- The Lap Band System
- Pre And Post Op Questions
- Life Style Changes
- Day Of Surgery
- What is Adjustable Gastric Banding (AGB)?
- How is the LAP-BAND� different from gastric bypass surgery?
- Is the LAP-BAND� permanent?
- Is the LAP-BAND� surgery safe? Is this surgery performed using minimally invasive surgical techniques?
- What are the risks and complications involved with the LAP-BAND� procedure?
- Is there anyone who should not have obesity surgery?
- How many times has your surgeon performed the LAP-BAND� procedure?
- What exactly is the Adjustable Gastric Banding "program"?
- How is the band adjusted?
- How many LAP-BAND� adjustments will I need?
- Are adjustments covered by my insurance company?
- What will happen if I become ill?
1. What is Adjustable Gastric Banding (AGB)?
In the adjustable gastric banding method a band is applied around the stomach about 20 mm below the gastro-esophageal junction. On the inner lining of the band, there is a longitudinal balloon (like a bicycle tire). This balloon is a small tube attached to a subcutaneous port. The band is left empty at time of surgery but is thereafter gradually filled with fluid by injection through the subcutaneous port. It is thus possible to vary the opening in the stomach after surgery.
The band system can be regarded as putting a straight-jacket on the stomach. The band induces a feeling of fullness in patients and thereby decreases food intake. Our method, as well as other methods for obesity surgery, does not however change the basic patient behavior pattern. If the band is removed the weight will quickly increase to what it was before surgery, due to lack of restriction. This means that the operation is not a definite solution to the patient eating pattern or the problem of morbid obesity. It does however induce sustainable weight loss and therefore it leads to a healthier life with fewer risks for obesity related secondary diseases.
In most cases the band is applied through laparoscopic surgery. The first patient was operated on in 1985 and the method has since then developed gradually. Today we can expect that approximately 75% of the patients will loose 80% or more of their overweight within 18 months after surgery. Recent results indicate that weight loss is sustainable since most patients have the same weight at four years as at two years after surgery.
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2. How is the LAP-BAND� different from gastric bypass surgery?
The LAP-BAND� is a silicone band that is placed around the stomach, creating a small upper stomach pouch that prevents a patient from eating excessively. It is only a restrictive device and can be adjusted and/or removed, if necessary. The procedure to place the band is done laparoscopically on an outpatient basis, so our patients go home the same day as surgery in most cases. Recovery is relatively quick - with patients returning to work and/or most normal activities within 2-3 days. It is currently the least invasive form of bariatric surgery, with a relatively low complication rate compared to alternate obesity surgeries. Gastric bypass surgery involves permanently changing the shape of the stomach by surgically reducing (cutting or stapling) its size to an egg-sized pouch, and then bypassing a portion of the digestive tract with the new smaller stomach. This type of surgery has both a restrictive and a malabsorptive effect, and unlike the LAP-BAND�, it is essentially irreversible. Generally, gastric bypass patients stay in the hospital 3-4 days following surgery, and recovery takes approximately 2-4 weeks. Due to the nature of the procedure, gastric bypass surgery has a higher rate of severe complications following surgery and a significant mortality rate.
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3. Is the LAP-BAND� permanent?
No � although it is not meant to be removed, one of the unique characteristics of the LAP-BAND� is that it can be removed surgically in a manner very similar to how it was inserted (laparoscopically, using a few small incisions). Surgeons report that the stomach generally returns to its original shape once the band is removed. After the removal, though, you may go back to your original weight because the restriction that the band provided will no longer be present.
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4. Is the LAP-BAND� surgery safe? Is this surgery performed using minimally invasive surgical techniques?
Yes. The LAP-BAND� procedure is considered the least invasive bariatric surgery available � offering fewer complications, less pain, less scarring, and a quicker recovery than any other form of obesity surgery. The LAP-BAND� procedure is performed laparoscopically. The cameras and instruments our surgeon uses offer superior visibility and access for precise dissection of tissues and associated blood vessels. The operation is completed in a relatively short period of time (approximately 1 hour) and with minimal blood loss. The benefits of using these minimally invasive methods are that patients experience less pain, easier breathing, minimal scarring and a quicker recovery.
