LAP-BAND® Vs Gastric Bypass - All You Need to Know

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The most important takeaways when evaluating LAP-BAND® vs gastric bypass include:

  • How they work: Both make you feel full sooner while eating. Only bypass reduces the amount of minerals you absorb. Only LAP-BAND® (i) requires initial and ongoing adjustment by your surgeon and (ii) is reversible.
  • Qualify: Same requirements (30+ BMI with health problems, 40+ without)
  • Hospital & recovery: LAP-BAND® is a less complicated procedure with a shorter operating time and shorter hospital stay. In-hospital and post-op recovery is similar.
  • Weight loss & health improvement: Gastric bypass results in faster and more short- and long-term weight loss.
  • Insurance: Same (if your policy covers bariatric surgery, both bypass and band will be covered)
  • Cost: Same with insurance, bypass is about $9,000 more expensive without insurance.
  • Diet & life after: Similar diet and exercise regimen. Bypass requires more stringent vitamin/mineral observation and supplementation.
  • Complications & side effects: Both have a 99.8+% survival rate. Bypass has a higher risk of short-term complications. Band has a higher risk of long-term complications.
Lap Band vs Gastric Bypass

Read and click the sections below for everything you need to know to decide which procedure is best for you.

Lap Band vs Gastric Bypass

Understanding gastric bypass surgery vs LAP-BAND® surgery starts with the fundamental differences in how each procedure impacts your digestive system:

Gastric Bypass

Gastric Bypass

Why Gastric Bypass Works

  • Reduced stomach size makes the patient feel full sooner after eating
  • Rearranged intestines causes the body to absorb fewer minerals
  • Dumping syndrome symptoms deter patients from eating unhealthy foods

How Gastric Bypass Is Performed

Gastric bypass, also called Roux-en-Y gastric bypass or RNY for short, is performed using the following steps:

  1. Cut and staple the top portion of the stomach to create a small pouch at the end of the esophagus
  2. Leave the remainder of the stomach attached to the top of the small intestines
  3. Go further down the small intestine, cut it, and attach it to the pouch
  4. Take the end of the small intestine that is still connected with the non-pouch portion of the stomach and attach it to the bottom of the “Roux limb.” This allows the digestive juices produced by the stomach to “meet up” with the food in the intestines.

LAP-BAND®

Lap Bnad

Why LAP-BAND® Surgery Works

  • A band wraps around and squeezes a narrow section in the upper-middle part of the stomach. This creates a smaller stomach “section” above the band which fills up quicker after eating, causing the patient to feel full sooner and eat less.

How LAP-BAND® Surgery Is Performed

The LAP-BAND®, also called the gastric band or laparoscopic adjustable gastric band, has been used in Europe since the 90’s but wasn’t approved by the FDA in the States until 2001.

The gastric band surgery procedure involves the sewing of a silicone and Silastic band around the top of the stomach. A balloon around the inner surface of the band (imagine the inside of a bicycle tire) is connected to a tube that leads to a half-dollar-sized port above the abdominal muscles but below the skin.

During follow up visits, your doctor will add or remove saline solution (salt water) to make it tighter or looser. The tighter it is, the less hungry you feel and vice-versa.

The procedure is also fully reversible (unlike gastric bypass).

Lap Band vs Gastric Bypass

Patients lose weight quickly after both gastric sleeve and LAP-BAND®. However, gastric sleeve patients:

  • Tend to lose weight faster
  • Tend to reach a lower “low weight” than band patients
  • Tend to gain back more weight over the long-term (bringing sleeve weight loss back in-line with LAP-BAND® weight loss by year 5)

The below chart compares average weight loss over time for each procedure:

Timeframe
Timeframe
3 months
3 months
6 months
6 months
1 Year
1 Year
2 Years
2 Years
3 Years
3 Years
5 Years
5 Years
Timeframe
% of Excess Weight You’ll Lose with Gastric Bypass
3 months
30%
6 months
50%
1 Year
65%
2 Years
60%
3 Years
60%
5 Years
60%
Timeframe
% of Excess Weight You’ll Lose with LAP-BAND®
3 months
20%
6 months
30%
1 Year
40%
2 Years
55%
3 Years
55%
5 Years
55%

Example

For for a person who is 5 feet, 7 inches tall and 250 lbs, following is the amount of average expected weight loss for each procedure:

Timeframe
Timeframe
3 months
3 months
6 months
6 months
1 Year
1 Year
2 Years
2 Years
3 Years
3 Years
5 Years
5 Years
Timeframe
Gastric Bypass: Total Expected Weight Loss for 5’7”, 250 lb patient
3 months
28 lbs
6 months
46 lbs
1 Year
60 lbs
2 Years
55 lbs
3 Years
55 lbs
5 Years
55 lbs
Timeframe
LAP-BAND®: Total Expected Weight Loss for 5’7”, 250 lb patient
3 months
18 lbs
6 months
28 lbs
1 Year
37 lbs
2 Years
51 lbs
3 Years
51 lbs
5 Years
51 lbs
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Lap Band vs Gastric Bypass

Studies evaluating LAP-BAND® vs gastric bypass surgery have found very similar health improvement for diabetes, hypertension, sleep apnea, and most other obesity-related health problems, depending on which study is referenced.

