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• How much weight will I lose?
• How do the weight-loss results with the LAP-BAND® compare to those with the gastric bypass?
• Can the band be removed?
• Will I feel hungry or deprived with the LAP-BAND®?
• Does the LAP-BAND® limit any physical activity?
• How do I find a qualified surgeon?
• How does a surgeon become LAP-BAND® System certified?
• How long will it take to recover after surgery?
• Will I be sick a lot after the operation?
• Does the LAP-BAND® require frequent visits to my doctor after surgery?
• How is the band adjusted?
• Do I have to be careful with the access port underneath my skin?
• Will I need plastic surgery for the excess skin when I have lost a lot of weight?
• Is it true that the LAP-BAND® seems tighter in the morning?
• What will happen if I become ill?
• What about pregnancy?
• Can I eat anything in moderation?
• Will I need to take vitamin supplements?
• What about taking medication?
• What if I go out to eat?
• What about alcohol?

 

How much weight will I lose?
Weight-loss results vary from patient to patient, and the amount of weight you lose depends on several things. The LAP-BAND® needs to be in the right position, and you need to be committed to your new lifestyle and healthy eating habits. Obesity surgery is not a miracle cure, and the pounds won't come off by themselves. It is very important to set achievable weight-loss goals from the beginning. A weight loss of two to three pounds a week in the first year after the operation is possible, but one pound a week is more likely. Twelve to eighteen months after the operation, weekly weight loss is usually less. Remember that you should lose weight gradually. Losing weight too quickly creates a health risk and can lead to a number of problems. The main goal is to have weight loss that prevents, improves, or resolves health problems connected with severe obesity.

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How do the weight-loss results with the LAP-BAND® compare to those with the gastric bypass?
Many surgeons have reported that gastric bypass patients lose weight faster in the first year. At five years, however, many LAP-BAND® patients have achieved weight loss comparable to that of gastric bypass patients.1 Focus on long-term weight loss and remember that it is important to lose weight gradually while reducing obesity-related risks and improving your health.

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Can the band be removed?
Although the LAP-BAND® System is not meant to be removed, it can be. Surgeons report that the stomach generally returns to its original shape once the band is removed. After the removal, though, you may soon go back up to your original weight. You may also gain more.

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Will I feel hungry or deprived with the LAP-BAND®?
The LAP-BAND® makes you eat less and feel full in two ways - first by reducing the capacity of your stomach and second by increasing the time it takes food to get through the digestive system. After a small meal, the amount of which varies from person to person, you should feel full. If you follow the nutrition guidelines when you choose your food and then chew it well, you should not feel hungry or deprived. Remember that the LAP-BAND® is a tool to help you change your eating habits.

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Does the LAP-BAND® limit any physical activity?
The LAP-BAND® does not hamper physical activity including aerobics, stretching and strenuous exercise.

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How do I find a qualified surgeon?
It is important to choose a surgeon who is qualified to perform your procedure and who has a comprehensive program for post-operative follow-up. Here are some suggested criteria to look for: Weight-loss (bariatric) surgery experience, Board certification (The American Board of Surgery), fellowships (The American College of Surgeons), and memberships (The American Society for Bariatric Surgery). A program with hospital facilities, supplies, and equipment specific to the needs of weight-loss surgery patients. A comprehensive team of staff and procedures to address weight-related health conditions, dietary instruction, exercise training, nursing care, and psychological counseling (if necessary). A program that emphasizes long-term care and goals.

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How does a surgeon become LAP-BAND® System certified?
It is the policy of INAMED to follow surgeon selection and training guidelines established by The American Society for Bariatric Surgery (ASBS) and Society of American Gastrointestinal Endoscopic Surgeons (SAGES). The LAP-BAND® surgeon certification requires that the surgeon have advanced laparoscopic and bariatric (weight-loss) surgery experience. It also demands surgeon commitment and ability to establish and maintain a multidisciplinary bariatric practice that provides long-term support and follow-up and features appropriate hospital facilities; nutrition and exercise counseling; and psychological, general medicine, and radiological support personnel. In addition, INAMED requires that all surgeons complete a LAP-BAND® System workshop conducted by the company’s professional education team and are proctored (supervised) for initial procedures by experienced surgeons.

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How long will it take to recover after surgery?
If LAP-BAND® surgery is performed laparoscopically, as it most frequently is, patients typically spend less than 24 hours in the hospital. It takes most patients about a week before they can return to work and a month to six weeks before they can resume exercising. In the case of open surgery or if there are complications, recovery may take longer.

