Frequently Asked Questions about Gastric Banding Surgery – also known as Lap Band Surgery
- What is the Laparoscopic Adjustable Gastric Band?
- The Lap Band is an adjustable gastric band designed to help you lose excess body weight, improve weight-related health conditions, and enhance quality of life.
- How does the Adjustable Gastric Band operation work?
- The adjustable gastric band is a silicone ring designed to be placed around the upper part of the stomach and filled with saline on its inner surface. This creates a new, smaller stomach pouch that can hold only a small amount of food, so the food storage area in the stomach is reduced. The band also controls the stoma (stomach outlet) between the new upper pouch and the lower part of the stomach. When the stoma is smaller, you feel full faster, while the food moves more slowly between your upper and lower stomach as it is digested. As a result, you eat less and lose weight.
- What happens during the surgery?
- During the procedure, surgeons usually use laparoscopic techniques (making tiny incisions rather than a large incision and inserting long-shafted instruments through “ports”) to wrap the Band around the patient’s stomach. A narrow camera is passed through a port so the surgeon can view the operative site on a nearby video monitor. Like a wristwatch, the band is fastened around the upper stomach to create the new stomach pouch that limits and controls the amount of food you eat. The band is then locked securely in a ring around the stomach.
- How is Gastric Banding different from the Gastric Bypass Roux-en-Y operation?
- Unlike gastric bypass surgery, gastric banding does not require stomach cutting and stapling or gastrointestinal rerouting to bypass normal digestion.
- Why is the Gastric Band considered adjustable?
- Once placed around the stomach, tubing connects the band to an access port fixed beneath the skin of your abdomen. This allows the surgeon to change the stoma (stomach outlet) size by adding or subtracting saline or salt water, inside the inner balloon through the access port. Adjustments are performed without any additional surgery.
- How often will I follow up in the office with band adjustments?
- Most patients have their first band adjustment 4-6 weeks after surgery. The surgeon, in consultation with the patient, schedules additional follow-up appointments and/or band adjustments as needed. Laboratory analysis of your blood is done every three months during the first year after surgery.
- How long will it take me to recover from surgery?
- If the surgery is performed laparoscopically, as it most frequently is, patients typically spend less than 24 hours in the hospital. It takes most patients about a week before they can return to work, and a month to six weeks before they can resume exercising. In the case of open surgery, or if there are complications, recovery may take longer.
- How much food will my new stomach hold?
- When your new stomach pouch has healed, an average meal will be about ½ to 1 cup of food, however, different foods move through at different rates, depending on the consistency.
- Will I be able to eat whatever I want?
- Your surgeon recommends that your source of nutrition be protein drinks for the first few weeks, to allow your new pouch to rest and your band to settle in. The body needs 60 grams of protein per day. Avoid fibrous, stringy foods, and raw vegetables. You may eat most foods that don’t cause you discomfort. However, because you can only eat a little at any given time, it is important to include foods rich in important vitamins and nutrients-foods such as those recommended by your surgeon and/or dietitian.
- Will I feel deprived or hungry?
- If you follow the nutrition guidelines when you choose your food and then chew it well, you should not feel hungry or deprived.
- How will surgery change my eating habits?
- The surgery will change the way you eat and will reinforce a new eating plan. Because your new stomach is smaller, you will feel full after eating less food. Your new stomach pouch will not be able to grind food as it once did, so you will need to eat small bites and chew food very, very well.
- When will I start to see results?
- Individual weight loss results vary but if you follow the general nutritional guidelines, you should expect to lose about 1 to 2 pounds every week on average over the first year.
- How much weight will I lose?
- Weight-loss results vary from patient to patient. A weight loss of two to three 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. But remember that you should lose weight gradually. Losing weight too quickly creates a health risk and can lead to a number of problems. The main goal is to have weight loss that prevents, improves, or resolves health problems connected with severe obesity.
- Why do I need to drink 64 ounces of water daily?
- Drinking water keeps you from becoming dehydrated. This is particularly important after gastric bypass surgery. Drinking plenty of water allows the body to be effective and efficient in ridding itself of the excess fat and also reduces food cravings.
