The LAP-BAND® System, or laparoscopic adjustable gastric banding, is a surgical procedure done laparoscopically through tiny, less invasive “holes” in the abdomen.  The surgeon places a silastic band with an inflatable collar inside of the band, around the top part of the stomach creating a small “pouch” that can hold 4-6 ounces of food and restricts the amount a client is able to eat.  The inflatable collar of this band is attached to tubing that leads to a port placed on top of the muscles of the abdominal wall, just below the skin.  This port can be accessed using a special needle, called a Huber needle to either inject saline into the band (to make it tighter and reduce the amount of food the client can eat), or to aspirate or remove saline from the band (to loosen the band and increase the amount of food a client can eat).  This adjustability of the band is seen by many as an advantage.  Additionally, the band, unlike the bypass and the sleeve, is completely reversible.  Weight loss is slower with an adjustable gastric band due to the time required to fill the band to the appropriate tightness.  Clients can expect about 40% excess weight loss over the first year and up to 60% over the next two years when our program is followed closely.  This means if you need to lose 100 pounds, by the end of the first year you can reasonably expect to have lost about 40 pounds, and over the next two years you can expect to lose an additional 20 pounds for a total of 60 pounds over three years.