Q: Will I be sick a lot after the operation?
A: The LAP-BAND System limits food intake. If you feel nauseous or sick on a regular basis, it may mean that you are not chewing your food well enough or that you are not following the diet rules properly. However, it could also mean that there is a problem with the placement of the LAP-BAND System, so contact your doctor 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 LAP-BAND System and reduce the success of the operation. In some cases, it may require another operation.
Q: How long will it take to recover after surgery?
A: If LAP-BAND Adjustable Gastric Banding System surgery is performed laparoscopically, patients typically spend less than 24 hours in the hospital. Most patients return to work in about a week, and to exercise in about a month to 6 weeks. In the case of open surgery, or if there are complications, recovery may take longer.
Q: How much weight will I lose?
A: Weight loss results vary from patient to patient, and the amount of weight you lose depends on several things. The LAP-BAND System needs to be in the right position, and you need to be committed to your new lifestyle and eating habits. Weight loss 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 start. A weight loss of 2 to 3 pounds a week in the first year after the operation is possible, but 1 pound a week is more likely. Twelve to 18 months after the operation, weekly weight loss is usually less. Gradual yet steady weight loss with the LAP-BAND System can be healthy for you. 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.
Q: How do the weight-loss results with the LAP-BAND System compare to those with the gastric bypass?
A: Surgeons have reported that gastric bypass patients lose weight faster in the first year. At 3 years, however, many LAP-BAND Adjustable Gastric Banding System patients have achieved weight loss comparable to that of gastric bypass patients.1,2 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.
Q: Does the LAP-BAND System require frequent office visits after surgery?
A: Check-ups with your doctor are a normal and very important part of the LAP-BAND System follow-up. Adjustments may be performed during some of these visits.
Q: Does the LAP-BAND limit any physical activity?
A: The LAP-BAND Adjustable Gastric Banding System should not hamper physical activity, including aerobics, stretching, and strenuous exercise.
Q: How is the LAP-BAND System adjusted?
A: Adjustments are often carried out in the X-ray department. They are done there so the access port can be clearly seen. When X-rays are used, your reproductive organs should 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.
Q: Do I have to be careful with the access port just underneath my skin?
A: The access port is placed under the skin in the abdominal wall, and 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.
Q: Can other people see that I have a port?
A: The port is placed under your skin and is generally not noticeable even if that area of your abdomen is exposed.
Q: Can the LAP-BAND System be removed?
A: Although the LAP-BAND Adjustable Gastric Banding 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 LAP-BAND System is removed. After the removal, though, you may gain more weight.
Q: Will I need plastic surgery for the surplus skin when I have lost a lot of weight?
A: 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 since the skin will sometimes mold itself around the new body tissue. Give the skin the time it needs to adjust before you decide to have more surgery.
Q: Is it true that the LAP-BAND System seems "tighter" in the morning?
A: This is a fairly common feeling, especially for people with a LAP-BAND Adjustable Gastric Banding System that is too tight or just after an adjustment. During the day, the water content in the body changes and this may cause the LAP-BAND System to feel "tighter" some of the time. Some women have also noticed that the LAP-BAND System feels tighter during menstruation.
Q: Will I feel hungry or deprived with the LAP-BAND System?
A: The LAP-BAND System helps 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 Adjustable Gastric Banding System is a tool to help you change your eating habits.
Q: What will happen if I become ill?
A: 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 LAP-BAND System can be loosened by removing saline from it. When you have recovered from your illness and want to lose weight again, the LAP-BAND System can be tightened by increasing the amount of saline. If the LAP-BAND Adjustable Gastric Banding System cannot be loosened enough, it may have to be removed.
Q: What about pregnancy?
A: 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 LAP-BAND System can be loosened. After pregnancy, the LAP-BAND System may be made tighter again and you can resume losing weight.
Q: Will I need to take vitamin supplements?
A: You may. It's possible to not get enough vitamins from three small meals a day. At your regular check-ups, we will evaluate whether you are getting enough vitamin B12, folic acid, and iron.
Q: What about other medication?
A: 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 stomach and make you sick. Always ask the doctor who prescribes the drugs about this. You may need to 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 LAP-BAND System removal.
Q: What if I go out to eat?
A: 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.
Q: What about alcohol?
A: 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.
Q: Can I eat anything in moderation?
A: 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, advised by your surgeon and/or 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 Adjustable Gastric Banding System may be greatly reduced or even cancelled.
Q: Will I suffer from constipation?
A: 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, your doctor may advise you to take a mild laxative and drink plenty of water for a while. Your needs will vary, but you should drink at least 6 to 8 glasses of water a day.
One final point:
It is important that you ask us all the questions you have about obesity surgery and the LAP-BAND System.
1. O'Brien PE, Dixon JB. LAP-BAND: outcomes and results. J Laparoendosc Adv Surg Tech A. 2003;13:265-270.
2. Clegg AJ, Colquitt J, Sidhu MK, et al. The clinical effectiveness and cost-effectiveness of surgery for people with morbid obesity: a systematic review and economic evaluation. Health Technol Assess. 2002;6:1-153.