Since you will not be able to drink water quickly as your stomach heals from surgery, you will need to sip small amounts of water throughout the day. Carry a water bottle for convenience and to remind you to keep sipping. The water bottle should become a familiar sight in and out of your home. If you do not like your tap water, treat yourself to bottled water. A slice of lemon can add flavor.
- When should I weigh and measure myself?
- We recommend that you weigh once a day. Plan to weigh and measure yourself on a regular schedule, at the same time of day and in similar clothing.
- Will my weight loss ever hit a Plateau?
- During the period of weight loss, you may hit a plateau when you notice you are not losing pounds. Your body may simply be adjusting to the chemical and biological changes that occur during weight loss.
If plateaus continue for more than a few weeks, review your nutrition plan and activity level. Are you following the nutrition guidelines for portions, protein and fluid intake and limiting fats and sugars in your food selections? Decreasing your activity level can also contribute to a weight plateau. Review your activity level and see if your level of physical activity can be increased. If you are weight training, remember that muscle weighs more than fat, and while you are building muscle, you are still losing inches even though you are not losing pounds.
Do not be concerned if your weight plateaus more than once during your weight loss. If a plateau continues for more than a few weeks, review your nutrition plan and your exercise program. Speak to your surgeon about any concerns you have and for more ideas on the best way to end a plateau.
- Does the Band limit physical activity?
- No. The Band does not limit or hamper physical activity. You should be able to do everything from simple stretches to strenuous exercises. In fact, exercise should become a regular part of your postsurgical routine. Remember, the Band is simply a tool that helps you lose weight – diet and exercise are still required. Always check with your doctor about the amount and type of exercise that is best for you.
- Why is Activity so important or me after surgery?
- Exercise maximizes weight loss and helps to maintain a healthy body. After surgery, you not only need good nutrition, you need to take the time for regular activity. You can build exercise into your daily schedule, and it even helps to walk to do your errands. Here are some reasons why physical activity is important to you:
- Exercise increases your metabolic rate, which can help you lose weight faster.
- Exercise is fat burning.
- Exercise improves your mood and feeling of well being by secreting endorphins (pleasure-chemicals) into your body.
- Exercise causes a person to feel less hungry.
- Exercise increases muscle tissue, which, unlike fat, constantly burns calories (even when the body is resting).
- Exercise will decrease muscle breakdown while losing weight.
- Exercise helps to alleviate constipation.
- Exercise can improve sexual activity.
There are many more reasons for exercise. Why not consider the benefits of joining a fitness program? Use your increasing energy to discover (or rediscover) some new, active interests.
- Who is eligible for Gastric Banding Surgery?
- The Gastric Band can help adults, at least 18 years old, who are 80-100 pounds over their ideal weight or have a Body Mass Index (BMI) of 40 or greater. People with a BMI of 35 or greater with weight-related health problems may also be eligible for Gastric Banding.
About the Operation
Learning a New Eating Plan
Following Your Weight Loss Progress
Chapman A, Game P, O’Brien P, Maddern G, Kiroff G, Foster B, Ham J. Executive summary: Laparoscopic adjustable gastric banding for the treatment of obesity: Update and re-appraisal. Australian Safety and Efficacy Register of New Interventional Procedures-Surgical (ASERNIP-S) Report No. 31, Second Edition. Adelaide, South Australia: ASERNIP-S, June 2002. (Laparoscopic adjustable gastric banding surgery, like the LAP-BAND® surgery, is associated with a mean short-term mortality rate of around 0.05% compared to 0.50% for Gastric Bypass and 0.31% for Vertical Banded Gastroplasty.) Parikh MS, Shen R, Weiner M, Siegel N, Ren CJ. Laparoscopic bariatric surgery in super-obese patients (BMI>50) is safe and effective: a review of 332 patients. Obes Surg. 2005 Jun-Jul;15(6):858-63. Chapman AE, Kiroff G, Game P, Foster B, O'Brien P, Ham J, Maddern GJ. Laparoscopic adjustable gastric banding in the treatment of obesity: a systematic literature review. Surgery 2004;135:326-351. Fisher BL, Schauer P.Medical and surgical options in the treatment of severe obesity. Am J Surg 2002;184:9S-16S.