Learn About the LAP-BAND® System

LAP-BAND system diagramThe Gastric Band or (Lap-Band) surgery has been performed in Mexico since 1998. Our surgeon has plenty of experience ensuring the best results in short term and long lasting results.

The LAP-BAND® System, placed at our Tijuana, Mexico, hospital, does not modify the gastro-intestinal anatomy but easily favors satiety that helps reduce food intake. Today, there are two brands of gastric bands approved by the U.S.F.D.A. the first is manufactured by Allergan and the other by Johnson & Johnson under the name of Realize.

Lap Band surgery is performed in Tijuana, Mexico with success due to the closeness with the San Diego International Airport allowing our patients to arrive from every part of the World, where they are picked up and taken to our facilities when the surgery will take place, pre-op testing evaluations and later on the procedure. The surgery time of Lap Band surgery is approximately 45 min. then you are taken back to your private room fully awake and ready to start walking for your recovery, the morning after a barium swallow (x-ray) will be performed with the first fill adjustment to confirm that everything is in position, post-op report and records are given and you are taken back to the five star hotel, you stay one more night there and a ride back the San Diego. San Diego and Tijuana are border cities, adjacent to the Pacific divided by only a few miles, reason why their security is very similar as the Infrastructure.

LAP-BAND® System Criteria

Patients with BMI higher than 30 and that also have diabetes or hypertension are very good candidates for a weight loss surgery like the Lap-Band, which controls obesity and the related diseases associated with it.

  • From obese teenagers to elder patients (13 -70 years old)
  • BMI higher than 30 associated with diabetes or hypertension
  • BMI higher than 35 not presenting diabetes or hypertension
  • Patients with at least 2 years of excess weight
  • Patients who have tried with exercise and nutritionist diet with bad results
  • Will not show endocrine disease
  • Patients who do not have addictions
  • Be willing to improve the quality of life

What is the LAP-BAND® System?

The Lap-Band is an adjustable belt made out of silicone with a balloon inside the ring that regulates the food intake to the stomach, allowing weight loss. It is placed at the abdominal esophagus in the union with the upper part of the stomach. It is placed laparoscopically inserting a camera through little incisions for the dissection of the omentum and a esophageal tunnel, being this tunnel where the band is placed with a few non-absorbable sutures sewn in permanent form. The gastric band is a restrictive, reversible surgery in which a new gastric reservoir is created which can be regulated through a port with just one needle and this way the patient can decide how much weight he/she want to lose.

Congratulations!

You are well on your way to achieving your goals, which will lead to a happier and healthier life. You will be playing a major role in ensuring that your new LAP-BAND System fits all aspect of your life.

This information is designed to help you get off to a great start, and continue making the right choices as you move forward. You will receive guidelines for what kinds of food to eat, as well as details about aftercare or follow-up visits. While you may be eager to start seeing results right way, remember that healing is more important in this first few weeks than losing weight.

The LAP-BAND® System can represent a new beginning for you. And with the right health care support and lifestyle changes, it’s one that can lead you to a healthier weight and a happier life.

It’s important to communicate closer with your health care team, and to follow their advice carefully. Call them promptly if you notice any symptoms that could indicate a complication.

This is a new beginning for you. And with the right health care support and lifestyle changes, it’s one that can lead you to a healthier weight and a happier life. As you move forward, keep in mind that success comes when you, your health care team, and your LAP-BAND System all work together. The partnerships you develop with your surgeon and clinicians are the keys to that success. 

Be sure to contact your doctor right away if you experience any of the following:

  • A fever of 101 degrees or higher
  • Sudden shortness of breath or chest pain
  • Pain, redness, or swelling in one or both of your legs
  • Nausea or vomiting
  • Severe pain in your belly
  • Pain, swelling, or fluid leaking from your incisions
  • A fever of 101 degrees or higher
  • Sudden shortness of breath or chest pain

The first few days-water, liquids, and walking

Right after the procedure…

Take an occasional sip of water or suck on an ice cube (any more than this may cause you to be nauseated or regurgitate).

The day after your procedure…

Drink a little more water (but again, take only a small amount at a time).

The next few days…

-Continue with small amounts of water

-Add clear, thin, broth-type liquids that have enough calories to help compensate for the food you’re not able to eat at the moment

-Drink low calories liquids such as 1% milk or decaf herbal tea or coffee

NOTE: Go slowly and find what works for you. Everyone is different.

Walk it off!