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5. What are the risks and complications involved with the LAP-BAND� procedure?
Any gastric operation for obesity is major surgery and carries with it the risks associated with any complex operation. And although the LAP-BAND� procedure is minimally invasive surgery, it is not without its own risks (laparoscopic surgery risks include: spleen or liver damage, damage to major blood vessels, lung problems, blood clots, rupture of the wound, esophagus/stomach perforation).
In rare cases, the LAP-BAND� surgery cannot be performed using the less invasive laparoscopic approach. For example, if unforeseen problems arise while attempting to position the band, surgeons may have to switch to an open method. In addition, there can be serious complications that may warrant the removal of the LAP-BAND� including:
- Slippage of additional stomach tissue over the band
- Erosion of the band into the stomach
- Infection and/or breakage of the injection port (rare)
- Gastric symptoms
It is important that after the LAP-BAND surgery, patients avoid the usage of all aspirin-based medications (Aleve, Motrin, Ibuprofin), steroids, and all anti-inflammatory medicines, due to their adverse effect on the stomach and the band.
While removal of the band can often be done laparoscopically, in some cases it may require open surgery. Serious problems such as peritonitis, infection, leaks, and long-term nutrition problems such as iron and vitamin deficiencies that are seen with gastric bypass surgery do not occur with the LAP-BAND�. Re-operation rates for gastric bypass are significantly higher due to leaks, bowel blockages, outlet scarring, ulcers, and bleeding.
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6. Is there anyone who should not have obesity surgery?
This surgery is obviously a very serious step. Patients with psychiatric conditions such as depression, bipolar disease, and/or schizophrenia should be under the care of a psychiatrist before they consider surgery. These conditions can become exaggerated by the body changes that are associated with weight loss. There are some medical conditions which make the surgery too dangerous to perform. These occur rarely but must be taken into account. If patients meet the eligibility guidelines they are obvious candidates for success with this surgery.
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7. How many times has your surgeon performed the LAP-BAND� procedure?
Dr. Jayaseelan is one of the most experienced outpatient lap-band surgeons in Dallas. He has performed thousands of laparoscopic procedures, over 3,250 LAP-BAND� procedures and is FDA-approved for LAP-BAND� surgery.
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8. What exactly is the Adjustable Gastric Banding "program"?
The program begins with the first call to our office. We know that people who are suffering with morbid obesity have gone through many "fad" programs, false promises, and 'diet industry' quackery, so we immediately want to dispel myths about morbid obesity and teach factual information about the realistic benefits and patient responsibilities related to choosing surgery for obesity. Our team has a high motivation for helping patients succeed post surgically. We define success as 80% of excess weight lost, with no major problems in quality of life and improved medical and psychological status.
So, the program actually begins before the surgery. We encourage our patients to become very involved in understanding the program, their personal commitment to have the Band, and their behavior and dietary choices BEFORE they arrive for surgery.
We strongly advise patients to attend our monthly support groups before surgery, and we have successful "veteran" patients with whom prospective patients can engage in private conversations. These pre-surgery steps help surgical candidates in many ways: the relationship between the patients and the clinical team is already under way and established on a sincere teamwork format, and the patient is more and more familiar with the surgery and the follow-up program. This latter point is very important because with more understanding and trust, there is less fear for new patients and they are able to 'get' the necessary guidelines to improve their success following surgery.
The actual "Adjustable Gastric Banding", is generally basic, good health care strategies. You must follow a simple but consistent program of 7 rules:
- Eat three meals per day, no skipping of meals. Each meal should last between 15-30 minutes.
- In each meal you must eat a low fat animal protein, what we call a "High Biological Protein", for example, chicken, fish, turkey, lean meat. You may also have a fruit and a portion of vegetables. You should take a one-a-day multi-vitamin. These include vitamins and nutritional supplements. There are certain drugs that you must avoid, including all Non-Steroidal Anti-Inflammatory Drugs (e.g. Advil, Motrin, etc), and aspirin.
- You may not drink with your meals. You must also allow a 30-minute window after your meal in which you do not drink any beverages.
