How to Prepare for Lap-Band Surgery (Gastric Band Surgery)
Medically reviewed by Robert Burakoff, MD, MPH
Lap-band surgery—also called laparoscopic gastric banding or gastric band surgery—is a popular surgical procedure for weight loss. This bariatric (weight-loss) procedure involves placing a silicone band around your stomach to reduce your stomach's capacity and the amount of food you can consume in one sitting.
It can help people who struggle with overeating learn to eat less, achieve a healthier weight, and improve their well-being.
The lap-band procedure is reversible, but is it safe? This article covers everything you need to know about gastric band surgery, including how it works, how to prepare for it, and the pros and cons to consider.
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How Does Lap-Band Surgery Work?
Lap-band surgery involves placing an inflatable silicone band around the stomach, creating two pouches with a passage called a stoma connecting the two. This is usually done laparoscopically and under general anesthesia.
Following surgery, food will first enter the smaller upper pouch and slowly move into the larger lower pouch. The pouch sizes can be adjusted by adding or removing saline from the band. A port to do so is located just beneath the skin's surface on the abdomen.
Furthermore, lap-band surgery is reversible as the band can be removed without permanently changing the stomach anatomy.
Who Is Lap-Band Surgery For?
You may be a candidate for lap-band surgery if you have obesity and suffer from related health conditions. Lap-band surgery is less invasive than other types of bariatric surgery. It's also reversible if you experience complications.
Lap-band surgery generally has fewer complications than other types of weight loss surgery. However, it doesn't usually result in the same amount of weight loss as other options.
You must also visit a healthcare provider for frequent monitoring and adjustments, especially in the initial year following the procedure. After all, it is a life-changing procedure meant to be permanent and requires a strong commitment to change.
Consider these factors if you are wondering whether lap-band surgery is the right option for you.
Does Gastric Banding Help Treat Obesity-Related Health Conditions?
Many people considering lap-band surgery have preexisting health conditions and obesity. Many health conditions can develop or worsen as body weight increases.
As a result, getting an adjustable gastric band that promotes weight loss can also benefit health in other ways. Some of the conditions that may see improvements include:
Type 2 diabetes
Obstructive sleep apnea
Heart disease
High blood pressure
High cholesterol
Non-alcohol-related fatty liver disease
Depression
Arthritis
Gastroesophageal reflux disease (GERD)
Remember that to get the most benefit from having lap-band surgery, it's critical to follow postoperative directions, including adopting healthier lifestyle habits.
Requirements to Qualify for Lap-Band Surgery
Not everyone is a good candidate for lap-band surgery. There are several requirements to qualify for lap-band surgery, including the following:
You must be 18 years old or older
You must have a history of unsuccessful weight loss attempts
You do not have other health issues that may have led to obesity
You must not be pregnant
You do not drink alcohol in excess
You are prepared to make significant lifestyle changes with a high commitment level
Additionally, you must have a body weight within a specific range. This is determined by body mass index (BMI), a weight-to-height ratio used to indicate underweight, obesity, and everything in the middle.
The BMI indications for lap-band surgery include at least one of the following critera:
BMI over 40
BMI between 35 and 39.9 with at least one serious health condition, such as high blood pressure, obstructive sleep apnea, or type 2 diabetes
BMI between 30 and 34.9 with metabolic syndrome or type 2 diabetes that is not well-controlled even with compliance to prescribed medical therapies
BMI Challenges
Healthcare providers use BMI because it's easy to calculate and requires no special equipment. However, it is flawed in many ways since it doesn't account for age, race, socioeconomic challenges, or muscle mass, which can impact your BMI.
It's important to note that Asian individuals with uncontrolled type 2 diabetes may be considered for this procedure even if their BMI is only 27.5. This is because Asian people are more prone to carry a buildup of fat in their abdomen even at lower BMIs, which translates to a higher risk for heart disease and other health problems.
How to Prepare for Lap-Band Surgery
Preparing for lap-band surgery can be stressful. Planning can help the procedure and recovery go smoothly. Your healthcare provider will provide detailed instructions and outline any required lifestyle changes in the months before your surgery.
Ways in which to prepare for gastric band surgery include:
Schedule your surgery at a day and time that is as convenient as possible for you and your post-operative support system.
Arrive for your surgery early.
Bring what you need to stay in the hospital for at least one night following your surgery.
Read your pre-op instructions carefully. You must remove jewelry, fake nails or nail polish, makeup, false eyelashes, contact lenses, dentures, and hair accessories.
Make medication adjustments as needed. This likely includes blood thinners, diabetes medications, gout medications, specific supplements—like Saint-John's-wort, glucosamine, and vitamin E—diuretics, and blood pressure medications.
Stop smoking.
A healthcare provider will also provide specific dietary instructions for you to follow in the days and weeks leading up to your surgery, which may include the following:
Reducing caffeine
Avoiding soda and alcohol
Starting a new vitamin regimen
Reducing calories while boosting protein (often with shakes).
Right before your surgery, you will be placed on a clear liquid diet that includes black coffee, water, Jello, and Gatorade.
What Happens During Lap-Band Surgery?
Lap-band surgery requires general anesthesia, which means you will be asleep while it is performed. It takes between 30 and 60 minutes to complete. It is a laparoscopic procedure, which means it's done through small incisions in the pelvic or abdominal area with a thin tool with a video camera and light on the end (laparoscope).
