Lap Band vs Gastric Sleeve: Which is Better?

Facing the challenges of obesity can feel overwhelming, especially when the stakes are your health and quality of life. Being significantly overweight puts you at greater risk of developing chronic conditions like heart disease, type 2 diabetes, sleep apnea, joint pain, depression, and more.

These risks can be significantly reduced or even eliminated with the right obesity treatment. Bariatric surgery offers an effective way to lose a significant amount of weight quickly, leading to better self-esteem, improved overall health, and increased quality of life.

If you are considering your weight loss options for the first time, you may be wondering about the differences between LAP-Band and gastric sleeve surgeries. Here’s what you should know about these weight loss procedures, their pros and cons, and a non-surgical alternative that may be a better fit.

Understanding Lap Band vs Gastric Sleeve

Lap band and gastric sleeve are surgical options for treating obesity and reducing the risk of obesity-related health conditions. Both procedures involve reducing the size of the stomach to hold less food, thereby limiting calorie intake and promoting weight loss. 

While both procedures have the same goal, the surgeries themselves - and the results - are quite different. Gastric sleeve surgery involves the removal of up to 75% of the stomach, while lap band involves the placement of an inflatable band around the upper portion of the stomach. 

What Is Lap Band?

Laparoscopic gastric banding surgery, commonly called LAP-Band surgery, is a surgical procedure that involves the placement of an inflatable band around the top portion of the stomach to restrict food consumption and help with weight loss. The band is placed laparoscopically under general anesthesia.

The band constricts the stomach opening, requiring the patient to eat less, resulting in reduced calorie intake and weight loss. The surgery was first performed in 1993 and became very popular. 

However, the number of lap band procedures has steadily decreased since 2011, dropping from almost 56,000 in 2011 to 2,393 in 2020. By 2019, it accounted for less than 1% of weight loss surgeries performed in the US. 

Why Has Lap Band Lost Popularity?

Some reasons for the dramatic decline in LAP-Band procedures include:

• Inconsistent Results: The surgery has had successes, with some patients experiencing 15% weight loss. However, the results have been inconsistent. Forty percent of patients have the lap band removed within 10 years, and they tend to gain back the weight they have lost.

• Higher Risk of Complications: Patients often experience complications after the procedure, including severe food intolerance, vomiting, difficulty swallowing, and acid reflux. Esophageal dilation, or stretching of the tissues in the esophagus, can also occur, preventing food from passing through the esophagus properly. 

  Band erosion or deterioration is also possible, and become infected if left unaddressed. Gastric prolapse, also known as “band slippage,” is another risk, which happens when the lap band slides down the stomach, creating a pouch above the band and leading to severe pain and nausea. 

  Complications after LAP-Band surgery can sometimes be corrected by revising the surgery or deflating the band, but band removal may be necessary in severe cases.

• Failure to Achieve Satisfactory Weight Loss: The surgery often leads to less weight loss than other bariatric procedures, with 31% of patients failing to achieve satisfactory weight loss.

  Many patients also struggle to keep the weight off afterward. According to a 2017 study, 20% of lap band patients require an additional procedure to achieve their desired weight loss, compared to 3-9% for gastric bypass and gastric sleeve surgeries.

  This is partly due to the fact that the band doesn’t trigger the same physiological or hormonal changes that other gastric surgeries do. Patients still feel just as hungry, even though they can’t eat as much food, greatly increasing the risk of developing eating disorders.

• Extensive Follow-Up Care: Lap band requires frequent follow-up visits and adjustments, especially in the first year. Of course, active management and follow up care is recommended after any procedure, but it’s important to know that lap-band requires a more intense follow-up regimen.

How Does Gastric Sleeve Compare?

Vertical sleeve gastrectomy, commonly called gastric sleeve surgery, involves the permanent removal of a significant portion of the stomach. The stomach is sutured into a smaller, sleeve-like shape, thereby reducing the amount of food that patients can eat at one time.

It also triggers hormonal changes that suppress hunger. As a result, patients feel fuller faster and eat less, which can lead to rapid weight loss, healthier lifestyle habits, and improved health. Gastric sleeve has a lower risk of complications compared to lap band and a much higher success rate.

Gastric sleeve accounted for 57% of surgery procedures performed in the US in 2022. Patients who undergo the procedure can expect to lose about 23% of their body weight, and they tend to keep it off more effectively. It triggers positive changes in your gut hormones, leading to increased satiety and reduced appetite.

However, it’s important to note that while gastric sleeve surgery can be revised, it is irreversible. You must have a BMI of 40 or higher to qualify, or a BMI of 35 or higher with certain health conditions. Gastric sleeve surgery also requires a short hospital stay, a longer recovery period, and comes with its own set of potential complications and regrets.

Gastric sleeve has also been linked to a higher risk of acid reflux, which could increase the risk of esophageal cancer. This may account for its decrease in popularity in recent years.

Is There a Non-Surgical Alternative to Lap Band and Gastric Sleeve?

ESG Stomach Tightening, or Endoscopic Sleeve Gastroplasty, is a non-invasive weight loss procedure that has some significant advantages over Lap Band and Gastric Sleeve.

• ESG is Effective: Patients who undergo ESG Stomach Tightening experience 18% weight loss within the first year. Many patients also experience significant improvement or resolution in obesity-related conditions like hypertension, type 2 diabetes, and hyperlipidemia.

• ESG is Non-Invasive: ESG doesn’t require incisions or cutting into the stomach. Instead, an endoscope is inserted through the mouth with specialized tools attached. It is used to suture the front and back walls of the stomach together, reducing its size by about 70%.

  Patients can usually go home the same day of the procedure and return to work within a day or two. They can also return to their normal exercise routine in just a few days, further supporting weight loss and a healthy lifestyle.

• ESG is Reversible: Because ESG doesn’t require permanent alterations to the anatomy, it can be reversed if you’re not seeing the results you expected or unexpected complications arise.

• ESG is Less Expensive: ESG is a non-surgical procedure that’s performed on an outpatient basis. The simplicity of the procedure and lack of hospital stay mean it is significantly less expensive than traditional bariatric surgeries like LAP-Band and Gastric Sleeve.

• ESG Has Fewer Complications: ESG is performed endoscopically, eliminating the need for incisions. It is also less traumatic on the body since there’s no removal of tissue. This results in a much lower risk of complications, including bleeding, infections, gastroesophageal reflux disease (GERD), nausea, and vomiting.

Which Weight Loss Procedure is Right for You?

The right weight loss procedure can be life changing for managing obesity and improving your overall health and quality of life. While LAP-Band has fallen out of favor, there are better options available for patients who need to lose large amounts of weight quickly to manage chronic health conditions.

At Bariendo, we specialize in long-lasting, non-surgical weight loss procedures performed by world-class doctors. Book a free consultation to explore your options and start your journey to better health today!