- Otherwise, you may drink to your preference, however, all beverages should be 'Zero' calories; therefore, a limited amount of fruit juices, alcohol, or soups may be consumed. It is advisable to avoid gulping beverages.
- You must eat slowly, and chew your food to a soft consistency. It may take about 20-30 chews in order to reach the consistency appropriate to swallow.
- All patients should participate in an exercise program, which is increased gradually, given the individual characteristics of patients. We encourage patients to begin walking in the hospital. This activity improves the recovery process by improving such factors as respiratory status, decreasing pain sensitivity after surgery, and increasing mobility. In the weeks immediately following surgery, we continue to support daily walking, gradually building up the time and speed of the walks. At this point we are beginning to introduce walking for aerobic benefits (exercise to increase oxygen use, increase metabolic efficiency to improve weight loss results). Walking, treadmill, stationery bike, and aerobics classes are some of the most popular activities.
Finally, several months after surgery, we advise patients to add in a moderate weight-training program, perhaps two sessions a week. This step helps patients maintain good lean muscle mass - in other words; body weight is lost from excess fat, not muscle. This fact is very important for maintaining general health status.
- Success - losing massive body weight, improving related medical problems, feeling and being well AND maintaining your weight loss over many years requires at least 80 % cooperation with these guidelines and any special orders given to you by Dr. Jayaseelan. There is just no way around this fact. Our final guideline is to advise patients to attend our monthly support group meetings. This rule is incredibly important because it gives us all the chance to help correct little adjustment problems before they become crises, and it gives the opportunity for patients to have monitoring and help to really make the most of their surgery.
Even though the program may sound impossible, having the surgery itself makes these major behavior and dietary changes not only possible, but also very "do-able". With the help of the team, and successful prior patients, we build each step of change carefully, one after the other, to help you reduce anxiety, create a healthy outlook and adjust to new, permanent way of living with a slim and healthier self.
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9. How is the band adjusted?
Adjustments are done in our office in the Fluoro room where we use a fluoroscopy (X-ray) machine to accurately perform the procedure. They are done there so the port can be clearly seen. Local anesthesia may or may not be needed, but we will usually numb the area before performing the adjustment. A fine needle is passed through the skin into the port to add or subtract saline. This process often takes only a few minutes. Most patients say it is painless.
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10. How many LAP-BAND� adjustments will I need?
The number of adjustments (fills) you may need cannot be determined in advance of your surgery. Some patients need one adjustment, while others need several in the first year depending upon their individual response to the band and the degree of weight loss desired. Generally, adjustments are not performed until at least 6 weeks after your surgery.
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11. Are adjustments covered by my insurance company?
Right now, we work with patients to get their insurance to cover the costs for adjustments. We will verify your benefits to ensure that you have coverage for the procedure. For the most part, patients with coverage are able to get their adjustments for the price of their office visit co-pay. If your insurance policy does not provide coverage for band adjustments, you will need to pay for this procedure yourself. For our cash-pay patients who have paid for the procedure out-of-pocket, the adjustments are $150. Also, all other patients who do not have insurance coverage will pay $150 for each adjustment.
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12. 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. This can be done by removing saline from it. When you have recovered from your illness and want to lose weight again, the band can be tightened. This can be done by increasing the amount of saline.
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- What pre-operative tests are required?
- Are there any short-term side effects of the operation? What complications may occur?
- Will I have any problems with gas post-operatively?
- Will the reflux and heartburn I have now will be 10x worse after the surgery even if I eat the protein as suggested and the extremely small portions as my life style changes?
- Will I be able to take all of my medications like I normally do?
- How soon after the surgery will I be able to start exercising? Will I be able to return back to work in 2 weeks?
- How does the body know when to stop losing weight?
- Will I be able to maintain my goal weight for many years or the rest of my life?
- Will I need plastic surgery for the surplus skin when I have lost a lot of weight?
1. What pre-operative tests are required?
We may require that you complete the following tests prior to surgery:
- Complete blood count (CBC), CMP, Lipid Panel, and TSH
- Electrocardiograph (EKG) and/or Stress Echo
- Upper GI
Depending on the patient, there may be additional tests that our provider may feel necessary to ensure the safety of the procedure.
