Post-Operative Follow-up:

Band Adjustments after Laparoscopic Adjustable Gastric Banding Surgery

The band is not filled at the time of surgery. It is left completely empty. Some patients may "feel" the band in place in the form of some slowing of the passage of liquids and especially solids if the diet recommendations are not followed. If you eat solid food (for example, a piece of steak that is not well chewed), a blockage of the pouch outlet can occur, which will require the removal of the food by a technique called gastroscopy.

The first band fill (adjustment) is usually done at 8 weeks after your surgery. This allows the band to settle properly around the upper part of your stomach and your body to build a capsule of tissue around the band to secure it in place. Band adjustments are done in Dr. Christou's office in 90% of the cases as the port is easily accessible. In about 10% of cases, the band adjustment must be done in the radiology department with the use of fluoroscopy (a special type of X-ray).

You will lie comfortably on your back (a pillow under your back may help). The port site is identified and the port marked with a pen. The area over the port is sterilized with antiseptic, a needle is inserted into the port, and the band is filled (or emptied) as needed. After an adjustment, you will be asked to take water and see how the band "feels". If water can be taken, you will be asked to return home, go back on full fluid diet and progress from there.

Subsequent adjustments will be made every 6-8 weeks until an adequate rate of weight loss is achieved. This should be 1-2 lbs ( about 0.5 to 1 kg) per week. Once the band is adjusted to achieve 1-2 lbs weight loss per week, the subsequent follow-ups occur every 6 months. At these visits, weight is measured and blood tests are requested as needed. If weight loss has leveled off, the band is adjusted as needed.

• What to do if a problem develops