Adjustable gastric banding (AGB), often known as the “lap band,” was once one of the most common bariatric procedures worldwide. The appeal was straightforward: a minimally invasive, reversible surgery that restricted food intake by placing a silicone band around the upper part of the stomach. While it offered an alternative to more invasive surgeries like gastric bypass or sleeve gastrectomy, research and long-term patient outcomes have revealed important limitations.
Today, AGB has declined significantly in popularity. Understanding the lifespan of the gastric band and its potential long-term complications is essential for patients considering the procedure or those already living with a band in place.
How Long Does an Adjustable Gastric Band Last?
- Intended durability: The band itself is made from medical-grade silicone and was designed to last for years. In theory, it can remain in place indefinitely.
- Reality in practice: Studies show that many patients require removal or revision within 5 to 10 years due to complications or poor weight loss outcomes.
- Reoperation rates: Up to 50% or more of patients may need a secondary procedure within 10 years.
Long-Term Complications of Gastric Banding
1. Mechanical and Device-Related Issues
- Band slippage or prolapse: The stomach can herniate through or slip past the band, causing obstruction, pain, and vomiting.
- Port or tubing problems: Breakage, leakage, or disconnection can occur, leading to loss of restriction.
- Erosion: The band may gradually erode into the stomach wall, requiring surgical removal.
2. Digestive and Nutritional Effects
- Difficulty swallowing (dysphagia): Especially with poorly adjusted bands.
- Esophageal dilation: Long-term pressure can cause the esophagus to enlarge and lose function.
- Reflux and heartburn: Gastroesophageal reflux disease (GERD) is common.
3. Weight Loss Durability
- Variable results: Early weight loss is often good, but long-term studies show that sustained weight loss with the band is lower than with sleeve gastrectomy or gastric bypass.
- Weight regain: Common as patients adapt eating behaviors or if band adjustments are inadequate.
4. Need for Revision Surgery
Many patients eventually undergo band removal followed by conversion to another bariatric procedure, such as sleeve gastrectomy or gastric bypass, to achieve durable weight loss and metabolic improvement.
Why Has the Popularity of Adjustable Gastric Banding Declined?
- High complication and reoperation rates
- Less durable weight loss compared to newer techniques
- Improved safety and outcomes with sleeve gastrectomy and gastric bypass
As a result, many bariatric programs have phased out AGB as a primary option, although some still manage patients with bands placed in previous years.
Conclusion: Adjustable Gastric Banding
The adjustable gastric band was once seen as a safe, reversible weight loss option. However, long-term studies show that many patients do not get lasting results, and problems such as slippage, erosion, and poor weight loss are common. Today, most centers use other procedures that are safer and more effective over time.
Patients with a gastric band need regular check-ups with a bariatric surgeon. If they experience trouble swallowing, reflux, or poor weight control, the surgeon may recommend adjusting the band, removing it, or switching to a different surgery.
