Prior to Surgery
Once it is decided that LAP-BAND is the appropriate procedure for
you, the following steps will become part of the pre-operative work
- Consultation with our Surgeons
to discuss your medical and weight history, and the procedure
in detail, including general and specific risks and to complete
the process of informed consent.
- History and Physical
by your family doctor. This allows us to identify any potential
medical conditions that could affect the safety of the operation
or the post-operative course.
- Pre-Operative Ultra Low Calorie Diet using OPTIFAST
this prescribed nutritionally complete dietary regimen is used
pre-operatively for at least 2 weeks to reduce fat stores in the
liver and make the surgical procedure easier and safer. It also
gives you a head start prior to your operation.
- Assessment by a dietician/nutritionist (if indicated)
this gives us a detailed report on your dietary history
including prior attempts at weight loss. It also identifies any
potential dietary factors that may affect the anticipated
success of the surgical procedure.
- Assessment by a psychologist (if indicated)
this gives us a report on any potential psycho-social factors
that may affect your ability to comply with the modified eating
pattern that is integral to the success of the gastric banding
The reduced surgical trauma and pain of the LAP band surgery
results in shorter hospitals stays and less risk for the patient.
However, follow-up treatment is an essential part of the operation.
Most patients are only kept overnight in the hospital, with a
post-op exam a week later. During this exam, the band size will be
checked and possibly adjusted through the injection port created
during the surgery. The band size will be adjusted throughout
treatment, when necessary, to help control over or under-eating.
Light physical activities can be resumed within five days in most
cases, avoiding heavy exercise and lifting. Patients can usually
return to work within three weeks. Banding requires careful
management of patient diet, both before and after surgery. If
possible, patients should reduce calorie intake by 25%, but avoid
any fad or binge diets. Increased physical activity is encouraged to
increase the healing time. Patients may be placed on a low energy
liquid diet for two to four weeks prior to the surgery to ease
surgical risks by reducing the size of the liver. Others may be
allowed a semi-normal diet, with a clear liquid diet on the day
before surgery. No food or drink is allowed the day of surgery.
Patients must also follow a completely liquid diet for two weeks
following the surgery. A pureed diet is prescribed for the following
two weeks; only then may patients gradually begin a normal diet
consisting of low energy foods spread out over several small meals
and snacks. Only by following these strict guidelines will the
patient continually lose weight. As this is a radical diet change
for most LAP band patients, patients are urged to seek a dietician's
input, as well as participate in group and/or individual therapy.
Patients who follow clinical advice will typically lose a third of
the weight within twelve to eighteen months.
LAP-BAND surgery is performed under general anaesthesia at The Taj
Medical Group's Internationally approved Hospital. Fellowship
trained anaesthetists with extensive experience will be performing
the anesthetic and directing the immediate post-surgical care.
LAP-BAND surgery is usually performed laparoscopically. A series of
small puncture openings are made in the abdominal wall to
accommodate instruments. A video camera is attached to a special
telescope to provide visualization in the abdominal cavity. The
abdominal cavity is filled with absorbable gas to create the space
necessary to complete the procedure.
A tunnel is created around the upper stomach and the LAP-BAND
device is manipulated into the proper location. Sutures are placed
in the stomach to hold the LAP-BAND in place and prevent it from
sliding into a less optimal position. Tubing from the Lap-Band is
then attached to a port, which is placed under the skin, but on top
of the muscle, of the abdominal wall. Fluid can be injected through
the port to precisely adjust the size of the Lap-Band reservoir and
thus modify the size of the opening into the rest of the stomach.
There may be situations where it may be necessary to make a larger
incision to place the LAP-BAND System. This could happen if there
are problems completing the surgical procedure using the
laparoscopic technique. These problems could be due to anatomical
variation, scarring from previous surgery and unexpected findings at
The operation usually takes about 60 minutes to complete. After the
surgery you will be closely monitored in the Recovery Area until you
are able to be discharged, which is usually 3 - 4 hours later.
You will be given extensive instructions regarding activity and
diet recommendations. Follow-up in the clinic with your surgeon and
the Clinical Nurse Specialist will be arranged.