|This procedure, also called the Lap Band, involves the placement of a small band around the upper part of the stomach. The band contains an inflatable chamber that is attached to a catheter that sits underneath the skin. This catheter allows the band to be tightened or loosened using an injection of saline solution. On average, patients lose 40-50% of their excess body weight.
The Lap Band operation works by giving patients a feeling of fullness after eating very little food. People eat less food, so they lose weight.
Our experienced surgeons perform the gastric bypass operation laparoscopically. Laparoscopically means the surgery is performed through five tiny abdominal incisions with the assistance of a video camera. This type of surgery speeds recovery, decreases common incision problems, and provides a better cosmetic result.
Lap Band Surgery causes major changes in a patient's lifestyle. The ability to eat "normal" amounts of food is gone forever. Many people with life-long obesity experience the feeling of satiety for the first time after Lap Band surgery.
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Changes in Eating After the Procedure
Unlike gastric bypass patients, Lap-Band patients absorb the food they eat normally, so additional vitamin supplements are usually not necessary. Health problems caused by obesity usually gradually improve or even disappear.
During the first month, the diet consists of liquid or blended foods. This allows the stomach around the new band to strengthen and heal. We do not add saline solution to the band in the operating room. Most patients will still notice they fill up more quickly after surgery but some patients don't notice their new band until we begin adjusting it after about 6 weeks.
After the first month, patients slowly advance to eating soft foods and then regular foods.
There will be foods that some patients will not be able to tolerate. These foods include red meats, untoasted bread, fruits with peels on them, and some raw vegetables after this operation.
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The average patient will lose 40-50% of his or her excess body over the first 2-5 years. Weight loss is slower but steadier than after a gastric bypass. Unlike a gastric bypass, the Lap-Band is adjustable so weight loss continues for a longer period of time. Patients who exercise regularly and adhere to the Lap Band diet can expect better long term results than those who do not.
The Lap Band should be seen as a tool to help you curb your appetite on a long-term basis. Success still depends on each individual patient. It is entirely possible for a patient to gain all of his or her weight back after Lap Band Surgery. The stomach pouch can be stretched over time by repeated over eating. Fatty foods, alcohol, and snacking or "grazing" throughout the day can greatly increase calorie intake and cause weight regain despite the pouch. For this reason, we believe in a life-long program where each patient's weight and food intake are assessed on a regular basis.
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Serious Risks Immediately After Surgery
A pulmonary embolism occurs when blood clots form in the large veins of the legs and pelvis, break lose, and travel to the heart and lungs. We administer a gentle blood thinner to each patient in the hospital, but the best way to prevent a pulmonary embolus is to get up and walk. Blood that's kept moving through regular activity usually will not clot.
Death [0.1% (1 in 1000 operations)]
Death occurs due to a complication of the operation, usually damage to another organ, heart attach or pulmonary embolism.
Sometimes patients can experience bleeding after surgery. Patients will occasionally receive a blood transfusion after surgery but this is usually for post-operative bleeding that stops on its own. For more serious post operative bleeding a re-operation may be necessary to stop the bleeding.
Sometimes after surgery patients may feel discomfort when taking deep breaths. When patients fail to take deep breaths or cough after surgery, portions of their lungs may collapse. This can cause fevers and a fast heart rate and can ultimately lead to pneumonia. The best way to avoid this potential complication is to take deep breaths, cough and get out of bed for short walks after going home.
Some patients feel nauseated for weeks after surgery, but this is typically uncommon. In most cases, the nausea resolves on its own without the need for medications. Regardless of nausea, every patient must take in enough fluid and nutrition to stay healthy.
Vomiting is most likely to occur after the band is tightened. We do not encourage patients to force themselves to vomit as it can result in band slippage. Vomiting can happen when a patient eats too much food or eats food too fast.
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Long Term Risks After Surgery
Lap-Bands patients typically do not have vitamin deficiencies. Each patient must, however, maintain a healthy diet.
Some patients form gallstones during the initial period of rapid weight loss. Most of the time gallstones don't cause problems, but in some people they can cause recurring upper abdominal pain. This pain can often be felt under the ribs on the right side and the pain may feel like it is going through to the patient's back. If this happens, we can remove your gallbladder laparoscopically, often on an outpatient basis.
Band Slippage occurs when a portion of the stomach slides up underneath the band. Band Slippage can cause difficulty in eating, vomiting and upper abdominal pain. The first step is to remove the fluid from the band. A formal diagnosis would be made by endoscopy or x-ray after band adjustment doesn't help. Treatment requires laparoscopic surgery to replace the band.
An erosion occurs when the Lap Band gradually moves from being wrapped around the outside of stomach to being partially inside the stomach. The problem can present with chronic port infections or symptoms similar to a band slippage. Treatment requires an operation to remove the band.
Many patients experience loose skin on their abdomen, arms, breasts or thighs after substantial weight loss. Unfortunately, the only way to get rid of this extra hanging skin is to remove it surgically. The bariatric program can refer you to a plastic surgeon for an assessment of this problem.
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