Adjustable gastric band surgery is an example of bariatric surgery designed for obese patients with a body mass index (BMI) of 40 or greater—or between 35 and 40 in cases of patients with certain comorbidities that are known to improve with weight loss, such as sleep apnea, diabetes, osteoarthritis, GERD, hypertension (high blood pressure), or metabolic syndrome, among others.

In February 2011, the United States Food and Drug Administration (FDA) expanded approval of adjustable gastric bands to patients with a BMI between 30 and 40 and one weight-related medical condition, such as diabetes or high blood pressure.

This slows and limits the amount of food that can be consumed at one time, thus giving the opportunity for the sense of satiety to be met with the release of peptide YY (PYY).

Gastric banding is performed using laparoscopic surgery and usually results in a shorter hospital stay, faster recovery, smaller scars, and less pain than open surgical procedures.

The gastric band is adjusted by introducing a saline solution into a small access port placed just under the skin.

Over the course of several visits to the doctor, the band is filled until the optimal restriction has been achieved – neither so loose that hunger is not controlled, nor so tight that food cannot move through the digestive system.

Two factors have been pointed out by experts that may help explain this increase in fertility: reversal of PCOS (polycystic ovary syndrome) and reduction in the excess of estrogen, which is produced by fat cells.

Unlike those who have procedures such as RNY, DS, or BPD, it is unusual for gastric band patients to experience any nutritional deficiencies or malabsorption of micro-nutrients.

[5] It is important to note that, in order to maintain their weight reduction, patients must carefully follow post-operative guidelines relating to diet, exercise, and band maintenance.

The National Institutes of Health recommendation for weight loss is 1 to 2 pounds (½ to 1 kilogram) per week, and an average banded patient may lose this amount.

Occasionally, the narrow passage into the larger, lower part of the stomach might also become blocked by a large portion of unchewed or unsuitable food.

However, with greater experience and longer patient follow up, several studies have found suboptimal weight loss and high complication rates for the gastric band.

[25] A systematic review concluded "LAGB has been shown to produce a significant loss of excess weight while maintaining low rates of short-term complications and reducing obesity-related comorbidities.

LAGB may not result in the most weight loss but it may be an option for bariatric patients who prefer or who are better suited to undergo less invasive and reversible surgery with lower perioperative complication rates.

[30] A meta-analysis of 174,772 participants published in The Lancet in 2021 found that bariatric surgery was associated with 59% and 30% reduction in all-cause mortality among obese adults with or without type 2 diabetes respectively.

Some gastric-band patients have criticized this approach because, while many of the underlying issues related to obesity are the same, the needs and challenges of the two groups are very different, as are their early rates of weight loss.

[35] At the end of the 1970s, Wilkinson developed several surgical approaches with a common aim to limit food intake without disrupting the continuity of the gastrointestinal tract.

[36] In 1978 Wilkinson and Peloso were the first to place, by open procedure, a non-adjustable band (2 cm Marlex mesh) around the upper part of the stomach.

[44] All of these early attempts at restriction using meshes, bands and clips showed a high failure rate because of difficulty achieving correct stomal diameter, stomach slippage, erosion, food intolerance, intractable vomiting and pouch dilatation.

[citation needed] The development of the modern adjustable gastric band is a tribute both to the vision and persistence of the early pioneers, particularly Lubomyr Kuzmak and a sustained collaborative effort on the part of bio-engineers, surgeons and scientists.

[46] In 1986, Lubomyr Kuzmak, a Ukrainian surgeon who had emigrated to the United States in 1965, reported on the clinical use of the "adjustable silicone gastric band" (ASGB) via open surgery.

[43] Kuzmak, who from the early 1980s had been searching for a simple and safe restrictive procedure for severe obesity, modified his original silicone non-adjustable band, which he had been using since 1983, by adding an adjustable portion.

His clinical results showed improved weight loss and reduced complication rates compared with his original non-adjustable band.

Kuzmak's major contributions were the application of Mason's teachings about VBG to the development of the gastric band, the volume of the pouch, the need to overcome staple line disruption, the ratification of the use of silicone and the essential element of adjustability.

In late March, Dr. Hallberg presented his idea of the "balloon band" at the Swedish Surgical Society and started to use the SAGB in a controlled series of 50 procedures.

At the time, laparoscopic surgery was uncommon and Dr. Hallberg and his assistant, Dr. Peter Forsell, started performing the open technique to implant the SAGB.

In 1992, Forsell, who fully owned the patent, was in contact with surgeons in Switzerland, Italy and Germany who began to implant the SAGB with the laparoscopic technique.

[47] Over the next few years, the Kuzmak ASGB was modified to make it suitable for laparoscopic implantation, eventually emerging as the modern lap band.

Single-port laparoscopy (SPL) is an advanced, minimally invasive procedure in which the surgeon operates almost exclusively through a single entry point, typically the navel.

Special articulating instruments and access ports make it unnecessary to place trocars externally for triangulation, thus allowing the creation of a small, solitary portal of entry into the abdomen.