In these first few days, you’ll also want to walk around as much as you comfortably can to regain your strength and prevent blood clots. Before doing more extensive physical exercise, give yourself two or three weeks time to recover-and then take it slow. While you may be ready to resume all your normal activities and new exercise program in four to six weeks, you should consult your doctor beforehand to ensure that your planned activity level is appropriate to your stage of recovery.

This information is meant is meant to be an overview. Your surgeon may give you more specific instructions.

The importance of eating and drinking right

First steps to a new you

After your procedure, you will require a new, temporary diet for recovery. Your specialist and/or dietitian can help you with the eating and lifestyle changes you need to make, so be sure to discuss these changes with them thoroughly.

Let the healing begin

This new diet allows your newly shaped stomach to heal completely and allows the LAP-BAND System to remain in the right position. It may take a month or more for this healing to happen. During this time, especially in the early weeks, you’ll want to keep from stretching the small stomach pouch above the LAP-BAND System. Regurgitation can stretch this pouch-and also increase the chance of your stomach tissue slipping up through the LAP-BAND System.

Discomfort while eating-what’s normal and what’s cause for concern?

Almost all LAP-BAND System patients will experience a food that doesn’t go down easily. Still, this should only occur when you’ve been drinking too quickly. As you get used to living with the LAP-BAND System, regurgitation should stop or become much less frequent. Listen to your body. If a food’s not for you. Everyone’s body adjusts differently. More persistent or unexpected regurgitation should be reported to your doctor to rule out the need for an adjustment or the possibility of a potential complication.

Eating guidelines: Weeks 1-5

Weeks 1-2: Stick to a liquid diet

The goal during this early period is to protect the small stomach pouch. Continue drinking water to keep hydrated, and see if you can add thin liquids, such as:

-Clear broth or soup (with no vegetables, meat, or cream)

-No sugar added ice pops

Weeks 3-4: add pureed foods to the menu

In the third and fourth weeks, you may start having slightly textured food. Aim for the consistency of baby food. This will help you maintain muscle while you are losing weight, eat protein rich foods first, and then move on to fruits and vegetables.

Week 5: enjoy soft foods, but chew well

Your meals can now include tender, cooked foods such as fish and ground turkey. Make it a habit to chew these foods well. If you don’t follow these precautions, you could experience nausea, stomach irritation, and swelling-or even an obstruction at the opening of the stomach. Advancing to heavier foods may also cause vomiting-which can increase the chances of band or stomach slippage, or stretching of the small stomach pouch above the band.

10 Rules for life with the LAP-BAND System

Eat only when you are hungry-about three small meals a day

The LAP-BAND System creates a small stomach pouch that can hold only about one-quarter cup (approximately 2 ounces) of food. If you try to eat more than this at one time, you may become nauseous or vomit. If you routinely eat too much, the small stomach pouch may stretch. That will cancel the effect of the operation. Frequent vomiting can also cause certain complications, such as stomach slippage. You need to learn how much your stomach pouch can hold comfortably and not exceed this amount.

Eat slowly and chew very well

Food can pass through the new stoma (stomach opening) only if It has been chewed into very small pieces. Always remember to take more time for your meals and chew your food very well.

Stop eating as soon as you feel full

Remember to eat your protein first. By doing so, you are ensuring that you’re getting in the proper fuel. Once your new pouch is full, your body receives a signal that you have eaten enough. It takes time, though, for you to become aware of this signal, so space out your meal, you may eat more than you need. This can lead to nausea and vomiting. Take time to eat and enjoy your meal. You want to feel satiated, not stuffed and uncomfortable. Try to recognize the feeling of fullness-then your utensils down.

Do not drink while you are eating

The LAP-BAND System can work only with solid food. If you drink at mealtimes, the food you have eaten becomes liquid, and the effectiveness of the LAP-BAND System is greatly reduced. You should not drink anything for one to two hours after a meal. This allows you to keep the feeling of fullness long as possible.

Do not eat between meals

After a meal, do not eat anything else until the next meal. Eating snacks between meals is one of the major reasons for weight-loss failure. It is very important to break this habit. Patients with proper “fill” levels do not feel hungry in between meals. If you do, this may be a sign that the LAP-BAND System is too loose, and you should tell your doctor.

Eat only high-quality food

Your meals should be high in protein and vitamins. Don’t fill your small stomach pouch with “junk” food that lacks vitamins and other important nutrients. Avoid foods high in fat and sugar. Instead, choose fresh vegetables, fruit (but not fruit juice), meat, and whole grain cereals. Ask your doctor or dietitian before you take any vitamin supplements.

