A laparoscopic adjustable gastric band is a restrictive device implanted via bariatric surgery and designed for obese patients with a body mass index (BMI) of 40 or greater—or between 35–40 in cases of patients with certain comorbidities that are known to improve with weight loss, such as sleep apnea, diabetes, osteoarthritis, or metabolic syndrome, among others. The gastric band is an inflatable silicone prosthetic device that is placed around the top portion of the stomach, usually via laparoscopic surgery. The first gastric band was patented in 1985 by Obtech Medical of Sweden (now owned by J&J/Ethicon) and is known as the Swedish Adjustable Gastric Band (SAGB). An American company, INAMED Health, later designed the BioEnterics LAP-BAND Adjustable Gastric Banding System. The LAP-BAND System was introduced in Europe in 1993. Neither of these bands were initially designed for use with keyhole surgery. The LAP-BAND System received Food and Drug Administration (FDA) approval for use in the United States in June 2001. In 2000, the first lower pressure, wider, one-piece adjustable gastric band called the MIDband was introduced in Lyon France by Medical Innovation Development. In 2002, the first lower pressure, wider, one-piece adjustable gastric band called the Bioring was introduced in France by Cousin-Biotech. Unlike many of the early bands this was designed specifically for laparoscopic insertion. It has swiftly become one of the leading bands placed in France. There are now many band manufacturers (approx 7-8 in total).