Contraindications

There are a number of specific contraindications to Lap-Band® placement:

Mentally defective patients, who are unable to understand the rules of eating and exercise, and therefore are unable to fulfill their part of the partnership.
Malignant hyperphagia - Prader-Willi syndrome combines mental retardation with an uncontrollable desire for eating.
Portal hypertension is seen as an excessive hazard to laparoscopic gastric banding surgery. This preclusion is based on the authors’ clinical experience and has not been demonstrated in the literature.

Age - With increasing age, weight loss is less effective and the risks of the procedure are greater. It is more likely that cardiovascular or pulmonary disease is present and the duration of benefit from the weight loss is shorter. We are generally reluctant to consider someone older than age 65 years for these reasons. At the other end of the scale, we would not accept patients under the age of 16 years, if we felt they lacked a good understanding of the significance of the decision.
Presence of severe, irreversible medical illness - In the presence of severe irreversible disease, the benefit of weight loss will be lessened and the risks of surgery are increased. A judgment needs to be made in each case to determine the wisdom of proceeding.
Reduced mental status - Obtaining a successful outcome after Lap-Band® placement requires a partnership between the surgeon and the patient, with both committed to fulfilling their role optimally. This cannot happen if there is a lack of understanding by the patient, and for this reason we would exclude those whose mental status precluded good understanding.

Patient Selection