Gastric Band: Frequently Asked Questions
How long does the gastric band surgery take?
Generally the procedure takes about an hour, but each individual is different and actual length of the surgery depends on the patient.
How long will I have to stay in the hospital?
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.
When can I return to work after surgery?
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.
What are the major risks of this surgery?
- Migration of implant (band erosion, band slippage, port displacement
- Tubing related complications (port disconnection, tubing kinking)
- Band, port or tubing leak
- Port site infection
- Esophageal spasm
- Gastro esophageal reflux disease (GERD)
- Inflammation of the esophagus or stomach
I've got a lot of discomfort in the larger incision. Is this normal?
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.
What if I start vomiting in the days following my surgery?
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.
Should I expect to be sick often after the operation?
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.
What happens if I go home and cannot drink fluids?
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.
Sometimes after I swallow I feel discomfort. What's causing this?
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.
How will I know if I'm too restricted?
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.
Do I have to follow a special diet after my fill?
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.
How will I know if I'm not getting enough fluids?
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.
Can I eat anything in moderation?
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.
Will I suffer from constipation?
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.
Can I continue my medications after surgery? Can taking pills cause blockages?
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.
Will I have to take a vitamin supplement?
Our surgeons recommend an over the counter chewable vitamin or a liquid multivitamin.
Why can't I drink with my meals?
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.
Why can't I drink carbonated beverages?
Carbonated beverages can cause the pouch to expand.
Is it okay to drink alcoholic beverages?
You can drink non-carbonated alcoholic beverages, but these drinks can be high in"empty" calories and tend to slow down your metabolism.
Does the band limit physical activity?
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.
When can I go swimming after surgery?
You can resume swimming once the abdominal incisions are healed.
My access port is just below the skin. Do I have to restrict my activities because of it?
There are no restrictions based on the access port. Once the incisions have healed it should not cause discomfort or limit any physical exercise.
Is it normal to have pain in my port area?
Each case is different, but talk to your doctor if you feel persistent discomfort in the port area.
When do I get my first fill?
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.
How is the band adjusted?
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.
Is it true that the band is tighter in the morning?
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.
How much saline does the LAP-BAND®<
This depends on which LAP-BAND® you have. The AP Small holds 10 cc and the AP Large holds 14 cc.
Can the band be removed?
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.
If the band needs to be removed for medical reasons, can it be done as a laparoscopic procedure?
Yes, but removal is rare and each case would be evaluated individually.
If there are no complications, can the band and port remain in place indefinitely?
Yes.
What happens if I become pregnant?
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 and arrange to see your surgeon.
What will happen if I become ill?
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.
What if I need surgery that is not related to the band in the future?
If you are going to have a surgical procedure done, please contact the Bariatric Center. Your surgeon may want to empty your band prior to your having surgery.
Is it important for me to follow-up with a primary care physician?
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.
What will the gastric staples do inside my abdomen? Is it okay in the future to have an MRI test? Will I set off metal detectors in airports?
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.
What if I am away from home on vacation and I am having problems with my band?
If you are experiencing any issues like vomiting, problems swallowing, unusual abdominal pain, you need to contact the Bariatric Center. 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.
What if I end up at a hospital that knows nothing about the adjustable gastric band?
If you are in a facility that is not familiar with the band, you need to have them contact the Bariatric Center. 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 (during business hours) or call the after-hours number if the problem occurs after regular business hours, on the weekend or a holiday.
What do I do about follow-up care if I move out of the state?
Follow-up care must be continued. You may call the McLaren Port Huron Bariatric Center 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.