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2. Are there any short-term side effects of the operation? What complications may occur?
Adjustable gastric banding is well tolerated by most patients. Complication rates are low but this does not mean that complications are non-existent. The following is a list of the complications that have been seen following this operation:
- Vomiting: Most patients will occasionally feel pain or vomit after intake of food. In most cases, this is caused by eating too much and too quick. If eating is slow and the food is well-chewed, patients will learn to listen to the signals from the stomach. Eating should be abandoned if the patient feels nauseated, has pain or vomits. Regular vomiting is a warning sign. This can either be caused by wrong eating behavior or be caused by the outflow of the gastric pouch becoming too narrow. This means that the band may need to be adjusted. Regular vomiting should be discussed with Dr. Jayaseelan and corrected.
- Constipation: Several patients feel constipated after surgery. This is mainly caused by the reduced food intake which leads to less matter, and thus fewer bowel movements. If laxatives become necessary, it is advisable to abstain from so called bulking agents and instead use liquid laxatives (preferably milk of magnesia). There may be some reduction in the volume of your stools. This should not cause severe problems. If difficulties do arise, check with your doctor. Drinking plenty of water will help in this area. Your needs will vary, but you should drink a minimum of 64 ounces, eight 8-ounce glasses of water a day.
- Hair loss: Many patients are suffering from increased hair loss during the first six months after surgery. This is caused by the relative starvation. This, however, never leads to baldness and normal hair growth will eventually return. Most often, hair loss is experienced due to lack of protein in the diet. We encourage all patients to consume 40-60 grams of protein everyday. Increasing protein intake will help resolve this problem.
- Infection: There have been a few cases of deep infection in the abdomen leading to removal of the band. There have also been some infections of the port system leading to removal of the port. Sterility during injection is always practiced in the office and is of great importance in order to minimize or avoid this complication.
- Port Problems: There have been port problems in about 4% of the cases. There have been two types of problems. The first is dislocation of the port. It may move around, turn up-side-down and can in this position not be injected. It is thus necessary to adjust it. This is a simple operation, under local anesthesia but nevertheless a nuisance to the patient. The second problem is perforation of the connecting tube close to the port. Some patients have extra fat over the chest and it is therefore sometimes difficult to hit the �bulls eye� with the needle and the tube may be accidentally perforated. This leads to loss of fluid, widening of the opening and subsequent weight gain. This can also be corrected with a small operation under local anesthesia. The port is brought to the surface, a bit of the tube including the hole is cut off, and the remaining tube is reattached to the port and finally the port returned into position.
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3. Will I have any problems with gas post-operatively?
Gas is common during the first post-operative week; some patients complain of "needing to burp, but nothing comes up". This problem can usually be alleviated by walking and drinking fluids as soon as you can after surgery. If the problem does not subside, over-the-counter GasX can also help to alleviate this pain.
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4. Will the reflux and heartburn I have now will be 10x worse after the surgery even if I eat the protein as suggested and the extremely small portions as my life style changes?
The heartburn you have right now is caused by reflux of gastric juice up to the esophagus. The acid in the gastric juice is not produced in the whole area of the gastric mucosa, it is produced in something called parietal cells. The upper limit of presence of these cells is about 2 inches from the gastro-esophageal junction. The band is placed above these cells. This means that the band actually prevents acid from running up in the esophagus. The second factor of importance is the hiatus (the opening in the diaphragm through which the esophagus goes up into the thoracic cavity). In most individuals the hiatus is tight and no gastric juice is allowed to pass up into the esophagus. In many obese individuals the hiatus muscle becomes slack - so reflux is actually a complication to obesity. When we perform gastric banding we usually tighten the hiatus muscle with a couple of sutures. The result of both these factors is that obese patients who have esophageal reflux, in most cases, experience an instant relief of those symptoms after surgery. The hiatus is tightened and the band prevents the acid from running up. Reflux disease can occur later as a result of dislocation of the band. If the band moves down it comes below the upper limit of the parietal cells and acid is produced above the band resulting in reflux.
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5. Will I be able to take all of my medications like I normally do?
