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LAP-BAND Adjustments

A unique aspect to LAP-BAND surgery is its ability to be adjusted, and patients need to come in for routine adjustment appointments in the first year after surgery, about 7-8 times on average. You can have an active role in your adjustments, by helping your surgeon determine how much to fill or loosen the band, depending on a number of factors.

The first adjustment appointment typically occurs at about six or more weeks after surgery, to allow adequate healing. The purpose of adjustments is to get patients in the “green zone,” where they are losing about one to three pounds every week, and they feel comfortable and satisfied after eating small portions. Nausea and vomiting should not be a issue when patients are in the green zone, and they should not feel uncomfortable or stuffed after eating appropriately small portions.

If a patient is in the “yellow zone,” they will feel hungry between meals and eat larger portions than are conducive to weight loss. The “red zone” is when the band is too tight and uncomfortable symptoms result, as well as the risk of malnutrition.

Although patients may be tempted to make the band as tight as possible, this is highly inadvisable. A number of negative side effects can come about from being the red zone, such as inability to swallow and a chronic night cough, as well as frequent nausea, reflux, and vomiting. Excessive vomiting may stretch the stomach pouch and be counterproductive for weight loss.

During adjustments, the bariatric surgeon uses a x-ray and monitor to view the access port and to facilitate needle position. The surgeon uses a washer or coin to localize the port. The needle should be placed perpendicular to the access port to prevent any damage to the port, or any leakage of fluid.

Common questions your surgeon may ask you when determining how much to adjust the band includes:

  • Are you losing weight?
  • Do you feel satisfied after eating small portions (not still hungry, or stuffed/uncomfortable)?
  • Are you hungry between meals?
  • How soon after eating do you feel hungry again?
  • Do you experience any nausea, vomiting, or reflux?
  • Do any foods give you trouble?
  • Have there been any relevant changes in your medical status (illness, pregnancy, etc.)?

Some patients have attempted to fill their own bands, but this is not recommended by our bariatric surgeons. Patients may accidentally puncture the tubing connecting to the access port, which causes leakage and band deflation, requiring reoperation, as a result. Adjustments have a specific protocol, and if patients do a self-adjustment, infection or other complications may result. Only allow a certified LAP-BAND professional to perform band adjustments.

If you are interested in learning more about LAP-BAND adjustments, please call our LAP-BAND VIP offices at 1-855-690-0560, and one of our staff will be happy to address any questions, comments, or concerns you may have.