How is the gastric band adjusted?
First band adjustment
The first gastric band adjustment is carried out at approximately 8 weeks after surgery at any of our nationwide clinics. The aftercare package also includes one adjustment under X-ray control should we need to assess the positioning or functionality of the band at any point.
Healthier Weight offers Free of charge band adjustments for 2 years, by which time we really should have found the ideal “fill point” for you.
Patients are sometimes more anxious about the adjustment procedure than about the operationto implant the band, but their anxiety is completely unfounded. Gastric band adjustment is usually a very straight forward procedure involving only minimal discomfort, or none at all!
Gastric band adjustments will normally be carried out in the consulting room. You will be asked to lie on the clinic couch and we will locate the band access port and introduce / remove saline (salt water) with a special needle.
When the gastric band adjustment is complete you will be asked to drink some water to ensure that you are able to tolerate fluids and are safe to return home. We ask that you return to a liquid regime for 3 days (to take into account the possibility of any swelling that may occur), followed by 3 days of soft foods. You may then resume eating normal textured foods.
It is not always possible to get the correct degree of restriction at the first band adjustment. You may need a little more saline in the band, or less often, a little taking out. Any subsequent adjustments will be performed at a Healthier Weight centre by a qualified practitioner, but we ask that you allow 4 weeks between fills to allow a settling in period. Sometimes it may not seem as though the gastric band has been adjusted correctly and that it has been unsuccessful, but after a week or so you may notice that you are losing weight and that the band is working well. Remember everyone is different and you must resist the temptation to compare yourself with other patients.
Less may be more
Patients occasionally make the mistake of thinking that ‘more is better’, that if the band is working well at one level of adjustment, it will work even better if we make it tighter. This is a mistake. Tightening the band when it is not required can cause problems and can even be dangerous.
X-Ray gastric band adjustments
An x-ray is sometimes used in order to assist with the band adjustment
If we need to assess the positioning or functionality of the band, you will be referred for an X-Ray adjustment. You will be asked to lie on the X-ray table and we will then ask you to swallow a white liquid called barium. This shows up very well on the X-ray and allows us to check that the band is in the correct position and functioning normally.
We then locate the band access port and saline (salt water) is introduced into the system with a special needle. The barium swallow is then repeated and the flow through the band is observed. By adjusting the amount of fluid in the gastric band against the flow of barium, we can achieve the correct level of restriction. This may take several attempts, so you must be patient!
Following these adjustments you will again be requested to have a drink and remain on our 3 day fluid and 3 day soft diet protocol to ensure your band is allowed to settle.
How frequently should the band be adjusted?
This really depends upon how well you are doing. In general, if you are losing 1-2 lbs (0.5-1kg) each week, have no symptoms and are feeling well, your band is fine. If your weight loss is very slow, or if you feel you have very little restriction, you may need a further gastric band adjustment. There is considerable individual variation in how many adjustments are required in the first 12-months. Some people need just one, a few may need five or six. But do remember that more is not necessarily better. Some people think that if the band is producing good weight loss, then tightening it further will result in even more dramatic losses. This is not true; a band which is over-adjusted can be dangerous, increasing the chance of slippage and other complications.