You should be able to take prescribed medication. You may need to use capsules or break big tablets in half or dissolve them in water so they do not get stuck in the stomach and make you sick. You should always ask the doctor who prescribes the drugs about this. Your surgeon may tell you to avoid taking aspirin or other non-steroidal anti-inflammatory pain relievers. This is due to the adverse effects they have on the band and how they may irritate the stomach. The problems these drugs may cause could mean the band would need to be removed due to erosion.
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6. How soon after the surgery will I be able to start exercising? Will I be able to return back to work in two weeks?
Walking should begin right after surgery. After 4 weeks everything should be normal and you can resume, or begin, a regular exercise program. You will also be able to return back to work, but you will have a 20 pound weight lifting restriction for six weeks. Any pain related to the surgery should go away after 10 days or so. General fatigue can last from 3 to 4 weeks after surgery.
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7. How does the body know when to stop losing weight?
Food is the same thing as gas in your furnace. If you have a bigger house you need more gas to heat it. If you have a small house you need less. So - every human being sooner or later reaches a steady state in terms of weight. You will continue to loose weight until your intake is equal to what your body is consuming. The smaller you get the less you consume, and eventually you stop loosing weight.
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8. Will I be able to maintain my goal weight for many years or the rest of my life?
Yes! As long as you commit to the guidelines of the program and keep a good relationship with Dr. Jayaseelan�s office. Remember morbid obesity is a chronic disease process and you must maintain good healthcare practices, following doctor�s guidelines for the rest of your life.
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9. Will I need plastic surgery for the surplus skin when I have lost a lot of weight?
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. Sometimes the skin will mold itself around the new body tissue. You should give the skin the time it needs to adjust before you decide to have more surgery.
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- What is expected of me if I decide to choose the LAP-BAND� as a surgical solution?
- What nutritional supplements will I need to take post-operatively?
- Are there any specific foods or beverages that I should not eat post-operatively?
- Can I drink alcohol?
- Will the intake of water and/or other liquids be restricted to a little at a time or do we at some point regain the ability to drink a glass of liquid in a usual and normal way?
- If I lose all this weight, how will my life change?
- After I have LAP-BAND surgery, how long would I have to wait to have children and how can I increase the intake of my foods to nourish my child?
- Have you had many patients conceive normally and deliver without incident? Have there been any complications that you are aware of?
- What is the true success rate without any complications?
- How much weight will I lose and how fast will I lose it?
- Two months after surgery, I experienced some pain. I spoke with a doctor and it turns out it was my gall bladder. Is this common?
1. What is expected of me if I decide to choose the LAP-BAND� as a surgical solution?
We expect that you will comply with our program including the pre-operative testing requirements, pre/post-operative diet and exercise programs, band adjustments (as necessary) and follow-up medical appointments. We recommend that our patients follow these guidelines for optimal success.
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2. What nutritional supplements will I need to take post-operatively?
We recommend that our patients take a multivitamin with iron every day. In addition, we suggest that our female patients also take a daily calcium supplement. Because the LAP-BAND� procedure is not a malabsorptive one, you should enjoy the full nutritional benefits of the food that you eat after surgery. The volume of the food you eat will decrease, however, so you will need to be sure to follow a nutritionally balanced meal plan.
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3. Are there any specific foods or beverages that I should not eat post-operatively?
Before surgery, our staff will review with you in detail the post-operative diet you should follow as well as additional dietary recommendations and restrictions. Most LAP-BAND� patients should NOT eat any dried fruits, as they can swell in the stomach pouch and become stuck. It is also recommended that patients avoid "fibrous" foods after surgery as they can also get lodged in the small opening of the stomach pouch. Such foods include, but are not limited to: asparagus, pineapple, rhubarb, corn (popcorn), broccoli, and grapes. (Note: in general, LAP-BAND� patients improve their digestion if they learn to chew their food well, particularly meats). Most liquids are fine, but patients should NOT drink carbonated beverages as they can cause distension of the stomach pouch. In addition, patients can help avoid feeling nauseated during the first 6 weeks post-operatively if they avoid acidic juices (e.g., orange, grapefruit, lemon). Otherwise, we recommend you eat a wide variety of foods and drink eight 8 ounce glasses of water every day.
