The lap band is a form of weight loss surgery. In this procedure, a plastic band is placed around the stomach, creating a small pouch. The pouch gets full quickly when you eat, so you eat less food. This helps you lose weight. The band itself does not provide much restriction, though. It is designed to be filled with saline solution, which provides the restriction.
The lap band is generally not filled with saline at the time of the surgery. Instead, you will probably be given four to six weeks to heal from your surgery before being given your first fill. Many lap band patients are unpleasantly surprised to find that they don’t have much restriction right after their surgeries. That’s because they haven’t received a fill yet. Between the time of your surgery and the time of your first fill, you will need to exercise self-control and eat a low calorie, low fat diet. Ask your doctor or dietician about what you should be eating and how much.
Ask your doctor how you should prepare for your fill. Patients are generally advised not to eat anything for at least 12 hours before a fill. It is important that the stomach be completely empty. Ask your doctor how soon before a fill you can drink. You will probably be asked not to drink for a couple of hours before a fill. However, it is important to be well-hydrated before that.
There is a port just below the skin of the abdominal wall that connects to the lap band with a thin tube. Saline solution is injected through the skin into this port in order to fill the band. The procedure is generally not painful. You should just feel a small pinching sensation. If it hurts a lot, let the doctor know.
The fill may be performed under an x-ray fluoroscope so the doctor can visualize what he or she is doing, or it may be performed with this aid. Ask your doctor how it will be done. You may wish to request that it be done under the x-ray. It only takes a couple of minutes to perform a fill.
A lap band typically holds 10 or 12 ml’s of fluid, but the band is not filled completely on the first fill. You may be given four or six ml’s to start with. You will then be given a few weeks to see how you do with that amount. The idea is to get enough restriction that you can’t eat as much, but you don’t want too much restriction. You need to be able to eat a certain amount of calories each day in order to be healthy. If you have too much restriction, you may find it difficult to eat solid foods, or it might even be difficult to drink fluids. This is obviously unhealthy.
After saline solution is injected into your port, you will be asked to drink some water. If you are unable to get the water down, the doctor will know your band is too tight and he or she will remove some of the saline through the port. Even if you think the fill is right, it is a good idea to hang around the doctor’s office for a couple of hours after a fill to make sure you feel OK and don’t start to vomit. If you have to travel from out of town to get your fill, it is advisable to stay in town overnight at a hotel just in case problems arise.
You will be asked to follow a full liquid diet for a day or two after a fill. A full liquid diet usually includes things like protein shakes, broth, cream soups, thin cream of wheat, low fat yogurt, sugar free pudding, sugar free Jello, and popsicles. Ask your doctor for a complete list of foods you are allowed. Then you may be moved on to soft foods for a day or two before resuming your regular diet. It’s important to follow the post-fill diet because it allows your stomach to adjust to the new restriction in your band.
It may take a couple of fills before you get the right amount of restriction. Fills are generally scheduled four to six weeks apart. Once you get the right amount of restriction, you may be able to go several months without needing an adjustment. However, after you lose a certain amount of weight, your band may get looser and you may need another fill.
Sources:
Lap-Band Surgery. http://www.lapbandsurgery.net/lap-band-fills.html. Lap Band Fills.
