Realize® Band vs Lap Band

Deciding between the Realize Band and Allergan Lap Band

This is an important decision which is very often made for you by your surgeon but is recommended that you are aware of the differences. The Allergan Lap Band is the “original” American Lap Band and has been trademarked the Lap Band. This band was introduced into the United States in 1995 in clinical trials and achieved FDA approval in 2001. Since then it has gone through a series of improvements and the most recent generation, the Advanced Platform (AP) Lap Band was released in late 2008.

The Realize Band was introduced into the United States with FDA approval in 2007. Both systems can tout that their products have been available outside of the USA for much longer, purest still believe in American published data and results. This is important as Americans are inherently different both culturally, socioeconomically and even maybe genetically.

Based on this supposition, the Lap Band has history on its side. As of 2007 over 300,000 Lap Bands have been implanted and we have 5 year American data and 10 year international data. It has withstood the test of time and made systematic and support changes which meet the demands of the surgeons and its patients. The Realize Band has just not been around in the United States long enough to openly endorse it. In reality, the Realize Band is the original Swedish Band. European data suggests that the original Swedish Band system is falling out of favor with European surgeons. This possible trend should we reviewed critically before the Realize Band becomes a mainstream in the USA.

Mechanical Advantages of the Lap Band over the Realize Band

This section should be prefaced by the fact that these are all theoretical advantages.

1. The Lap Band System comes in two sizes (AP standard and AP large) which allow the surgeon to make a choice of what best fits the patient as opposed to a one size fits all.

2. The AP Large is larger than the Realize band thus allowing it to be placed in larger patients particularly large males.

3. The Lap Band provides better 360 degree coverage. Pictures of the Lap band show you that band closes into an almost complete circle as opposed to the Realize Band closes into a tear drop shape. Interestingly, due to this distinction, promotional items almost never show the Realize band in its closed or buckled state.

4. The Lap Band comes with two different port sizes such that smaller patients can have a low profile port so that it is not so obtrusive and larger patients can have a taller port which is easier to palpate. The ports can also be exchanged out. The Realize system has a one port fits all approach.

In summary, the mechanical advantages of the AP Lap Band system are that it allows the surgeon to provide a customizable combination for a surgeon with choices in band and port size. The advances that have been made from the original Lap Band to the AP Lap Band have been based on strong clinical data and an American track record that is incomparable to any other product in the market. The sum advantages should be fewer complications such as slips and erosion, better clinical outcomes and greater patient satisfaction. To date, preliminary data suggests that these expectations have been surpassed as the AP system has been reported to provide superior initial weight-loss compared to the original Lap Band system.

Does the Realize Band Provide More Personalized Support Compared to the Lap Band?

The answer to this question is very individualized. Both the Realize Band and the Lap Band provide an internet-based self assessment tool with virtual feedback. This is an awesome advent and demonstrates the commitment of both systems to enhance patient support and education. Compliance and, in turn, results should be theoretically improved when these tools are used regularly at home and work. At the moment, these tools are more advanced in the Realize Band program as compared to the Lap Band program. The However, the fact is that most patients will never use these tools as much as they should and those who do will probably have great results based on personality and commitment and not computer generated advice. We feel that live-human support can never be replaced by a computer generated algorithm. As such our band program is based on an open access policy with ad lib nutritional counseling, free local support groups, local nutritional resource stores, personalized exercise programs and surgeon performed fills. Aside from virtual support, local support is the key. The Realize Band is placed routinely by only one group in San Antonio and in Austin and no one in Corpus Christi and Laredo. As such aftercare and support outside of the region may be more difficult to find.

The Practice’s Bottom Line

The outcomes after laparoscopic adjustable banding may have very little to do with the type of band system and ultimate success is based on patient selection and local support. The practice has firm beliefs that change for the sake of change is not a good mantra in medicine and has been slow to adapt the Realize Band as the time-tested American data for the Lap Band is excellent and at best is matched but not exceeded by the Realize Band.

 

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