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4. Can I drink alcohol?
It is inadvisable to consume alcoholic beverages during the weight loss period, as alcohol digests to sugar. Also, we prefer that patients avoid carbonated beverages. After you have reached your goal weight, you may drink moderately.
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5. Will the intake of water and/or other liquids be restricted to a little at a time or do we at some point regain the ability to drink a glass of liquid in a usual and normal way?
No, it is just during the first 3-4 weeks after surgery. Later you can take more at a time, but you will have problems if you drink a full glass in one big "gulp." Moderation is always the key word after obesity surgery.
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6. If I lose all this weight, how will my life change?
Of course, we can't predict exactly how your life will change after losing 100, 150 or 200+ pounds. That old motto, "everyone is an individual" is wise and true! We can ASSURE you that your life WILL change and the changes are very likely to be quite dramatic! Over the last few years that we have monitored our patients, we find that some of the major changes to be:
- Improved physical status, such as: blood pressure, blood sugar and respiratory regulation, increase in energy, less body aches and pains, and improved sleep.
- Improved psychological status, including decreased depression, improved self esteem, improved social skills, more confidence and realistic hope for the future.
- Changes in relationship, including family, love relationships, friends and co-workers. In general these changes are positive and exciting. They are also demanding. In order to cooperate with our program, patients must really put their own healthcare choices first. This is very often a change for our patients, since many have felt depressed and hopeless they have given their own lives the lowest priority. Our patients have to learn to make assertive, healthy decisions for themselves, even when these decisions upset their loved ones. For example, they may choose to go on their exercise walk instead of sitting down and eating pretzels, OR they may have to deal with their spouse's jealousy or discomfort when they become increasingly attractive and self-confident.
- Body image: Patients undergo incredible changes in how they see and feel about their bodies. Losing 100 or more pounds creates drastic changes in body size, appearance, and related areas such as dressing choices and feelings of being attractive.
- Accepting normal body image is sometimes a major challenge for obesity surgery patients. Even though wearing a size 8 dress may be a lifetime goal, some patients require some adjustment time to accept this reality, sometimes still "feeling fat," or worrying that they will gain weight back. We find that as more time passes and patients learn to become experts in managing the program guidelines with their individual lives, they experience more real success, and the new healthy body image becomes more comfortable and reliable.
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7. After I have LAP-BAND surgery, how long would I have to wait to have children and how can I increase the intake of my foods to nourish my child?
There is no problem with pregnancy and birth after obesity surgery. It is good to wait about 6 months so that you get over the first phase of rapid weight loss after surgery. One of the benefits of the Lap-band is that the saline that is in the band can always be removed, if it becomes necessary. There are no special dietary requirements after surgery. The rule is that the baby always takes what he/she needs. So, you can feel confident that there are no problems with pregnancy should you decide to have surgery.
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8. Have you had many patients conceive normally and deliver without incident? Have there been any complications that you are aware of?
Having a child is no problem. It is in fact often easier to conceive after obesity surgery than before. One of the complications of severe obesity is irregular ovulation and irregular periods. Some women even lose their periods all together when they become real obese. So there is absolutely no problem with having a child.
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9. What is the true success rate without any complications?
Approximately 85-90%. There are three reasons for failure. First, patient-related reasons: Some patients make incorrect food choices and consume a high-calorie diet (ice-cream, chocolate, etc.). A second complication lies with the band itself (leakage, slipping, etc.). The third issue, placement failure or dislocation of the band (slippage, pouch dilatation, wrong initial placement). The most important thing is not really the surgery itself. This is, in most cases, a very straightforward and simple procedure. The determining factor effecting final outcome is the post-op, follow-up and patient compliance. The patient has to work with the band, listen to it and behave accordingly. Patients who fight the band are not doing as well as those who are compliant.
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10. How much weight will I lose and how fast will I lose it?
