Adjustable Gastric Band Surgery

The Lap Band is adjustable. A band adjustment could consist of using a special needle to access the port underneath your skin and then inserting fluid into the band or taking fluid out. Everyone will have different levels of fluid in their band, so you cannot compare how many CCs of fluid you have to someone else’s experience. The goal is for you to be able to eat 8 ounces of food and feel satiety for at least 4–6 hours before your next meal. If you cannot eat approximately 8 ounces or you are feeling discomfort after a few bites, it may mean your band is too tight and fluid should be taken out. When in doubt, call the office to discuss your symptoms with a trained staff person.

Patients typically spend less than 24 hours in the hospital. It takes most patients about a week to return to work and a month to 6 weeks to resume exercising. In the case of open surgery or if there are complications, recovery may take longer.

Weight-loss results vary from patient to patient, and the amount of weight you lose depends on several things. The band needs to be in the right position, and you need to be committed to your new lifestyle and eating habits. Obesity surgery is not a miracle cure, and the pounds won’t come off by themselves. It is very important to set achievable weight-loss goals from the beginning. A weight loss of 2–3 pounds a week in the first year after the operation is possible, but one pound a week is more likely. Twelve to eighteen months after the operation, weekly weight loss is usually less. Remember that you should lose weight gradually. Losing weight too quickly creates a health risk and can lead to several problems. The main goal is to have weight loss that prevents, improves or resolves health problems connected with severe obesity.

Surgeons have reported that gastric bypass patients lose weight faster in the first year. At five years, however, many LAP-BAND patients have achieved weight loss comparable to that of gastric bypass patients.1 You should focus on long-term weight loss and remember that it is important to lose weight gradually while reducing obesity-related risks and improving your health.

Check-ups are a normal and very important part of the LAP-BAND System follow-up.

The LAP-BAND does not hamper physical activity including aerobics, stretching and strenuous exercise.

Adjustments are often carried out in the X-ray department so the access port can be clearly seen. When X-rays are used, your reproductive organs will be shielded. Sometimes adjustments can be done in an outpatient clinic or office, and local anesthesia may or may not be needed. A fine needle is passed through the skin into the access port to add or subtract saline. This process most often takes only a few minutes and most patients say it is nearly painless.

There are no restrictions based on the access port. It is placed under the skin in the abdominal wall. Once the incisions have healed, it should not cause discomfort or limit any physical exercise. The only sensation you may experience from the port occurs when you go in for adjustments. If you feel persistent discomfort in the port area, let us know as soon as possible.

Although the LAP-BAND System is not meant to be removed, it can be, in some cases laparoscopically. Surgeons report that the stomach generally returns to its original shape once the band is removed. After the removal, though, you may soon go back up to your original weight or even gain more.

That is not always the case. As a rule, plastic surgery will not be considered for at least a year or two after the operation, as sometimes the skin will mold itself around the new body tissue. Give the skin the time it needs to adjust before you decide to have more surgery.

This is a fairly common feeling, especially for people with bands that are tight or just after an adjustment. During the day, the water content in the body changes and this may cause the band to feel “tighter” some of the time. Some women have also noticed that the LAP-BAND feels tighter during menstruation.

The LAP-BAND makes you eat less and feel full in two ways—first by reducing the capacity of your stomach and second by increasing the time it takes food to get through the digestive system. After a small meal, the amount of which varies from person to person, you should feel full. If you follow the nutrition guidelines when you choose your food, and then chew it well, you should not feel hungry or deprived. Remember that the LAP-BAND is a tool to help you change your eating habits.

One of the major advantages of the LAP-BAND System is that it can be adjusted. If your illness requires you to eat more, the band can be loosened by removing saline from it. When you have recovered from your illness and want to lose weight again, the band can be tightened by increasing the amount of saline. If the band cannot be loosened enough, it may have to be removed.

Becoming pregnant can be easier as you lose weight. Your menstrual cycle may become more regular. If you need to eat more while you are pregnant, the band can be loosened. After the pregnancy, the band may be made tighter again, and you can resume losing weight.

You may. It’s possible to not get enough vitamins from three small meals a day. At your regular check-ups, your specialist will evaluate whether you are getting enough vitamin B12, folic acid, and iron.

You should be able to take prescribed medication though you may need to use capsules, break big tablets in half or dissolve them in water so they do not get stuck in the stoma and make you sick. You should always ask the doctor who prescribes the drugs about this.

Order only a small amount of food, such as an appetizer. Eat slowly. Finish at the same time as your table companions. You might want to let your host or hostess know in advance that you cannot eat very much.

Alcohol has a high number of calories and breaks down vitamins. An occasional glass of wine or other alcoholic beverage, though, is not considered harmful to weight loss.

After your stomach has healed, you may eat most foods that don’t cause you discomfort. However, because you can only eat a little, it is important to include foods full of important vitamins and nutrients such as those advised by your dietitian. If you eat foods that contain lots of sugar and fat or drink liquids full of “empty” calories, such as milkshakes, the effect of the LAP-BAND may be greatly reduced or cancelled.

There may be some reduction in the volume of your stools, which is normal after a decrease in food intake because you eat less fiber. This should not cause you severe problems. If difficulties do arise, let us know as soon as possible. And remember to drink at least 6–8 glasses of water a day.