When do I need a gastric band adjustment?
Gastric band fills are performed to tighten the band around the stomach with the aim of further reducing portion size and inducing satiety.
Most surgeons leave the gastric band empty after initial insertion and consider filling it for the first time once the patient is eating a range of solid foods without difficulty. This is usually at around 6 weeks post insertion. Tightening the gastric band too much can lead to excessive vomiting and sometimes complete obstruction. This is why most surgeons will proceed with a stepwise approach, performing a series of four or five fills over the course of 12 to 18 months to get the patient to the level of restriction which maximises weight loss but does not cause frequent vomiting, reflux or obstruction.
The process of gastric band fills and adjustments is an individual one which depends on the surgeon’s philosophy and the particular requirements of each patient.
When the fluid is injected into the gastric band it is typical to feel that things are “tight” for a few days and it is best to stick to a fluid or soft diet over this time. After this, the tightness tends to settle somewhat.
Typically we first consider a fill of the gastric band at about 6 weeks post-surgery. At this time, the stomach has become used to the band and the patient has settled in to consuming a range of solid foods. If the weight is coming off consistently there may be no need for any fill at this time. After this we instigate a series of consultations approximately 4-6 weeks apart to determine the need for further fills. Once 12 months have passed, the right level of restriction should have been reached and it is uncommon to need any more fills.
The first gastric band fill is usually considered at around 6 weeks after insertion of the band
The right amount of fluid inside the gastric band is different for everyone and different for each type of band. The Lap Band system has two sizes: small (APS) and large (APL). The small Lap Band ® takes a maximum of 10ml and the large Lap Band 14ml. The older, 9.75cm diameter Lap Band holds only 4ml of fluid. The most recent Swedish Band takes a maximum of 11ml.
The right level of restriction will maximise the level of appetite suppression and portion control without excessive vomiting. This level is completely different for every individual and may depend on your stomach size, eating habits and individual physiology.
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