The amount of weight you may 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. In the U.S. clinical trial, 2 percent of patients gained some weight. 5 percent neither gained, nor lost weight (t5%). 61 percent of the patients lost at least 25 percent of their excess weight. 52 percent of the patients lost at least 33 percent of their excess weight. 22 percent lost at least 50 percent of their excess weight, and 10 percent lost at least 75 percent of their excess weight. You should lose weight gradually. Losing weight too fast creates a health risk and can lead to a number of problems. Nausea and vomiting are only the most minor examples. A weight loss of 2 to 3 pounds a week in the first year after the operation is possible, but one pound a week is more likely. Twelve to 18 months after the operation, weekly weight loss is usually less. Remember that your main goal is to have a weight loss that prevents, improves, or resolves health problems connected with severe obesity. The amount of weight you lose and the rate at which you lose it is dependent on a number of factors in addition to the LAP-BAND� itself such as: your starting weight, your post-operative diet, the amount of exercise you do, etc. On average, however, patients have lost about 50% of their excess weight within the first year of surgery. Most patients find they are losing between 5-10 pounds a month, depending on their individual diet and exercise regimens.
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11. Two months after surgery, I experienced some pain. I spoke with a doctor and it turns out it was my gall bladder. Is this common?
At a recent conference, a recent French study showed that about 20% of patients having undergone obesity surgery develop gallstones within the next 24 months. The French had looked at this problem in detail and their conclusion was that quick weight loss changes the balance between the various salts in the bile. The result is that the bile becomes supersaturated with cholesterol (obese patients have a lot of that!) and the cholesterol crystallizes and forms stones in the gallbladder. Many of us have seen this in patients, but we have not had clear data and there has never been such a detailed study about it this issue before. An obvious discussion was of course if we should automatically take out the gall bladder in all patients undergoing obesity surgery. There was no distinct answer to this question. It is obviously of benefit in 20% of the patients - but in 80% you take something out without a real reason. So - this is a difficult ethical issue. If it should become necessary that you need for your gall bladder to be taken out, Dr. Jayaseelan is also a general surgeon and would be able to do this procedure for you.
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- On the day of my surgery, how much time beforehand do I need to arrive?
- Are the facilities properly equipped for bariatric patients? Will they have gowns, beds and other equipment large enough to accommodate me?
- Are the anesthesiologists experienced with the unique needs of obese patients?
- How long will I be in recovery following my surgery?
- Will I have respiratory therapy?
- How long will I need to stay at the Center following my surgery?
- Will I feel much pain after the procedure?
1. On the day of my surgery, how much time beforehand do I need to arrive?
You will receive a phone call from a staff nurse the day before your surgery to review last minute pre-operative instructions with you and confirm your arrival time the day of surgery. Generally, we ask that our patients arrive to arrive at the facility 1 hour prior to surgery.
2. Are the facilities properly equipped for bariatric patients? Will they have gowns, beds and other equipment large enough to accommodate me?
Yes, we have made a sincere commitment to our patients and made sure that everything in the facilities accommodates your special requirements. As a result, we have customized beds, gowns, wheelchairs, operating room equipment and x-ray equipment designed precisely for obese patients. Furthermore, our nursing staff is fully trained to address the needs of overweight patients.
3. Are the anesthesiologists experienced with the unique needs of obese patients?
Absolutely! In keeping with our commitment to the highest quality care, our facilities only use Board Certified anesthesiologists in the operating room, all of whom are experienced in treating obese patients.
4. How long will I be in recovery following my surgery?
Following surgery, patients are monitored in a recovery room for approximately 3 to 6 hours before being discharged from the facility. Recovery times vary and sometimes depend on the patient.
5. Will I have respiratory therapy?
Yes, following surgery you will be asked to breathe in a tube every hour (incentive spirometry) until you are discharged.
6. How long will I need to stay at the Center following my surgery?
As the LAP-BAND� surgery is performed on an outpatient basis, almost all patients are released the same day as their surgery.
7. Will I feel much pain after the procedure?
Patients are given pain medication for use at home following surgery. Most individuals experience only mild discomfort, which is generally relieved by the pain medicine to take off of work after your LAP-BAND� surgery.
Usually about 4-5 days. Most patients feel some fatigue and weakness for 3-5 days but are able to return to normal functions after about 5-7 days. If you do manual labor, you may wish to stay off of work a little longer because you will have a weight lifting restriction for six weeks after surgery.
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