Weight-Loss Surgery: About Gastric Band Surgery

Gastric band surgery, also referred to as “adjustable” gastric band surgery, is the least invasive type of weight-loss surgery.

The procedure is done laparoscopically and involves no stomach stapling or gastrointestinal bypass.

During the surgery, an adjustable band is placed around the upper portion of the stomach, forming a small pouch with a narrow opening into the lower stomach. The band — which can be adjusted as needed following surgery — causes food to remain in the pouch for a longer period of time, helping the individual to eat less and feel and more satisfied with less food.

Periodically, the band needs adjusting to continue the weight loss process. Adjustments are made through a port located under the skin.

Success with the adjustable gastric band is best achieved with its lifelong (or long-term) intended for use, it may be removed if necessary. Removal is also typically done laparoscopically.

Get more information about weight-loss surgery at Penn

Learn if bariatric surgery is right for you by attending a free informational session about the Penn
Metabolic and Bariatric Surgery Program.

At this free session, you will learn more about weight-loss surgery at Penn, and meet physicians and team members from the Penn Metabolic and Bariatric Surgery Program.

Register for this free event here.

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What is Bariatric Surgery?

Bariatric surgery is a type of weight-loss approach that uses surgical procedures to help patients lose weight, avoid or reverse some diseases such as type 2 diabetes and high blood pressure, and improve overall health.

Because every patient considering bariatric surgery is unique, the Penn Metabolic & Bariatric Surgery Program offers a full range of bariatric surgical options. This ensures that patients receive the bariatric surgery that will provide them with the best possible results.

Here are four types of bariatric surgery at Penn.

Sleeve Gastrectomy

Sleeve gastrectomy is typically considered for patients with a body mass index (BMI) of 50 or higher. During the surgery, a sleeve–shaped tube is created from a small portion of the stomach and the majority of the stomach is removed. The small intestine is not surgically altered. Sleeve gastrectomy may require a second operation like conversion to Roux-en-Y gastric bypass (see below) if even more weight loss is required to improve a patient's health.

Robotic-assisted Bariatric Surgery

All procedures performed by Penn bariatric surgeons are available using a minimally invasive approach called laparoscopic surgery. Laparoscopic surgery offers many benefits for patients including shorter recovery times and less post-operative pain. In addition, Penn performs robotic-assisted bariatric surgery for the adjustable gastric band and sleeve gastrectomy procedures. Penn's bariatric specialists are highly experienced in robotic-assisted surgery and have performed more than 500 robotic LAP-BAND® and sleeve gastrectomy procedures.

Roux-en-Y Gastric Bypass (RGB)

The most common type of bariatric surgery performed in the United States, during the Roux-en-Y procedure a Penn surgeon divides a small gastric pouch from the upper portion of the stomach and attaches it directly to the small intestine, completely bypassing the larger part of the stomach.

Adjustable Gastric Band

The adjustable gastric band does not divide or reattach any part of the gastrointestinal tract. During the procedure, a Penn surgeon places a band around the upper portion of the stomach creating a small pouch with a narrow opening to the lower stomach. The food eaten stays in the small pouch for more time, so the patient feels full longer. The band is adjustable, which means it can be tightened or loosened after surgery as needed.

Get more information about weight-loss surgery at Penn

Learn if bariatric surgery is right for you and attend a free information session about the Penn Metabolic and Bariatric Surgery Program. 


At this free session, you will learn more about weight loss surgery at Penn, and meet physicians and team members from the Penn Metabolic & Bariatric Surgery Program.

Register for this free event here. 

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Adjustable Gastric Band: A Tool for Weight Loss

Samantha Warner-Grimsley, RN, CBN, member of the Penn Metabolic and Bariatric Surgery team, provides tips for achieving weight loss success with an adjustable gastric band.

If you have or are considering an adjustable gastric band as a way to lose weight, it is important to remember that the band is just a tool for weight loss. Like most tools, it requires proper management to function optimally.

Making the most of your adjustable gastric band requires a combination of lifestyle and dietary changes along with gastric band adjustments.

Follow these tips to to achieve the best results from your adjustable gastric band surgery:

Set reasonable, incremental goals for weight loss.
Aim to lose one to two pounds per week.

Follow the postoperative dietary guidelines.
For four to six weeks after surgery, follow the postoperative dietary guidelines provided by the dietitian. Slowly advancing from a liquid to solid diet gives your stomach the chance to heal while keeping the lap band in the right position.  It may take up to one month for your stomach to fully heal from surgery.

Re-introduce solid food gradually.  After the initial postoperative period, slowly re-introduce soft and then solid foods to your diet.

Take small bites and eat slowly. Always remember to take small bites, eat slowly and chew well. Developing these habits teaches you to recognize when you are satisfied and prevent stomach upset.

Adjust the gastric band to manage symptoms.The band can be tightened or loosened to manage symptoms or help you achieve better portion control to expedite weight loss. Symptoms that should be reported to your health care team include:

• Painful or difficult swallowing
• Severe abdominal pain
• Heartburn
• Food sticking in the esophagus
• Frequent regurgitation or inability to tolerate solid foods
• Vomiting

Remember that success is a team effort.
Schedule regular follow-up visits with your surgeon or nurse practitioner and dietitian. The Penn Metabolic and Bariatric Surgery Program recommends visits every six to eight weeks.

Exercise regularly. Make sure to exercise regularly but within your limitations. For the best results, add 30 minutes of moderate exercise into your daily schedule. Keep in mind that every minute of exercise counts, so even 10 or 20 minutes of exercise is better than nothing.

Get support. Attend support group meetings to connect with other people who have adjustable gastric bands, share your experiences and exchange ideas. For a list of support group meetings at Penn Medicine, click here.

- Samantha Warner-Grimsley, RN, CBN

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FDA recommends Extending Weight-Loss Surgery Eligibility

A recent front-page article in the Philadelphia Inquirer highlighted an FDA advisory panel recommendation to allow doctors to use the adjustable gastric band – a less invasive form of weight-loss surgery – in patients with milder obesity.

Under the new guidelines, people with a body mass index (BMI) of 30 to 35 and weight-related medical complications of obesity would qualify. Currently the device is only approved for people with BMIs of 40 and higher, or 35 to 40 with other medical complications.

The article includes comments from Penn Metabolic and Bariatric Surgery Program faculty Noel Williams, MD, FRCSI, David Sarwer, PhD, and Thomas Wadden, PhD.

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