Frequently Asked Questions

Sleeve gastrectomy is a restrictive bariatric surgery. It encourages weight loss by restricting the stomach size, so it holds only a limited amount of food. This helps patients eat less without hampering the normal digestive process.

Some of the advantages of sleeve gastrectomy include the following:

• Reduced stomach volume increases feeling of fullness
• Stomach functions normally allowing most foods to be eaten, just in smaller amounts
• Stomach portion that produces hunger stimulating hormone (Ghrelin) is removed.
• No dumping syndrome due to pyloric portion of stomach is left intact
• No intestinal bypass and its associated risks
• Can be performed laparoscopically
• Simpler procedure than gastric bypass
• Safer first stage procedure of two-stage surgery for super morbidly obese
• Less operative time than bypass surgeries
• Less hospital stay than bypass surgeries
• No foreign bodies used such as in band surgery

• Your doctor will prescribe pain relieving medications to keep you comfortable following the procedure.
• You will be advised to take medication to reduce the amount of acid produced by your stomach.
• Avoid strenuous exercises and lifting heavy weights until approved by your surgeon
• For the first month after the procedure, eat only small amounts of soft foods
• Sip water throughout the day to prevent dehydration.
• Eat a highly nutritious diet rich in proteins with a low-fat content.
• Your dietitian will tailor a new diet regimen for you to follow.

Sleeve gastrectomy is a relatively new procedure; however, most patients who have had a sleeve gastrectomy with more than 5 years of follow-up show sustained weight loss. Talk to your doctor to know more about what you can expect.

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 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 you should contact us if this problem persists. Vomiting should be avoided as much as possible. It can cause the small stomach pouch to stretch. It can also lead to slippage of part of the stomach through the band, which would reduce the success of the operation. In some cases, it would also require another operation.

How long will it take to recover after surgery?

If LAP-BAND surgery is performed laparoscopically, patients typically spend less than 24 hours in the hospital. It takes most patients about a week to return to work and a month to six weeks to resume exercising. In the case of open surgery or if there are complications, recovery may take longer.

How much weight will I lose?

Weight-loss results vary from patient to patient, and the amount of weight you may lose depends on several things. The band needs to be in the right position, and you need to be committed to your new lifestyle and 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 2 to 3 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 fast creates a health risk and can lead to a number of problems. Your main goal is to have weight loss that prevents, improves, or resolves health problems connected with severe obesity.

How do the weight-loss results with the LAP-BAND compare to those with the gastric bypass?

You should 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.

Does the LAP-BAND require frequent office visits after surgery?

Check-ups are a normal and a very important part of the LAP-BAND® System follow-up.

Does the LAP-BAND limit any physical activity?

The LAP-BAND does not affect or hamper physical activity including aerobics, stretching and strenuous exercise.

How is the band adjusted?

Adjustments are often carried out in the X-ray department. They are done there so the access port can be clearly seen. When X-rays are used, your reproductive organs should be shielded. Sometimes adjustments can be done in an outpatient clinic or office. Local anaesthesia may or may not be needed. A fine needle is passed through the skin into the access port to add or subtract saline. This process most often takes only a few minutes. Most patients say it is nearly painless.

Do I have to be careful with the access port just underneath my skin?

There are no restrictions based on the access port. It is placed under the skin in the abdominal wall, and once the incisions have healed it should not cause discomfort or limit your movements or any physical exercise. The only sensation you may have from the port is when you go in for adjustments. If you feel persistent discomfort in the port area, let us know as soon as possible.

Can the band be removed?

Although the LAP-BAND System is not meant to be removed, it can be. In some cases this can be done laparoscopically. 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 or even gain more.

Will I need plastic surgery for the surplus skin when I have lost a lot of weight?

That is not always the case. As a rule, plastic surgery will not be considered for at least a year or two after the operation. Sometimes the skin will mold itself around the new body tissue. You should give the skin the time it needs to adjust before you decide to have more surgery.

Is it true that the LAP-BAND seems "tighter" in the morning?

This is a fairly common feeling, especially for people with bands that are tight or just after an adjustment. During the day the water content in the body changes and this may cause the band to feel "tighter" some of the time. Some women have also noticed that the LAP-BAND feels tighter during menstruation.

Will I feel hungry or deprived with the LAP-BAND?

The LAP-BAND makes you eat less and feel full in two ways - by reducing the capacity of your stomach and 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.

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.

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 the pregnancy, the band may be made tighter again, and you can resume losing weight.

Will I need to take vitamin supplements?

You may. It's possible you may not get enough vitamins from three small meals a day. At your regular check-ups, your specialist will evaluate whether you are getting enough vitamin B12, folic acid, and iron.

What about other medication?

You should be able to take prescribed medication. You may need to use capsules, break big tablets in half or dissolve them in water so they do not get stuck in the stoma and make you sick. You should always ask the doctor who prescribes the drugs about this.

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.

What about alcohol?

Alcohol has a high number of calories. It also breaks down vitamins. An occasional glass of wine or other alcoholic beverage, though, is not considered harmful to weight loss1.

Can I eat anything in moderation?

After your stomach has healed, you may eat most foods that don't cause you discomfort. However, because you can only eat a little it is important to include foods full of important vitamins and nutrients such as those recommended in the nutrition section of this booklet and as advised 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 cancelled.

Will I suffer from constipation?

There may be some reduction in the volume of your stools, which is normal after a decrease in food intake because you eat less fibre. This should not cause you severe problems. If difficulties do arise, let us know as soon as possible.