On average we expect gastric band patients to lose 50-60% and gastric bypass patients to lose 60-70% of their excess weight.
Yes, you are likely to have some discomfort from two main sources. Firstly the port entry sites, through which the operating instruments and camera were passed can be sore, especially where the band access port was placed in the deep tissues. Secondly, it is quite common to have left shoulder pain after the procedure. This is actually pain coming from the diaphragm which is the large, thin sheet of muscle separating the chest from the abdominal cavity. It usually settles down after a few days. As a general rule, most do not have severe pain and what discomfort they do have responds to simple painkillers such as paracetamol.
You should not drive for 2-3 days after surgery to allow the effects of the anaesthetic and any post-operative analgesia (painkillers) to wear off. Thereafter you may find driving a little uncomfortable until the port sites have fully healed – usually around 10 days.
This depends upon what you do for a living, but if you have a sedentary occupation you can expect to be back at work after about one week. If your job involves some lifting, you will probably need a two week period to allow the wounds to heal.
Generally there is minimal scarring following a laparoscopic procedure. The ports are placed in the abdomen through 4 or 5 narrow (1cm) incisions and the access port is fixed through an incision about 3-4 cms. These are sutured and/or glued and will normally heal in 10-14 days. Thereafter the scars should fade gradually. Some individuals have a greater tendency to form keloid, which may result in thicker and more prominent scars.
Usually, you will be able to continue with your regular medication. However, if your tablets are very large, it may be necessary to break them up (most good chemists have a device to do this quite easily). Try them first. If you feel they are sticking, you can crush them up and take them with a spoonful of yoghurt to disguise the taste. Before doing this, however, you should check with the pharmacist that this is OK. Some tablets are specially formulated to be released slowly or coated to protect the stomach and these properties may be destroyed if you crush them. Capsules should not be a problem because they are soft and designed to soften and melt inside the stomach.
Yes. Because you are eating much less and losing weight, we recommend that you take a soluble multivitamin each day just to make sure you are covering all your requirements, especially B vitamins, folate and iron.
Regular physical activity is a very important factor in achieving your weight loss goals. You will be given specific information and advice about physical activity after surgery, but to begin with we strongly recommend walking. As you become fitter you may wish to become involved in more strenuous forms of activity and there is no exercise that must be excluded.
What happens if I lose too much weight?
It is very unusual for this to be a problem, but if your weight continues to decline even when you have achieved your goal, we would remove some fluid from the band to reduce the amount of restriction. This is a great strength of the band – it can be adjusted to suit the requirements of the individual.
Yes. It is usually perfectly safe to have other surgical procedures. However, it is important to let your surgeon know that you have had weight loss surgery. You must also let us know immediately. We recommend that if your surgery involves general anaesthesia, we empty your band beforehand. This is just a precaution in case you have a reaction to the anaesthetic which may result in vomiting, thus putting pressure on your band. After have recovered from the operation, the band can be re-adjusted.
Possibly. As you eat less the amount of residue (especially fibre) in your diet falls and your bowel activity decreases. If you do become constipated, there are plenty of effective remedies todeal with the problem. You will be given advice about this later.
Weight loss surgery does not interfere in any way with normal pregnancy, of course the likelihood of becoming pregnant is much higher as a result, since weight loss is known to increase fertility. If you have a gastric band, there is a protocol for managing the band if you become pregnant, so you need have no concerns about this.
Yes – in moderation. Alcohol has a high calorific value (7kcal/gram) and can provide a lot of unwanted calories which will pass easily through your band. So you need to exercise caution. However, there are some health benefits to be derived from moderate alcohol intake and there is some evidence to suggest that it may even enhance weight loss. So we are quite happy for you to have the equivalent of one unit of alcohol per day. [NB. There is one unit of alcohol in half a pint of normal strength beer, half a standard (175ml) glass of wine or a small single measure of spirits].
Yes. You may eat most foods that don’t cause you discomfort. However, because you can only eat small amounts, it is quite important to include foods which are rich in protein but low in fat and sugar. We encourage you to eat vegetables, fruit, wholegrains, lean meat and fish. You will receive detailed nutritional information following your surgery.
Every medical treatment has a failure rate. About 10-15% of LAGB patients will fail due to a variety of reasons, including an inability to comply with the nutritional requirements of the band, physical inactivity or a failure to attend the follow-up clinic to have the band adjusted properly. It may occasionally be due to leakage from the band or a slippage. We do all we can to reduce the risk of band failure, but it becomes very difficult in circumstances where an individual is simply not committed to working with the device. However, if you are really determined to get a good outcome, most of the reasons for failure can be overcome.
Possibly. The amount of lax skin depends upon your age and weight before your operation. Generally, the older and heavier you are, the more likely you are to have lax skin. Younger patients have a greater degree of natural elasticity in the skin, so there is a lot of re-modelling as weight loss progresses. The most common need is to have the abdominal apron removed, though some patients have more extensive “body-contouring”. Whatever your inclination, you should wait at least one year, preferably two, before making any decisions about cosmetic surgery. It is imperative that any corrective surgery be done by a specialist surgeon. If you are interested in cosmetic surgery, please contact us and we will arrange a consultation with our own bariatric cosmetic specialist.