The laparoscopic adjustable gastric banding procedure is a procedure in which a small gastric pouch is created by placing an adjustable gastric band around the top of the stomach. This band is inflatable via an access port that is imbedded under the skin. This allows the band to be adjusted to meet individual patient needs. As a result, the amount of food a patient can eat is limited, creating an earlier feeling of fullness.
Generally, you will have your surgery in the morning or afternoon and stay overnight. You will have an x-ray to make sure you are able to swallow liquids before you are released from the hospital. This is considered outpatient surgery and you are in the hospital about 24 hours. (Back to Top) (Index of Questions)
If you have a light duty job (i.e., desk job) then generally you’d return after one week. If you have a job that requires heavy lifting, you’ll require two weeks off.(Back to Top) (Index of Questions)
For most patients, there will be more discomfort at the larger incision where the port is located. This is partly due to the size of the incision. There is more manipulation at this site during the surgery, because this is where the surgeon implants and sutures the port.
It is very important during the first four to six weeks that you not vomit. The area around the LAP-BAND® is healing during this time and when you start vomiting, there’s a possibility that the sutures could tear, causing band slippage. Sometimes nausea is caused by taking in too much at one time, causing distention of the pouch. If you do experience vomiting, call the Bariatric Center of Michigan as soon as possible. (Back to Top) (Index of Questions)
No, you shouldn’t be sick often. If you feel nauseated or sick on a regular basis, it may mean that you are not taking small enough bites, chewing your food well enough or that you are not following the diet guidelines. However, it could also mean that your band is too tight or that there is a problem with the placement of the band. Vomiting can cause the small stomach pouch to stretch. It can also lead to band slippage. In some cases, it can require another operation. (Back to Top) (Index of Questions)
Sometimes, even a few days post-op, there can be some swelling around the band site. This makes it very difficult for you to drink liquids, and since the first two weeks post op allow the patient to consume only clear liquids, it is very important that the patient recognize this before they become dehydrated. Sometimes the swelling can be so severe that the patient cannot swallow their own saliva. If this happens you need to call the Bariatric Center of Michigan as soon as possible and make arrangements to see your surgeon, who will evaluate you and determine what needs to be done. Swelling can also develop following a band fill. (Back to Top) (Index of Questions)
You probably took too large a bite or didn’t chew the food completely. Make sure you eat slowly, take very small bites and chew thoroughly before swallowing. Patients are advised to chew 20 to 30 bites prior to swallowing.
If you are having problems swallowing liquids or if you are experiencing episodes of vomiting when you are taking small bites and chewing well, it is likely that you are too restricted. Being too restricted can lead to complications. Call the Bariatric Center of Michigan and schedule a time to have some of the saline removed. (Back to Top) (Index of Questions)
Contact the Bariatric Center of Michigan. There is a nurse available Monday-Friday who will talk to you and give you the appropriate instructions. If it is after hours, weekend or holiday, use the after-hours number located on the business card you received at your first visit to the Bariatric Center of Michigan. (Back to Top) (Index of Questions)
Yes. After you have an adjustment, you need to remain on full liquids for 12 to 24 hours and then you may advance slowly to soft foods; then to solids. Remember, after every fill you need to treat what you eat like you’ve never had it before. If after 24 hours, you can only tolerate liquids or experience problems swallowing or advancing to solids, call the Bariatric Center of Michigan.
Follow the diet guidelines given. Watch your urine output. Your first morning specimen is generally dark and more concentrated because it’s been sitting in your bladder all night. When you are well hydrated, as you urinate throughout the day, your urine will be a light yellow in color. If you are not taking in enough fluids, your urine will be very dark, may be cloudy and will have a strong odor. If this happens, try to consume more fluids. If you are unable to, contact the Bariatric Center of Michigan. Follow the diet guidelines you were given, making sure you drink plenty of fluids during the day. (Back to Top) (Index of Questions)
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 recommended by your surgeon and dietitian. If you eat foods that contain lots of sugar and fat or drink calorie laden liquids, the effect of the band may be greatly reduced. (Back to Top) (Index of Questions)
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, check with your doctor. He or she may suggest you take a mild laxative and drink plenty of water for a while. Your needs will vary, but you should drink at least 6-8 glasses of water a day.
