What is a Gastric Lap-Band Fill?
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What is a Gastric Lap-Band Fill?
The gastric lap-band is an adjustable band that's placed around the upper portion of the stomach to help reduce how much you eat. It can be made tighter or looser by injecting or withdrawing sterile saline from an access port that's connected to the band.
The access port is implanted beneath the skin of your abdomen during gastric banding surgery and will stay there for life, along with the band.
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The process of adding saline to the band to make it tighter is generally referred to as a "fill" or an adjustment. However, an adjustment may also involve removing saline from the band if it's too tight.
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When do I get my first gastric lap-band fill?
The gastric band is usually implanted empty. That is, there is no saline in the band to start. This gives your body a chance to get accustomed to the band and to heal. Any "restriction" you feel after surgery is due to the band itself and the swelling of the tissues around it.
Approximately 4-6 weeks after your bariatric surgery (exact times vary), your weight loss will slow or plateau and you'll be ready to have the band tightened up a bit...
...that is, you'll be ready for your first "fill."
What does the process of getting a "fill" involve?
You'll either go to your bariatric surgeon's office or a local hospital where your surgeon or a trained clinician will inject sterile saline into the port in order to tighten the band.
The port is accessed in one of two ways:
- Palpation (simply pressing down on the skin to locate the access port)
- X-ray (fluoroscopy)
...You'll only feel a slight needle prick as the surgeon injects the port with a fine needle!
Watch a live gastric lap-band fill adjustment.
Important: Only a trained clinician should administer your fills. Never let an untrained person do it and never try to to adjust your own gastric band!
How will my eating change after a gastric lap-band fill?
You'll follow a liquid diet and work your way back to eating solids after having a fill. However, the diet progression is much faster after a fill than it is after the surgery. You should be able to progress from drinking liquids all the way back to eating solids in 3-7 days. Follow your bariatric clinic's guidelines.
Refresh yourself on the post-op lap-band diet progression.
How many cc's of saline are added in a fill?
Everyone is different and the exact amount of fluid required to tighten the band enough (but not too much) is unique.
Tighter isn't necessarily better! Indicators that you may be "over-adjusted" include:
- Difficulty swallowing food or saliva
- Regurgitation
- Waking up at night coughing or vomiting
- Frequent reflux/heartburn
You and your bariatric surgeon will go through what I call a "Goldilocks" period, where you'll add fluid and the band will be too tight and you'll remove fluid and it's too loose. You'll eventually uncover the "sweet spot" where you figure how many cc's make it just right.
When a fill is "just right," the gastric band:
- is tight enough to reduce the overall amount you eat
- is loose enough to let you eat solid foods and have them "go down" without difficulty
- lets you eat enough to get the nutrients you need and not feel hungry between meals
- lets you gradually lose weight
How many gastric lap-band fills do I need to have?
Of course this is individual, but during the first year, most patients get between five and eight adjustments in the process of trying to find the amount of fill that's "just right."
Sometimes, small adjustments are made over the years.
How long does a gastric lap-band fill take?
A follow up fill procedure generally only takes ~ 15 minutes.
Do I have to pay for every gastric lap-band fill?
This is an excellent question to ask your bariatric surgeon! Find out:
- Are your fills covered for the first year only?
- If so, how much will each one cost after that?
- What will happen if your surgeon stops accepting your insurance? Will you then have to pay for fills out of your own pocket?
(If you're thinking about getting weight loss surgery in Mexico factor in the cost of flying back and forth to Mexico to get your gastric lap-band fills! It might be difficult to find a surgeon in your city who's willing to take on your case and manage fills for a surgery done in Mexico.)
Regular follow up visits with your bariatric surgeon so he/she can properly adjust your band are key to achieving success with the gastric banding surgery!
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