Overview
A reversible bariatric option — and care for the bands already in place.
The laparoscopic adjustable gastric band is an inflatable silicone band placed around the upper stomach, creating a small pouch above the band that fills quickly and signals fullness. A small port placed under the skin allows the band to be tightened or loosened in the office by injecting or removing saline. Unlike sleeve gastrectomy or gastric bypass, no stomach is cut and the procedure is fully reversible. The trade-off is generally less long-term weight loss and a higher rate of revision over the years.
In 2026, most bariatric programs offer fewer new bands than they did a decade ago — sleeve gastrectomy and Roux-en-Y gastric bypass have become the default operations because of their more reliable outcomes. But the band is still a reasonable option for some patients, and many bands placed in the 2000s and 2010s remain in patients today. We do three things for these patients: place new bands when appropriate, adjust and manage existing bands, and remove or convert bands that are slipping, eroding, or no longer producing weight loss.
Who is a candidate?
For a new band, candidates have a BMI of 30+ with weight-related medical conditions, or BMI 35+ without them, and have completed the multidisciplinary bariatric evaluation (nutrition, psychology, medical clearance). We discuss the trade-offs of band vs. sleeve vs. bypass honestly — outcomes data favor sleeve and bypass for most patients, but for those who specifically want reversibility, who have specific medical reasons to avoid stomach resection, or who have a thoughtful preference for the band, it remains a real option. For patients with existing bands, anyone with a band that needs adjustment, removal, or conversion is a candidate for evaluation.
How we perform it
Placement is done laparoscopically through four to five small ports. We create a tunnel behind the upper stomach just below the gastroesophageal junction, pass the silicone band through, and lock it. A few stitches secure the upper stomach over the band to prevent slippage. The port is placed under the skin, usually below the left rib cage, and is anchored to the fascia. The whole operation takes 45–60 minutes. Adjustments are done in the office with a small needle through the port — typically taking 5–10 minutes.
Recovery
Most band placements are outpatient or overnight stays. You are on liquids for the first week, then progressive soft food. The first adjustment is typically 4–6 weeks later. After that, adjustments are made every few months as needed based on weight loss and hunger. Band removal is also outpatient and recovery is quick — typically back to normal in a week. Conversions to sleeve or bypass require a hospital stay of 1–2 nights.
Why Florida Surgical
We see many patients who had bands placed years ago and want a frank conversation about whether to keep the band, remove it, or convert. We give honest, evidence-based recommendations. Both Dr. Shaw and Dr. Decio are experienced with all three bariatric operations and the safest approach to band complications and conversions. Same-surgeon continuity makes the long-term follow-up — particularly the years of band adjustments — much smoother.
Frequently asked questions
Is the gastric band still a good option?
Use has declined substantially in favor of sleeve gastrectomy and Roux-en-Y gastric bypass, which offer more reliable long-term weight loss. We discuss the band honestly: it is reversible and avoids cutting the stomach, but long-term weight loss is generally less and revision rates are higher. For some patients, especially those with prior surgery or specific medical concerns, it is still a reasonable choice.
How are adjustments done?
In the office. We use a small needle to add or remove saline through the port under your skin. The whole adjustment takes a few minutes. Tighter bands create more restriction; looser bands allow more food through. We adjust based on weight loss, hunger, and food tolerance.
Can the band be removed?
Yes. We commonly remove bands that are slipping, eroding, intolerable, or no longer producing weight loss. Removal is usually laparoscopic and outpatient. Some patients have a second bariatric procedure (sleeve or bypass) at the same time as removal or a few months later — this is called a conversion.
What are the long-term issues?
Band slippage, esophageal dilation, band erosion through the stomach wall, and port problems are the main long-term issues. We follow bands closely. When complications occur, we either adjust, replace, or convert to a different operation.
Do you also offer band conversion to sleeve or bypass?
Yes. Many of our gastric band consultations are for patients who already have a band and want it removed or converted. We perform single-stage and two-stage conversions to sleeve gastrectomy or Roux-en-Y gastric bypass, depending on what is safest given the band history.