Lap-Band Fills: What You Should Know

Lap-Band surgery has become increasingly popular in the U.S. since the adjustable gastric band was approved by the Food and Drug Administration (FDA) in 2001. Although Lap-Band surgery generally has less risk of complication than gastric bypass or gastric sleeve surgery, those considering the procedure need to be aware of the follow-up protocol. Lap-Band fills are a necessary part of the process and require a firm commitment from the patient for the long-term effects of surgery to be successful.

Initially, the Lap-Band was approved for use in severely obese patients with a body mass index (BMI) of 40 or higher, or those who had a BMI of at least 35 and one obesity-related medical condition, such as type 2 diabetes. In early 2011, the FDA expanded its approval to include obese patients with a BMI of 30 or higher and at least one obesity-related medical condition. This change has made adjustable gastric banding surgery a viable option for millions of Americans who struggle with excess weight.

How it Works
“The adjustable gastric band can be placed around the stomach laparoscopically, and the procedure is reversible, if necessary,” says Dallas Lap-Band surgeon Dr. David Provost. He adds, “The band is usually left unfilled when it is implanted into the body, but later it can be tightened around the stomach by adding a saline solution, which inflates the balloon that lines the inside of the band.” This is what creates the smaller pouch at the top of the stomach to restrict calorie consumption, Dr. Provost explains.

As with other forms of bariatric surgery, patients will be restricted to a liquid diet for the first few weeks after surgery, and will gradually transition to soft foods and eventually to solid foods. As a patient loses weight, the stomach will become smaller and the band will become looser around the stomach, which will reduce its effectiveness. To promote further weight loss, the surgeon will need to adjust the band a little tighter. This is done by injecting more saline solution through a small port just under the skin on the abdomen, a process known as a “fill.”

What to Expect
A Lap-Band fill is painless and can be done as an in-office procedure in a few minutes. The first fill is generally 6-8 weeks after surgery. Going forward, patients may need to visit their surgeon every six weeks for the first year and every three months during the second year post-surgery.

A fill may not be necessary at every visit, but it is important that the surgeon continually monitor the speed and amount of weight loss to determine whether or not an adjustment is needed. (The band can also be loosened by removing saline to address any negative side effects, such as nausea and vomiting.)

Lap-Band fills are critical to the success of gastric banding surgery, and patients should commit to the follow-up protocol prior to having the Lap-Band procedure. If you have any questions about the adjustable gastric band, including insurance coverage for Lap-Band fills and how to prepare for a Lap-Band fill, please call our office at 254-724-2397.

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