The Lap Band system is a restrictive weight loss option. The lap band is placed around the upper part of the stomach which creates a smaller stomach. This smaller stomach restricts the amount of food that can be eaten within a time span and ensures that it takes longer to empty the pouch since the band creates a small opening. Weight loss is achieved by eating less food.
Gastric bypass is a restrictive and malabsorbtion procedure. The stapling of the stomach creates a much smaller stomach that restricts the amount of food that can be eaten. However, a portion of the intestines is bypassed by stapling them to the smaller stomach. This results in the patient eating less and lower absorption of nutrients and calories.
The advantages the lap band has are that it is less invasive, reversible, adjustable and there is a low malnutrition risk. The advantages of gastric bypass are rapid initial weight loss, higher average weight loss, and it has been around longer so more is known.
The disadvantages of the lap band are slower initial weight loss, follow ups are required to be successful, band erosion, possible port revision if there is a malfunction and a foreign device is implanted in the body. The disadvantages of gastric bypass are stapling of the stomach, higher risk of complication, higher mortality rate, not adjustable, very difficult to reverse, nutritional deficiencies and dumping syndrome can occur.
Comparison of rates
Lap Band Gastric Bypass
Mortality: .05% .05%-2%
Total Complications 9% 23%
Major Complications .2% 2.1%
The cost of the lapband is typically cheaper averaging 17,500. The cost of gastric bypass averages to 22,500. The hospital stay with the band is typically under 24 hours while the bypass requires 48-72 hours. With the lap band most people can return to normal activity within one week with some physical restriction. With gastric it is about 2.5 weeks with some of the same physical restrictions.
Each person must decide what is important to them to choose between the two surgeries. If a less invasive procedure is important then you probably choose the band. If initial weight loss is more important then gastric bypass is probably what you want.