Although many people don’t have problems taking their medications, yes, it is possible for large pills to get stuck as you become more restricted with your adjustments. Many people take chewable or liquid vitamins. Check with your physician or pharmacist about the medications you are taking and whether it would be advisable to crush them or empty the capsules. Many pills are time-released and must be taken in the form they are dispensed. Your physician may prescribe an alternate medication. It is recommended that when you do take pills, to wait at least 10 minutes between taking each pill. (Back to Top) (Index of Questions)
Our surgeons recommend an over the counter chewable vitamin or a liquid multivitamin.
The purpose of the band is to form a small pouch that the solid food
will enter into first, giving you a feeling of
fullness. Drinking with meals can result in food passing through the pouch into the stomach without giving you a feeling of fullness. You should avoid fluids for 15 minutes to an hour before and at least one hour after meals. (Back to Top) (Index of Questions)
Carbonated beverages can cause the pouch to expand.
After you have recovered from surgery and you’ve allowed time for healing, the band shouldn’t hamper activity such as aerobics, stretching and strenuous exercise.
There are no restrictions based on the access port. Once the incisions have healed it should not cause discomfort or limit any physical exercise.
Four weeks after surgery. You then return at eight weeks. If you are losing 1-2 pounds a week, the band will probably not need adjusting. If weight loss is less than 1-2 pounds a week, your physician will determine if you need a fill. Overall, your weight loss should average one to two pounds a week. (Back to Top) (Index of Questions)
A fine needle is passed through the skin into the access port to adjust the amount of saline in the band. This process typically takes only a few minutes and most patients say it is nearly painless.
This is very individualistic. Many band recipients report feeling tighter in the morning, especially with bands that are tight or just after an adjustment. However, others report that their band gets tighter throughout the day, which might be explained by the fact that during the day the water content in the body changes. Some women have also noticed that the band feels tighter during menstruation. (Back to Top) (Index of Questions)
This depends on which LAP-BAND® you have. The AP Small holds 10 cc and the AP Large holds 14 cc.
Although the band is not meant to be removed, it can be. Surgeons report that the stomach generally does not return to its original shape once the band is removed due to scar tissue formation.
Yes, but removal is rare and each case would be evaluated individually.
If you become pregnant, the band can be emptied to ensure you and your baby get adequate nutrition during the pregnancy. Call the Bariatric Center of Michigan and arrange to see your surgeon.
One of the major advantages of the band is that it can be adjusted. Depending on your illness, your doctor may recommend that your band be emptied of saline so that you are not restricted. In the rare situation that the band cannot be loosened enough, it may have to be removed. When you have recovered from your illness and want to lose weight again, the band can be tightened by increasing the amount of saline. (Back to Top) (Index of Questions)
If you are going to have a surgical procedure done, please contact the Bariatric Center of Michigan. Your surgeon may want to empty your band prior to your having surgery.
Yes. It is extremely important to see a primary care physician after surgery. Your follow-up care is a collaborative effort between your surgeon and primary care physician. Regular follow-up appointments with your primary care physician are strongly recommended. (Back to Top) (Index of Questions)
The staples used on the stomach and the intestines are very tiny in comparison to the staples you will have in your skin or the staples you use in the office. Each staple is a tiny piece of stainless steel or titanium so small it is hard to see. They are made of titanium or stainless steel which are non-magnetic and will not be affected by MRI. The staples will not set off airport metal detectors.
If you are experiencing any issues like vomiting, problems swallowing, unusual abdominal pain, you need to contact the Bariatric Center of Michigan. If it is an after-hours issue, call the after-hours number and the surgeon on call will be notified and will call you back. If you are in serious distress, go to the nearest urgent care or emergency center. (Back to Top) (Index of Questions)
If you are in a facility that is not familiar with the band, you need to have them contact the Port Huron Hospital Bariatric Center of Michigan. At the time of surgery, every patient receives an ID card with the name of the surgeon and their contact number. Ask the physician/nurse to contact the Bariatric Center of Michigan (during business hours) or call the after-hours number if the problem occurs after regular business hours, on the weekend or a holiday. (Back to Top) (Index of Questions)
Follow-up care must be continued. You may call the Port Huron Hospital Bariatric Center of Michigan to help you find an experienced surgeon out of the area. Once arrangements with that office are made, all of your medical records will be transferred. (Back to Top) (Index of Questions)
Port Huron Hospital HealthAccess
1.800.228.1484 (Michigan Callers)
Port Huron Hospital
Bariatric Center of Michigan
Wismer 3rd Floor Clinic
1221 Pine Grove Avenue
Port Huron, MI 48060