45 kg) or more over their estimated ideal weight according to the 1983 Metropolitan Life Insurance Tables (still used today). Or for those people between 30 to 40 who have co-morbidities (high blood pressure, diabetes, sleep apnea, arthritis), which may improve with weight loss. Those who are eligible to have it must be between ages 18 and 55 years, although there are doctors who will perform surgery outside these ages, some may be as young as 12. It should not be performed when severe cardiopulmonary diseases or other conditions are present, which make them poor candidates.

Inflammatory diseases of the g. i. tract like ulcers, esophagitis or Crohn's disease don't make a person a good candidate. In order to be considered one must have a good comprehension of the risks and benefits of the procedure and have a willingness to comply with the substantial lifelong dietary restrictions that are required for long term success.

Unlike people who have procedures such as the Roux-en-Y gastric bypass surgery, duodenal switch or biliopancreatic diversion surgery, it's unusual for gastric band patients to experience any nutritional deficiencies or malabsorption of their micro-nutrients. So as the upper part of the stomach perceives that it's full, the message to the brain is that the stomach is full and this sensation is what helps the person eat smaller portions and lose weight over time. Calcium supplements and Vitamin B12 injections are not usually required as they are with the Roux-en-Y and other types.

The adjustable gastric band or Lap Band is an inflatable silicone prosthetic device which is placed around the uppermost section of the stomach using the preferred keyhole laparoscopic surgery. The placement of the band creates a small pouch right at the top of the stomach which holds about 50 ml. The pouch 'fills' with food quickly and the passage of food from the top to the bottom of the stomach is quite slowed down. This surgery, unlike the traditional malabsorptive weight loss type (Roux-en-Y, biliopancreatic and duodenal switch) doesn't cut out or remove any part of the digestive system.

After surgery the patient should eat less, eat more slowly and chew food thoroughly. Initial weight loss is slower than with Roux-en-Y but statistics show that over five years the weight loss outcome is pretty much similar. Some patients may find that before their first 'fill' they're still able to eat large portions.

The band may remain deflated during pregnancy and once breast feeding or bottle-feeding is completed it may gradually be re-inflated to help with postpartum weight loss if necessary. Many physicians make the first adjustment between six to eight weeks following surgery to allow the stomach adequate time to heal. Then after that the fills are done as needed.

A common occurrence for patients is regurgitation of swallowed - acidic food from the upper pouch, which is commonly known as productive burping and is not normal. Other complications include ulceration and irritated stomach tissue.

On occasion, the narrow passage into the lower part of the stomach may become blocked by a large portion of food that is unchewed. Mechanical malfunctions can occur including port leakage, some cracking of the kink-resistant tubing or disruption of the tubing connection from the port to the band, pain at the port site and port displacement.

Lap band surgery and gastric banding if compared to other weight loss surgeries have shown a much lower mortality rate, the stomach returning to normal if the band is removed, there's no cutting or stapling of the stomach, the band is adjustable without additional surgery and there are no malabsorption issues because no intestines are bypassed. There are also fewer life threatening complications. And the psychological effects of any weight loss procedure also should not be ignored. Be aware that some people have died undergoing this surgery.