A silicone band is placed around your stomach to divide it into two pouches. The pouch on top will be smaller than the one on the bottom. Then, a small port will be inserted just beneath the skin on your abdomen.
The port will be connected to your stomach band with a small tube, which is used to deliver or remove saline from the band. Changing the amount of fluid in your band tightens or loosens it depending on your health goals.
Once your procedure is done, your surgeon closes the small incisions, and you will eventually wake up from the anesthesia. Plan to stay overnight in the hospital for at least one night following this surgery.
What’s My Diet Like After Gastric Band Surgery?
Having gastric band surgery makes your stomach physically smaller. This translates to being unable to consume as much food in one sitting as before. If you were to try to eat solid foods right after your surgery, you would likely experience vomiting. Before you can go back to eating a "regular diet," you must follow strict diet instructions for a period.
You must be on a liquid diet for at least a couple of weeks after this surgery to allow for healing and adjustment. You will slowly transition to a pureed diet, a soft foods diet, and a solid diet afterward. Expect this dietary transition period to last at least one month after surgery.
Eating after lap-band surgery requires slowing down and eating smaller portion sizes. This is an excellent opportunity to practice mindfulness when eating. Learning to be more present with your food and hunger and fullness cues can support your healing process from surgery and benefit your long-term eating habits.
In addition to dietary restrictions, your healthcare provider may recommend a vitamin and mineral supplementation routine after bariatric surgery. With the reduced volume and variety of food in your diet comes a higher risk of developing nutritional deficiencies. Take your supplements as prescribed.
You will be referred to a bariatric registered dietitian to develop a nutritionally adequate diet plan before surgery and make adjustments afterward.
Follow-Up Care After Lap-Band Surgery
It's essential to stay in close communication with your healthcare providers following lap-band surgery. Be sure to let them know if you are experiencing any unusual symptoms or discomfort or have other questions or concerns. Nothing you have to say is anything they have not heard before, so don't be embarrassed to ask.
Physical movement is also essential following lap-band surgery. This helps prevent blood clots, promotes healthy circulation, and supports your overall healing process. Your healthcare providers will assist you in getting out of bed and walking while you're recovering in the hospital. You will receive instructions for safe physical activity at home.
Aftercare will also include monitoring your blood work and evaluating symptoms like heartburn, nausea, and pain. Your dietitian will also help you adhere to your nutrition plan, including the type of diet you're permitted to eat and your supplement regimen. You will also have a plan for wound care to keep the incision sites clean.
How Long Does a Lap-Band Last?
Lap bands are designed to last forever, but that's not always the case. They may be placed permanently but are also reversible and can be removed. You should see your healthcare provider regularly to monitor and adjust your band size as needed.
Some research suggests that around one-third of lap bands are removed within a decade. The Lap-Band Revision department at UCLA Health reports that over 50% of gastric bands placed are removed within seven to 10 years.
This is primarily because the individual does not lose enough weight or experiences significant long-term complications warranting reversal.
Pros and Cons to Bariatric Surgery
When considering any bariatric surgery, it's essential to consider the pros and cons to decide if it's right for you. All surgeries come with potential risks and benefits, which vary depending on the procedure and your overall health.
Some of the pros of bariatric surgery include:
It can be an effective weight loss tool among people committed to compliance.
It may also improve or reverse obesity-related health conditions, like type 2 diabetes, obstructive sleep apnea (stopping and starting breathing throughout the night), and heart disease.
The lap band is a reversible, nonpermanent procedure.
Downsides to bariatric surgery include:
It can be costly, reaching upwards of $15,000 to $25,000 or more, depending on the procedure.
It requires significant changes to eating habits, including the amount and frequency of foods and liquids that can be consumed.
It requires strict adherence to a vitamin and mineral supplement regimen to prevent nutritional deficiencies.
There are many potential side effects and complications to consider, some of which are long-term.
Possible Complications of Lap-Band Surgery
Gastric band surgery comes with potential complications, which can be short- or long-term, and include the following:
Loss of appetite
Difficulty finding a comfortable degree of fullness when eating
Heartburn
Nausea
Vomiting
Trouble swallowing
Inflammation of the esophagus
It's also possible for your band to begin to degrade or slip from its original spot.
How Much Weight Could You Lose With Gastric Banding?
Everyone who undergoes lap-band surgery is different and has unique factors to consider. This also goes for how much weight one can expect to lose after having the procedure. In general, lap bands work the best for people who don't have as much overall weight to lose.
On average, most people who have lap-band surgery and follow their postoperative lifestyle instructions lose between 30% and 50% of their original weight within the first two years. With good compliance, you can lose additional weight at around two pounds per week.
Weight loss following lap-band surgery is often slower than that after other weight loss surgeries. Patience and consistency are key.
Summary
Lap-band surgery is a common weight loss procedure to help support weight loss goals and improvement in other health conditions. Bariatric surgeries are lifelong commitments, requiring careful attention to your diet, vitamin and mineral supplementation, and physical activity, as well as frequent visits to your doctor for monitoring and band adjustments as needed. Speak with your healthcare provider to learn more about the pros and cons of lap-band surgery and whether it's appropriate for your needs.
Read the original article on Verywell Health.