Avoid fibrous food

Foods that contain many fibers, such as asparagus, can block the stoma. You can’t chew it well enough to break it up into small pieces and your saliva can’t break it down, so these foods can be problematic. If you would like to eat asparagus or other fibrous foods once in a while, be sure to cook them well, cut them in very small pieces and then chew them thoroughly. 

Drink enough fluids during the day

Drink at least 6 to 8 glasses of water a day. As you lose weight, and your fat content drops, your body will need to eliminate wasted products. You will need to drink large amounts of liquid every day in order to urinate enough to excrete these waste products from your body. Remember to drink only water, tea, skim milk or coffee (without milk, cream, or sugar). But don’t drink during or immediately after meals.

Drink only low-calorie liquids

Drinks, including those containing calories, simply run through the narrow outlet created by the band. If you drink high calorie liquids, even healthy ones like fruit juices, you may not lose weight, even if you otherwise follow your diet.

Be active

This rule is important. Physical activity burns calories and is important to successful weight loss. And don’t be intimidated by strenuous exercise regimens. Lots of calorie-burning activities can be rewarding and fun. 

Meat, fish, poultry, eggs

1 to 2 oz. of meat, fish, or poultry, or one egg, for additional protein. A food scale may be your best friend at this point to form good habits. Remove all visible fat from the meat. Remove the skin from poultry. Prepare the meat in ways that require very little fat. Grilling, steaming, microwaving, and boiling are all good ways to do that. Remember, you are eating this of your meal first, so make it count!

Whole grains

1 small portion of cornflakes for breakfast, or 1 to 2 slice of whole wheat or rye bread, preferably toasted, each day. (If you find bread obstructs your pouch opening, substitute other forms of whole grains.)

Dairy products

Milk and yogurt are calories in liquid form. In theory, then, they should be low-fat. These types of food also have calcium. That makes them an important part of a healthy daily diet. Choose a maximum of 2 cups of low-fat milk or low-fat yogurt or 1 oz. of low-fat cheese a day.

Fats

Restrict the use of fat to 3 to 4 teaspoons of margarine, butter, or oil per day. You can have low-fat salad dressing and mayonnaise in moderation

Drinks

Drink as many calorie-free liquids per day as you wish.

Proceed with caution

Certain foods may cause problems for some people. Introduce these foods to your diet slowly and individually to see if they are tolerated. Always be careful.

Get active-and stay active

Along with the LAP-BAND System and a healthy diet, physical activity should be an important part of your weight loss journey. Staying active not only contributes to weight loss, it can also help increase your overall fitness and help you maintain your eventual weight. 

After the operation-follow-up visits make a difference

In the first year following your operation, you should see your surgeon (or someone in their practice) about every four to six weeks for a follow-up visit. During these visits, your surgeon will keep track of your progress, and he or she will decide whether or not you need a band adjustment. Remember, because the LAP-BAND System journey is different for each person, not all follow-up visits will involve band adjustments.

This explains how to tell when your band needs an adjustment. When the right amount of fluids is in the band, it is called being in the “Green Zone”. Ideally, the band should be just tight enough for you to lose weight gradually.

  • -Hungry between meals
  • -Eating large portions
  • -Not losing weight

You may need more fluid in the band

  • -Not hungry between meals
  • -Good weight loss
  • -Portion control
  • -Patient satisfaction

You’re in the green zone! Right amount of fluid in band  

  • -Poor food choices
  • -Regurgitation
  • -Discomfort while eating
  • -Poor weight loss
  • -Night cough

You may need LESS fluid in the band

The adjustment process:

-The adjustment procedure is done by inserting a fine needle into the access port under the skin of your abdomen (you may feel a pricking sensation similar to when you give blood)

-Adjustments can be made either in the hospital or in a doctor’s office

-Your surgeon may use fluoroscopy (a type of x-ray technique) to assist in locating the access port, to guide the needle into the port, and to view the insertion of the needle

-Fluoroscopy may also be used after the LAP-BAND System has been adjusted to evaluate your pouch size and stomach size

Your first adjustment usually takes place four to six weeks after surgery, but this can vary from patient. You and your surgeon can determine the timing and level of restriction that’s right for you.

Frequently asked questions

Will I be in pain after the procedure?

You may feel some pain around the incision sites, especially under the skin of the abdomen where the access port is placed. You may also experience pain and discomfort in your joints and shoulders. This pain is caused by gas-different from intestinal gas-that’s lingering in the body after being used to inflate the abdomen during surgery. It will go away, but it’s important to walk around after your surgery to allow it to dissipate.

