**4. Laparoscopic adjustable gastric band**

The laparoscopic adjustable gastric band method has been available in the USA since 2001 [15]. This method decreases the food intake with its complete restrictive effect and results in loss of weight. An inflatable silicone band is wrapped around the stomach 3 cm below the esophagogastric junction, and a reservoir of 25–30 cm long is formed at the proximal section. At the other end of the band, there is a subcutaneously placed port (**Figure 3**). The calibration of the gastric opening can be changed by fluoroscopy-guided filling and emptying of the silicone band. The band is initially inserted in completely deflated form. The pars flaccida technique has become the standard since band prolapse and erosion are less common in this way. The laparoscopic adjustable gastric band method requires frequent follow-up and should therefore only be performed in patients who live in close proximity to the hospital. Only multivitamins are recommended after the surgery. Adjustment of the band is as important as the surgery itself, and weight loss of 0.5 kg per week is ideal with this method [16]. Patients lose 58–60% of their extra weight in 7–8 years after

**Figure 3.** *Laparoscopic adjustable gastric band.*

the surgery. The complication and mortality rate are less than the absorption-disrupting techniques [7]. Prolapse (3%), displacement (<3%), band erosion (1–2%), and port and tube complications (5%) can be seen. Although a high reoperation ratio is the major disadvantage, the technique is still popular in the USA [17].
