Laparoscopic adjustable gastric banding (320x240)
credit: © 2016-2019 Healthwise, IncorporatedLaparoscopic adjustable gastric banding

Laparoscopic adjustable gastric banding is surgery to make the stomach smaller. It is done to help people lose weight. The surgery limits the amount of food the stomach can hold. This helps you eat less and feel full more quickly.

Adjustable gastric banding is done through several small cuts, called incisions, in the belly. The doctor will place small surgical tools and a camera through the incisions. The doctor will then wrap a device around the upper part of your stomach to form a ring. Attached to the ring is a thin tube leading to an access port that is left under the skin. The access port is the place where the doctor puts in a needle to add or take away saline. Adding saline tightens the band and makes the stomach smaller. The doctor can take away saline if the ring is too tight.

During surgery, the band is not inflated. You will need to recover from surgery before the band is adjusted for weight loss. This is usually 4 to 6 weeks after surgery.

Another name for this surgery is gastric banding. Sometimes people refer to it by brand names, for example the Lap-Band System or the Realize Band.

What can you expect after adjustable gastric banding surgery?

After surgery, you may need pain medicine to help with discomfort and soreness. You'll be encouraged to start moving around to help your body heal. You may have an X-ray the day after surgery to see that everything is working correctly.

Your doctor will give you specific instructions about what to eat after the surgery. For the first 2 weeks, your stomach can only handle small amounts of liquids while you are healing. Some people feel full after just a few sips of water or other liquid. Other people won't notice much difference. It is important to try to sip water throughout the day to avoid becoming dehydrated. You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements.

Bit by bit, you will be able to add solid foods back into your diet. You must be careful to chew food well and to stop eating when you feel full. This can take some getting used to, because you will feel full after eating much less food than you are used to eating. If you do not chew your food well or do not stop eating soon enough, you may feel discomfort or nausea and may sometimes vomit.

Your doctor may recommend that you work with a dietitian to plan healthy meals that give you enough protein, vitamins, and minerals while you are losing weight. Even with a healthy diet, you probably will need to take vitamin and mineral supplements for the rest of your life.

After you can eat solid food again, your doctor will adjust the band around your stomach by inserting saline into your port, which will inflate the band and cause it to tighten. You will probably have many adjustments to the band in the first year to find the right size that helps you lose weight, feel full at the right time, and not vomit. You'll need to visit doctor each time you need the band adjusted.

Weight loss

After this surgery, weight loss is usually gradual but steady. You will have regular visits with your doctor to check how you are doing. The doctor can adjust the band if you are not losing weight as expected or if you have problems with the band. Some people continue to lose weight for up to 3 years after surgery.

Emotions

It is common to have many emotions after this surgery. You may feel happy or excited as you begin to lose weight. But you may also feel overwhelmed or frustrated by the changes that you have to make in your diet, activity, and lifestyle. Talk with your doctor if you have concerns or questions.

What are the risks of adjustable gastric banding surgery?

Risks common to all surgeries for weight loss include an infection in the incision, bleeding, and a blood clot in the legs (deep vein thrombosis, or DVT) or lung (pulmonary embolism). Some people develop gallstones or a nutritional deficiency condition such as anemia or osteoporosis.

Although adjustable gastric banding is considered the least invasive of the weight-loss surgeries, problems can occur. They include:

Obstruction. The band can cause something (usually food) to block the opening from the upper part of the stomach to the lower part of the stomach. This can cause pain, nausea, and vomiting.

Band slippage. The band can slip out of place. Symptoms might include belly pain or heartburn (acid reflux). This may be treated by removing the fluid from the band. Or you may need a second operation.Access port problems. You could get an infection around the access port, or the access port could disconnect or leak. The tube that leads from the band to the access port could also become blocked.

GERD. You could develop esophagitis or gastroesophageal reflux disease (GERD).

Esophageal dilation. If the band is too tight, or if you eat too much, your esophagus could expand. This can make it hard for you to swallow, which could cause food to get stuck in your throat. If it is not fixed, you could get pneumonia.

Poor nutrition. Eating less may mean that you are not getting enough nutrients, which can cause health problems. You will probably have to take vitamin supplements for the rest of your life.

How can you care for yourself after laparoscopic gastric banding?

Activity

Rest when you feel tired. Getting enough sleep will help you recover.

Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.

Avoid strenuous activities, such as bicycle riding, jogging, weight lifting, or aerobic exercise, until your doctor says it is okay.

Until your doctor says it is okay, avoid lifting anything that would make you strain. This may include a child, heavy grocery bags and milk containers, a heavy briefcase or backpack, cat litter or dog food bags, or a vacuum cleaner.

Hold a pillow over your incisions when you cough or take deep breaths. This will support your belly and decrease your pain.Do breathing exercises at home as instructed by your doctor. This will help prevent pneumonia.

Ask your doctor when you can drive again.

You will probably need to take 2 to 4 weeks off from work. It depends on the type of work you do and how you feel.

You may shower, if your doctor okays it. Pat the incisions dry. Do not take a bath for the first 2 weeks, or until your doctor tells you it is okay.

Ask your doctor when it is okay for you to have sex.

Diet

Your doctor will give you specific instructions about what to eat after the surgery. For the first 2 weeks, you will need to follow a liquid or soft diet. Bit by bit, you will be able to add solid foods back into your diet.Y

our doctor may recommend that you work with a dietitian to plan healthy meals that give you enough protein, vitamins, and minerals while you are losing weight. Even with a healthy diet, you probably will need to take vitamin and mineral supplements for the rest of your life.

At first you may feel full after just a few sips of water or other liquid. It is important to try to sip water throughout the day to avoid becoming dehydrated.

You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements.MedicinesYour doctor will tell you if and when you can restart your medicines. He or she will also give you instructions about taking any new medicines.

If you take blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin, be sure to talk to your doctor. He or she will tell you if and when to start taking those medicines again. Make sure that you understand exactly what your doctor wants you to do.Be safe with medicines. Take pain medicines exactly as directed.If the doctor gave you a prescription medicine for pain, take it as prescribed.

If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.

If you think your pain medicine is making you sick to your stomach:

Take your medicine after meals (unless your doctor has told you not to).

Ask your doctor for a different pain medicine.If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Incision care

If you have strips of tape on the incisions, leave the tape on for a week or until it falls off.Wash the area daily with warm, soapy water, and pat it dry. Don’t use hydrogen peroxide or alcohol, which can slow healing. You may cover the area with a gauze bandage if it weeps or rubs against clothing. Change the bandage every day.Keep the area clean and dry.

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