Everyone is different but on average we expect gastric band patients to lose 50-60% 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. 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. The scars should fade gradually. Some people have a greater tendency to form keloid, which may result in thicker and more prominent scars.
There should be no vomiting at all. The LAGB is designed to provide a gentle restriction or “brake” on your eating. It is NOT meant to stop you eating. If you are vomiting frequently, there is something wrong with your band adjustment or you are not following the eating rules. Persistent vomiting may be a sign of band slippage.
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). Try them first. If you feel they are sticking, you can crush them up and take with a spoonful of yoghurt. 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.
No. Although it is a very common belief – even among health professionals – that sweet eaters will do poorly after LAGB, this is emphatically NOT true. There are good scientific data to show that sweet eaters do just as well as anyone else.
No. Experience suggests that some people worry more about the adjustment procedure than the surgery itself. In practice, each adjustment consists of a brief scratch of the skin with a small needle and then some very mild discomfort as we push on the access port . It usually takes a few minutes and does not require any form of anaesthetic.
This depends on how well you are doing. If you are losing 1-2lbs (0.5-1kg) a week, have no symptoms and feel well, your band is fine. If your weight loss is very slow or if you have little restriction, you may need a further adjustment. There is considerable variation in how many adjustments are required in the first 12 months. Some need one, others need five or six. But remember more is not necessarily better. Some people think if the band is producing good weight loss, tightening it further will give more dramatic results. This is not true. An over-adjusted band can be dangerous, increasing the chance of slippage and other complications.
The answer is YES. A tiny amount of fluid can leak from the band over time so you will probably need a top-up to restore your usual level of restriction. If you don’t realise this, you may find yourself hungry and putting on weight for no obvious reason and blaming yourself. So even when you have achieved your weight loss, we ask you to stay in touch and attend for an annual “MOT”.
It is very unusual for this to be a problem, but if your weight continues to decline after achieving your goal, we would remove some fluid from the band to reduce the restriction. This is a strength of the band – it can be adjusted to suit an individual's requirements.
Yes. It can be removed relatively easily, though it is not our intention to do so. Furthermore, because the LAGB does not involve any cutting of the bowel or stomach, removal of the band will leave behind a fully restored and normal stomach and alimentary system.
Yes. It is usually safe to have other surgical procedures but it is important to let your surgeon know you have a gastric band. You must also let us know immediately. If your surgery involves general anaesthesia, we will empty your band in case you have a reaction to the anaesthetic that results in vomiting, putting pressure on the band. When recovered, 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.
The LAGB does not interfere in any way with normal pregnancy, of course the likelihood of becoming pregnant is much higher as a result of the band, since weight loss is known to increase fertility. There is a protocol for managing the band if you become pregnant, so you need have no concerns about this.
Yes – in moderation but you need to exercise caution. Alcohol has a high calorific value (7kcal/gram) and provides a lot of unwanted calories to pass easily through your band. However, there are health benefits of moderate alcohol intake and 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. 1 unit of alcohol = half a pint of normal strength beer, half a standard (175ml) glass of wine or small single measure of spirits].
Not very easily. As we eat it is normal to swallow a certain amount of air, but we can usually bring this up again without difficulty. The band interferes with this natural process so that whilst people may want to burp they find it much more difficult. The good news is that for some reason this is a relatively short-lived problem which does not seem to persist beyond the first few months.
This is a fairly common feeling, especially for patients with bands that are tight to begin with to facilitate maximum weight loss or for patients who have just had an adjustment. Some women have also noticed that the band feels tighter during menstruation. It is probably a function of changes in fluid balance in the tissues and is of no real significance other than the fact that you may need to be more careful eating or drinking in the morning.
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.
Some people feel that the band is tighter when they are flying. This can occur if there are any small air bubbles in the band. At normal pressure on the ground, tiny bubbles don’t matter, but at 30,000 feet the pressure in the cabin may be inadequate and the bubbles can expand making the band feel tighter. As a result, you may find it a little more difficult than normal to swallow solid foods. This will return to normal once you get back to ground level. We do all we can to remove air bubbles from the band, but it’s not always possible to eliminate them entirely. Incidentally, the gastric band does not set off airport security or x-ray systems.
There is no evidence at all to suggest that silicone is dangerous. Silicone implants have been used in various areas of medicine for more than 50 years, but have never been shown to be dangerous. Even the widely publicised concerns about breast implants turned out to have no scientific foundation. The gastric band is made of solid silicone and, unlike breast implants which had a liquid silicone core, cannot leak into the tissues.
The short answer is that we don’t know. The first band was implanted in 1993 so our experience is limited to the years since then. However, silicone has been used in the manufacture of medical devices for many years and there is no evidence to suggest it carries any long-term risks. Whether the band structure will remain intact in the very long-term (30+ years) remains to be seen.
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.
