For your insurance company, the code for this operative procedure is: CPT 43770 and the ICD-9 code for the diagnosis of morbid obesity is 278.01

Considerable experience has been obtained, mainly in Australia and Europe, with placement of an inflatable Silastic band around the top part of the stomach to create a small gastric pouch, without the need for any bowel anastomoses. This procedure is performed laparoscopically and is called the Lap-Band® procedure. The surgical incisions for the needed laparoscopic ports are similar to those for the Roux-en-Y gastric bypass:

The device consists of a band, connection tubing, and a plastic access port. The band has a plastic ring lining the inside that can be filled with water to narrow the stomach opening, thus limiting the amount of food that can pass over time. The access port is used to add or remove water from the band, here shown with a needle and syringe placed for an adjustment.

An area is cleared at the top of the stomach for passage of the band and the band is secured about the stomach by an interlocking mechanism. After placement of the band, all instruments are removed from the abdomen and a small plastic access port is implanted just under the skin. The band has a plastic ring lining the inside that can be filled with water to narrow the stomach opening, thus limiting the amount of food that can pass over time. The amount of water in the plastic ring is adjusted by placing a needle into the plastic access port and adding or withdrawing fluid. Placement of the needle is minimally painful.

Expected Weight Loss

Results of the Lap-Band procedure have been encouraging, however weight loss is less than for the Roux-en-Y gastric bypass and management requires more frequent clinic visits to adjust how the band narrows the stomach. Most patients will lose between 80 and 100 pounds. The exact amount of weight you lose will depend on your compliance with the dietary instructions and your tolerance to adjustments to the tightness of the band.

Weight loss is slower with this procedure with most of the weight loss occurring after the first three months. You will need to watch your diet very carefully as the band is adjusted and continue long-term follow up to maintain weight loss.

Patient Manual Index

• Introduction
• Questions to Ask Your Insurance Company
• Your Health Care Team
• Roux-en-Y Gastric Bypass
• Lap-Band Procedure
• Path to Surgery
• The First Clinic Visit
• The Second Clinic Visit
• The Third Clinic Visit
• Preparation Instructions for Surgery
• Day of Surgery and Postoperative Stay
• Hospital Course Following a Roux-en-Y Gastric Bypass
• Hospital Course Following a LapBand Procedure
• Post Surgery Follow-up Care
• Potential Complications of Roux-en-Y Bypass Surgery