Lap Band Surgery - How the Lap-Band Works and Adjustments to Lap Band

The band divides the stomach into two parts. The smaller, upper stomach takes over as the dominant functioning stomach. As food is swallowed, it enters the new stomach first.

The most appealing feature of the lap-band is the ability to adjust it without additional surgery, allowing a proper fit for every patient. The band is adjusted until the correct outlet size for your pouch is reached. The size of the pouch limits how much food you can eat, while the size of the outlet controls how quickly it can empty. The smaller the outlet size, the better it will work to control meal portion size, prolong satiety, reduce hunger and cravings, and thus reduce calorie intake.

The small pouch and small outlet produce early satiety, which in a cooperative, compliant patient induces behavioral changes leading to less caloric intake, and therefore, weight loss. Inadequate chewing can result in pain, or reflux. Patients must eat slowly, reduce meal and bite size and avoid overeating or drinking fluids with calories. Failure to follow these guidelines can defeat the purpose of the surgery. The amount of weight that you will lose will depend on the band as well as on your motivation and compliance.

Unlike other weight loss surgery procedures, placement of the band does not alter the gastrointestinal tract. No stapling or cutting of the stomach or the intestine reduces potential surgical complications, such as leakage and infection.

The lap-band is completely adjustable. The secret is to adjust the band so that it is tight enough to make one feel full on a smaller meal, but loose enough to allow food to pass through and not cause pain, reflux or vomiting.

A fill is the term used to describe the "filling" of your lap-band with saline solution. This adjustment to your band is what gives each patient the restriction necessary to eat less food and ultimately lose weight.

To adjust the band a syringe containing saline is inserted through the skin into the access port. Saline is injected or withdrawn to achieve the desired fill volume and tightness of the band. Lap-band adjustments are normally done in a hospital or a doctor's office with the necessary x-ray equipment to assist in locating the access port and evaluating your pouch and stoma size. Most adjustments take 10 to 15 minutes and patients say the adjustment feels like the pricking sensation you experience when giving blood.

When you have lap-band surgery, your doctors will initially leave the band empty or partially inflated to allow for healing to occur around the new band site. About four to six weeks after surgery, your doctor will want to make your first band adjustment.

To get the best results from lap-band surgery, you will likely need several adjustments. This is because the exact amount of fluid that is required to make the stoma the correct size is different for every patient.