Lap-Band


Can my procedure be done using single incision laparoscopic surgery?
Calvin Selwyn, Jr., MD, can accomplish Laparoscopic Gastric Banding using the SILS technique.  The Single Incision Laparoscopic Surgery (SILS) technique is accomplished through the belly button using only one incision. In addition to potentially reducing scar visibility, the SILS technique also may eliminate the wound pain associated with multiple points of entry required by standard laparoscopic surgery. You may also benefit from a shortened recovery time from a single incision in the belly button compared to the long incision used in a traditional open procedure.

Will I be sick a lot after the surgery?
The Lap-Band® system limits food intake.  If you feel nauseated or sick on a regular basis, it may mean that you are not chewing your food well enough or that you are not following your diet plan properly.  However, it could also mean that there is a problem with the placement of the band, so contact your physician if this problem persists.  Vomiting should be avoided as much as possible as it can cause the small stomach pouch to stretch.  It can also lead to slippage of part of the stomach through the band and reduce the success of the operation.  In some cases, it can require another operation.

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 physician. They may suggest you take a mild laxative and drink plenty of water.  Your needs will vary, but you should drink at least 48 oz. of fluid daily.

Will I need to take vitamin supplements?
Yes.  It’s difficult to get enough vitamins from four small meals a day.  At your regular check-ups, your physician will evaluate whether you are getting enough vitamin B12, folic acid, and iron.  You may be required to take additional supplements every day.

How is the band adjusted?
Adjustments are often carried out in the clinician’s office. After numbing the skin of the abdomen; 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. Adjustments may also be done in the x-ray department if it is difficult to locate the port by palpation. When x-rays are used, your reproductive organs should be shielded.

How long will it take to recover after surgery?
If Lap-Band® surgery is performed laparoscopically, patients typically spend less than 24 hours in the hospital. It takes most patients about a week to return to work and six weeks to resume exercising.  In the case of open surgery or if there are complications, recovery may take longer.

How much weight will I lose?
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 quick fix, and it requires full commitment and compliance to achieve successful weight loss.

What will happen if I become ill?
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.

What about getting pregnant?
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 pregnancy, the band may be made tighter again and you can resume losing weight.

Can the band be removed?
Yes, it can be removed, although the Lap-Band® system is not meant to be removed. Surgeons report that the stomach generally returns to its original shape once the band is removed.  After the removal, you may soon return to your original weight.  You may also gain more weight than prior to placing the Lap-Band®.

Is it true that the Lap-Band® seems “tighter” in the morning?
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.

Will I feel hungry or deprived with the Lap-Band®?
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.

What about alcoholic beverages?
Alcohol is high in calories and breaks down vitamins. An occasional glass of wine or other alcoholic beverage though is not considered harmful to weight loss.

What if I go out to a restaurant to eat?
Order only a small amount of food, such as an appetizer.  Eat slowly. You may want to let your host or hostess know in advance that you cannot eat much.  You may also share meals with someone.

Will I need plastic surgery for excess skin?
That is not always the case.  As a rule, plastic surgery will not be considered for at least 2-3 years after the operation. Give the skin the time it needs to adjust before you decide to have more surgery.

What about other medications?
You should be able to take prescribed medication, though you may need to open capsules, break big tablets in half or dissolve them in water so they do not get stuck in the stomach outlet and make you sick.  Always ask the physician who prescribes the drugs about this.  Avoid taking aspirin and other non-steroidal anti-inflammatory pain relievers because they may irritate the stomach. The problems these drugs may cause could result in band removal.

Does the Lap-Band® limit any physical activity?
The Lap-Band does not hamper physical activity including aerobics, stretching, and strenuous exercise.

How does weight loss after the Lap-Band® differ from gastric bypass?
These are two different weight loss surgery options.  The Lap-Band® procedure creates restriction in the amount of food able to be eaten. Research has shown that patients average between 40-60% loss of excess weight after surgery.  This typically occurs in the 2-3 years after placement of the Lap-Band®. The gastric bypass offers a restrictive and malabsorptive component to the surgery.  Research has shown that excess weight loss after gastric bypass is approximately 60-80%.  This typically occurs 12-18 months after surgery.