Will I feel sick a lot after the operation?

If you feel nauseated or sick on a regular basis, it may mean you need to chew your food more thoroughly or follow your new diet’s rules more strictly. However, feeling sick could indicate a problem with the placement of the band-so contact your doctor if you feel sick regularly. In either case, chew your food slowly and as thoroughly as you can to help prevent vomiting or regurgitation-which can cause the small stomach pouch to stretch or lead to slipped of part of the stomach through the band. These scenarios could reduce the success of the operation or require an adjustment (to remove some of its fluid content). In some instances, another operation may be required.

How long is the average recovery period?

The average hospital stay is less than 24 hours. Typical, it takes about one week before you can return to work. You can start preparing yourself by making sure you get out of bed and move around in the first two days after surgery-even if you’re just able to take a few steps at first. In the first one to two weeks, walking is recommended as a simple, safe way to start getting exercise and building up stamina. You can also try other light forms of exercise-for example, moving your arms up and down or, while seated, raising or stretching your legs. But give yourself at least a full month before you attempt anything more strenuous, like light aerobics. And always check with your doctor about the amount and type of exercise that is best for you.

Will I suffer from constipation?

There may be some reduction in the volume of your stools. This is normal because with decreased food intake, you eat less fiber-and it shouldn’t cause severe problems. If difficulties do arise, speak with your doctor. He or she may suggest you take a mild laxative and drink plenty of water for a while. Drinking six to eight glasses of water a day is a good idea, anyway.

What should I expect at my first follow-up appointment?

You should expect to discuss your eating and exercise habits, and your rate of weight loss. This discussion will help determine whether or not it is the right time for you to have an adjustment. If it is, you can expect the following.

  • A pre-adjustment evaluation of your pouch size and stoma size. (This isn’t always done: your surgeon may or may not evaluate your pouch size and stoma size before the adjustment)
  • Adjustment of your LAP-BAND System
  • Evaluation of your pouch size and stoma size after the procedure to confirm that the procedure to confirm that the proper adjustment was made. (This may simply confirm that you can comfortably take a sip of water)

How much fluid is needed in the band for it works?

The LAP-BAND System is designed to suit your individual needs. Because every person is different-some people need less fluid and some need more-there is no set formula to determine how much you need. Do not compare someone else’s fluid fill to yours. Your doctor needs to evaluate you and will consider:

  • The size of your small upper pouch
  • The size of the opening (stoma) to the lower pouch
  • Your weight loss progress
  • How and what you eat

What is the most important thing I need to know about adjustment?

Do not be in a hurry to have one too soon. The LAP-BAND System offers you a way to achieve steady and safe weight loss. Finding the right balance between losing weight gradually and receiving adequate nutrition. Also, you could have symptoms such as reflux (“heartburn”) or vomiting.

 

How would I know if the LAP-BAND System is “too tight” or “overfilled”?

If the adjustment results in too tight a stomach opening, you could have a hard time eating most foods. Sometimes this causes people to avoid solid food and instead drink liquid meals-but this can result in weight gain, especially if the liquid is high in calories. If the LAP-BAND System is too tight, it can cause reflux symptoms (“heartburn”), particularly at night. It can also cause frequent vomiting. The opening into the larger stomach could become completely blocked and prevent you from being able to keep any food or fluids down. Should you develop these symptoms, notify your surgeon at once.

How much does an adjustment cost-and will my insurance pay for it?

The answers to these questions will vary. Ask your clinical coordinator or office manager.

Will I need to take vitamin supplements?

It is recommended that you begin taking a daily multivitamin after you have the LAP-BAND System procedure. Your doctor can help you choose the right supplement.

What about my other medications?

You should be able to take prescribed medications. You may need to use capsules, or break big tablets in half or dissolve them in water so they do not get stuck in the stoma. Always ask the doctor who prescribes your drugs about this. Your surgeon may tell you to avoid taking aspirin or other nonsteroidal anti-inflammatory pain relievers. That’s because they may irritate the stomach, which may cause you to have the LAP-BAND System removed.

Is it okay if I drink 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 loss.

What about pregnancy?

Placement of the LAP-BAND System is contraindicated for patients who currently are or may be pregnant. Patients that become pregnant after band placement may require deflation of their bands.

For more information about affordable LAP-BAND surgery at our hospital, please contact us today.

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