These surgeries can improve joint health. For every pound of weight lost, there is a 4 pound reduction in pressure on the knee joint (8). This improves mobility and reduces pain in the knees.

Both surgeries were part of research on cancer that included over 88,000 participants. Patients who undergo weight loss surgery have 33% less risk of developing cancer (9).

Risk rates were even further reduced for obesity-related cancers, including (10):

  • Colon cancer
  • Postmenopausal breast cancer
  • Endometrial cancer
  • Pancreatic cancer

The chart below compares study results by condition for each procedure:

Co-morbidity
Co-morbidity
Dyslipidemia hyperchole­sterolemia
Dyslipidemia hyperchole­sterolemia
Diabetes
Diabetes
Hyperli­pidemia (high levels of fat in the blood, high cholesterol)
Hyperli­pidemia (high levels of fat in the blood, high cholesterol)
High Blood Pressure (hyper­tension)
High Blood Pressure (hyper­tension)
Joint/Bone Disease (osteoar­thropathy)
Joint/Bone Disease (osteoar­thropathy)
Depression
Depression
Migraines
Migraines
Pseudo­tumor cerebri
Pseudo­tumor cerebri
Cardiova­scular Disease
Cardiova­scular Disease
Venous Stasis Disease
Venous Stasis Disease
Gastroeso­phageal Reflux Disease (GERD)
Gastroeso­phageal Reflux Disease (GERD)
Non-Alcoholic Fatty Liver Disease
Non-Alcoholic Fatty Liver Disease
Mortality Reduction/ Life Expectancy (5 year mortality)
Mortality Reduction/ Life Expectancy (5 year mortality)
Quality of Life Improve­ments
Quality of Life Improve­ments
Metabolic Syndrome
Metabolic Syndrome
Polycystic Ovarian Syndrome
Polycystic Ovarian Syndrome
Pregnancy
Pregnancy
Asthma
Asthma
Obstructive Sleep Apnea
Obstructive Sleep Apnea
Stress Urinary Inconti­nence
Stress Urinary Incontinence
Co-morbidity
Bypass % Improved /Resolved
Dyslipidemia hypercholesterolemia
63%
Diabetes
83%
Hyperlipidemia (high levels of fat in the blood, high cholesterol)
73%
High Blood Pressure (hypertension)
69%
Joint/Bone Disease (osteoarthropathy)
43%
Depression
Most
Migraines
57%
Pseudotumor cerebri
96%
Cardiovascular Disease
79%
Venous Stasis Disease
95%
Gastroesophageal Reflux Disease (GERD)
80%
Non-Alcoholic Fatty Liver Disease
90%
Mortality Reduction/Life Expectancy (5 year mortality)
89%
Quality of Life Improvements
95%
Metabolic Syndrome
80%
Polycystic Ovarian Syndrome
Most
Pregnancy
Most
Asthma
80%
Obstructive Sleep Apnea
98%
Stress Urinary Incontinence
88%
Co-morbidity
Band % Improved /Resolved
Dyslipidemia hypercholesterolemia
70%
Diabetes
60%
Hyperlipidemia (high levels of fat in the blood, high cholesterol)
23%
High Blood Pressure (hypertension)
43%
Joint/Bone Disease (osteoarthropathy)
81%
Depression
57%
Migraines
Some
Pseudotumor cerebri
Most
Cardiovascular Disease
73%
Venous Stasis Disease
Gastroesophageal Reflux Disease (GERD)
87%
Non-Alcoholic Fatty Liver Disease
Most
Mortality Reduction/Life Expectancy (5 year mortality)
89%
Quality of Life Improvements
Most
Metabolic Syndrome
78%
Polycystic Ovarian Syndrome
48%
Pregnancy
Most
Asthma
82%
Obstructive Sleep Apnea
85%
Stress Urinary Incontinence
82%
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In order to have LAP-BAND® surgery or gastric bypass surgery, your body mass index (BMI) must fall within one of the following ranges:

  • Body mass index 40 or above or
  • Body mass index from 35 to 40 as long as you have a serious obesity-related health problem (“comorbidity”) such as diabetes, asthma, hypertension, joint problems, sleep apnea, or one of many others.
  • Body mass index from 30 to 35 may be accepted if certain health issues are present

Use the BMI Calculator above to determine your body mass index.