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Will I be sick a lot after the operation?
The LAP-BAND® System limits food intake. If you feel nauseated or sick on a regular basis, it may mean that you are not chewing your food well enough or that you are not following the diet rules properly. However, it could also mean that there is a problem with the placement of the band, so contact your doctor if this problem persists. Vomiting should be avoided as much as possible as it can cause the small stomach pouch to stretch. It can also lead to slippage of part of the stomach through the band and thus reduce the success of the operation. In some cases, excessive vomiting can necessitate another operation.

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Does the LAP-BAND® require frequent visits to my doctor after surgery?
Check-ups with your doctor are a normal and very important part of the LAP-BAND® System follow-up. Many surgeons see their patients weekly or biweekly during the first month and every four to twelve weeks for the first year. Adjustments are performed during some of these visits. It is typical for follow-up visits to be scheduled every three to six months during the second and third year, depending on the individual case.

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How is the band adjusted?
Adjustments are performed without surgery using a thin needle to inject or withdraw saline from the band via the access port. They can be done in an office setting or can be carried out in the X-ray department under flouroscopy. When X-rays are used, your reproductive organs should be shielded. Sometimes-most adjustments take 10 to 15 minutes and patients say they are nearly painless.

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Do I have to be careful with the access port underneath my skin?
After a successful operation, you will not have any activity restrictions based on the access port. It is placed under the skin in the abdominal wall, and once the incisions have healed the access port should not cause discomfort or limit any physical exercise. The only sensation you may experience from the port occurs when you go in for adjustments. If you feel persistent discomfort in the port area, talk to your doctor.

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Will I need plastic surgery for the excess skin when I have lost a lot of weight?
That is not always the case. As a rule, plastic surgery should not be considered for at least a year or two after the operation since sometimes the skin will mold itself around the new body tissue. Give the skin the time it needs to adjust before you decide to have more surgery.

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Is it true that the LAP-BAND® seems tighter in the morning?
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. During the day the water content in the body changes, causing the band to feel tighter some of the time. Some women have also noticed that the LAP-BAND® feels tighter during menstruation.

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What will happen if I become ill?
One of the major advantages of the LAP-BAND® System is that it can be adjusted. If your illness requires you to eat more, the band can be loosened by removing saline from it. When you have recovered from your illness and want to lose weight again, the band can be tightened by increasing the amount of saline. If the band cannot be loosened enough, it may have to be removed.

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What about pregnancy?
Becoming pregnant can be easier as you lose weight. Your menstrual cycle may become more regular. If you need to eat more while you are pregnant, the band can be loosened. After pregnancy, the band may be made tighter again and you can resume losing weight.

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Can I eat anything in moderation?
You may eat most foods that don’t cause you discomfort. However, because you can only eat a little at any given time, it is important to include foods rich in important vitamins and nutrients—foods such as those recommended by your surgeon and/or dietitian. If you eat foods that contain lots of sugar and fat or drink liquids full of empty calories, such as milkshakes, the effect of the LAP-BAND® may be greatly reduced or even cancelled.

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Will I need to take vitamin supplements?
You may. It's possible to not get enough vitamins from three small meals a day. At your regular check-ups, your surgeon will evaluate whether you are getting enough vitamin B12, folic acid, and iron. Your surgeon may advise you to take supplements.

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What about taking medication?
You should be able to take prescribed medication, though you may need to (1) use capsules or (2) break big tablets in half or dissolve them in water so they do not get stuck in the stoma and make you sick. Always ask the doctor who prescribes the drugs about this. Your surgeon may tell you to avoid taking aspirin and other non-steroidal anti-inflammatory pain relievers because they may irritate the stomach. The problems these drugs may cause could result in band removal.

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What if I go out to eat?
Order only a small amount of food, such as an appetizer. Eat slowly. Finish at the same time as your table companions. You might want to let your host or hostess know in advance that you cannot eat very much.

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What about alcohol?
Alcohol has a high number of calories and breaks down vitamins so it is not recommended as a healthy food choice. However, an occasional glass of wine or other alcoholic beverage is not necessarily considered harmful to weight loss.2

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One final point:
It is important to ask your surgeon all the questions you have about obesity surgery and the LAP-BAND® System. It is also essential that you follow his or her advice.

1. O’Brien, et al. LAP-BAND®: Outcomes and results. J of Laparoend & Adv Surg Techniques. 2003;13(4):265-270. Clegg A., Colquitt J., et al. The clinical and cost effectiveness of surgery for people with morbid obesity. Health Technology Assessment. 2002;6(12):1-153.
2. Dixon J., Dixon A., O’Brien P. Light to moderate alcohol consumption: Obesity and the metabolic syndrome. Am J Bariatric Medicine. 2002;17(4):11-14.

Disclaimer:
As with any surgery, there are specific risks and possible complications associated with the LAP-BAND® System surgery. Talk to your doctor to determine if you are a candidate for the LAP-BAND® System.
M898-03 05/06