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A Note from Dr. Ortiz....

Dear All

Thank you for you questions on the forum. One topic that requires my intervention is the use of particular bands for weightloss surgery.

After more than a decade of performing weightloss surgery, gastric bands have become available from different companies.

We will discuss two in particular: The Lap-Band AP System (Allergan Medical) and the Realize Band (Johnson and Johnson) both are FDA approved.

The original Lap-Band System now has a newer model out called the AP System (Advanced platform). This band was designed with a wider profile and a softer balloon and buckle that can be unlatched during a surgical procedure. The Lap-Band AP was introduced in the market to compete with the newer Realize band, manufactured by Medical giant Johnson and Johnson. Both bands are very similar, the Lap-Band having two sizes, the AP and the AP-L. The claims that you see on the internet about one band is better than the other are misleading. Both implants have a decade of history and research backing them up. Whenever an update or improvement was needed, it was addressed.

The Lap-Band AP system is still not available for sale in Mexico. I work directly with the President of Allergan Medical who updates me on the status of its availability. The versions of the Lap-Band (standard and VG) that are available in Mexico are still used and manufactured in the US, so the notion that these are “old” bands is inaccurate.

The Realize band by Johnson & Johnson called SAGB in Mexico is one and the same (name changes for the Mexican market). We are using the Realize band more and more because it has proven to be as safe and effective as the previous models and it is also the updated version of the two competing bands in the US market. We also feel that because fewer surgeons around the world are using the smaller sizes of the Lap Band (9.75 & 10), it may be phased out of the market. This will be a corporate decision and I am only expressing my personal opinion. If you have one of these bands, they have proven to be safe and effective, over 400,000 of these bands have been placed world wide. Speaking from experience, in the huge market of weight-loss surgery implants, a company is not going to put their reputation at risk with an inferior product, so whichever band you have, it has been proven safe and effective. After over 7000 procedures (This is verifiable information) we at Obesity Control Center are not going to put our patients or our reputation at risk by using anything less than the best. I was recently invited to visit Johnson and Johnson corporate headquarters and meet with design engineers and share our findings. They value our opinion! We are dedicated to the highest standards and quality as well as advancing what we do for the sole benefit of the patient. At this point in time we have performed over 700 procedures with the newer Realize gastric band we are very happy with the results. We also have not seen the need for different size bands since the adjustability of the implant itself is what has eliminated the need for larger or smaller bands. This is why a larger patient may need a smaller initial fill and a smaller patient a larger initial fill. We theorized that higher BMI patients would need a larger band but have not seen it at this point.

In conclusion, whichever band you have, you know it is not just the actual implant that promotes weightloss, it is how you use it as a tool. You are required to do your part. Any band can slip. The worst enemy of a gastric band is too much restriction and over dependence on the band. Wider bands, softer balloons and smarter buckles are not going to take the place of your part in this weightloss journey. Restriction is not food getting stuck. Restriction is not “I don’t ever get hungry anymore”. Hunger is a natural condition of the body and you will be hungry several times a day. While the band will help reduce the intensity of your hunger, it will not eliminate it. . Restriction will not help you if you eat mushy or liquids. Restriction will not work if you do not follow the guidelines. In fact if you completely depend on restriction physically or mentally you will end up failing. The restriction patients should seek is when eating solid foods, three times a day. You should be able to eat around a third of your typical pre-surgery intake by eating slower and chewing better. It is this combination that will provide satiety by enjoying food and feeling mild fullness.

We will be following up on this topic with one of our webinars… stay tuned!

Disclaimer: These statements are intended as a reference guide for persons interested in the treatment of obesity, not as a medical guide for self-diagnosis or self-treatment. The information contained in this statement should not be used as a substitute for advice from a qualified medical professional, and accordingly, the author and publisher expressly disclaim responsibility for any adverse effects that might arise from the reader’s use of the information found in this statement. If you believe that the obesity treatment described in this information might be of benefit to them, please contact your physician or a member of the Obesity Control Center staff to discuss their personal situation.

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