Fill Center

LAP BAND ADJUSTMENT

  Adjusting the LAP-BAND: The Key to Success

• Adjustability is the most important attribute the lap band provides you.

• Use it freely

– Adjust the lap band as necessary to support gradual, steady weight loss

– Lap Band adjustments should average 3 to 4 times in the first year

One of the most important features in having a lap band is its adjustability, also referred to as LAPBAND FILLS

The LAP-BAND System is the only adjustable weight loss surgery available. The diameter of the band has the flexibility to expand or detract in order to meet your individual needs, which can change as you continue to lose weight. For example, pregnant patients can expand their band to accommodate a growing fetus, while patients who aren't experiencing significant weight loss can have their bands tightened that will allow a patient to feel satisfied with less portions of food.

To modify the size of the band, its inner surface can be inflated or deflated with saline solution. The band is connected to a reservoir, which is placed well under the skin during surgery. After the operation, the surgeon can control the amount of saline in the band by entering the reservoir with a fine needle through the skin.

When do you need to have your first fill?

Based on our experiences dealing with multiple patients over the past 9 years, we have found that every patient is different, that is why we do not give the patient a scheduled appointment for their first fill.

Although it’s our responsibility to inform patients when they should schedule their first lap band adjustment, we depend on the patients to make their own appointment for their first fill.

There are three rules or indications in order to have the first fill (and all of the fills):

1. Loss of restriction (eating larger amount of food)
2. Hunger between meals
3. No weight loss

The lap band is connected by a tube to a reservoir placed beneath the skin during surgery. The physician can control the amount of saline in the band by piercing the reservoir through the skin with a fine needle. Being able to adjust the band is a unique feature of the LAP-BAND® system and is a normal part of
the follow-up.

How are fills done?

We do all of the fills in an X-Ray office with a special device called “fluoroscope” (real time X-Rays). This allows the doctor to check the entire system: Position of the band, tubing and port. In addition, the physician is able to identify any possible complication with the lap band, for example: Pouch dilatation, obstruction, band slippage, flipped port, disconnected tubing, and is some cases erosion.

The patient is lied down on the table as the physician locates the access port, then injects a special syringe into the access port.

After the syringe is injected, the patient is stood up and given a barium shake to drink, while the doctor watches the fluoroscope to identify the exact amount of saline that is needed by the patients.

The key benefit of the LAP-BAND is its adjustability, and optimal use of this feature is integral to success. The determinants of the need for adjustments are the rate of weight loss, the degree to which satiety has been induced, and the presence of symptoms that may suggest obstruction.

A Well-Adjusted Band

• Good weight loss
  -Approximately 1.5-2.0 pounds per week
  
  
• Able to eat most solid foods
  – Exceptions thick breads and thick meats
  – Must thoroughly chew food and eat slowly
  – Comfortably eat a small selected solid meal
  
  
• No limitations of liquids
  – Except during meals
  – Never recommend high calorie liquids

*Signs & Symptoms of an Adjustment that is “Too Tight”*

• Nocturnal coughing
• Asthmatic symptoms
• Appetite has increased
• Patient experiences hunger all the time
• Drinking/eating “empty” calories to make up for nutritional needs
• Reflux
• Regurgitation
• Patient will state that they can’t eat anything more than “mushy”
  foods