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Patient Instructions

You had laparoscopic gastric banding surgery to help with weight loss. Your surgeon placed a band around the upper part of your stomach to separate it from the lower part. The upper part of your stomach is now a small pouch with a narrow opening that goes into the larger, lower part of your stomach. The surgery was done using a camera placed in your belly. The camera is called a laparoscope. This type of surgery is called laparoscopy.

You will lose weight quickly over the first 3 to 6 months. During this time, you may have body aches, feel tired and cold, have dry skin, mood changes, and hair loss or hair thinning. These problems should go away as your body gets used to your weight loss and your weight becomes stable. Weight loss slows down after 12 to 18 months.

You will remain on liquid or puréed food for 2 or 3 weeks after surgery. You will slowly add soft foods and then regular food to your diet. By 6 weeks you will probably be eating regular foods.

• You will feel full very quickly, sometimes after just a few bites of solid food. This is because at first your new stomach pouch holds only a tablespoonful of food, about the size of a walnut.
• The pouch will get larger over time. Eat only the amount of food that your doctor or dietitian has recommended for each meal. Eating more than this will stretch out your pouch and decrease the amount of weight you lose.

Once you are eating solid food, remember to eat slowly and chew each bite very slowly and completely. The opening for your new stomach pouch is very small. If you cannot chew something until it is smooth or puréed, do not swallow it.

• Take at least 30 minutes to eat a meal. If you vomit or have pain under your breastbone during or after eating, you may be eating too fast.
• Eat 6 small meals throughout the day instead of 3 big meals. Do not snack between meals.
• STOP EATING AS SOON AS YOU ARE FULL.
• Drink up to 8 glasses of water or other liquids that do not have calories every day. Do not drink anything for 60 minutes before or after you eat food, or when you are eating. Having liquid in your pouch will wash food out of your pouch and make you hungrier. Take small sips when you are drinking. Do not gulp. Do NOT use a straw, since it brings air in your stomach.

Your doctor, nurse, or dietitian will teach you about foods you should eat and foods you should avoid. It is very important to follow your diet. After surgery when you are losing weight quickly, your doctor or dietitian will make sure you are eating enough protein and fluids. You will need to take several vitamins and minerals.

See also: Your diet after gastric bypass

Aspirin, ibuprofen (Advil, Motrin), and some other drugs may harm the lining of your stomach or even cause ulcers. Ask your doctor if you should avoid these drugs.

Avoid foods that are high in calories.

• Do NOT eat foods that contain a lot of fat, sugar, or carbohydrates.
• Do not drink alcohol.

Eat mostly protein, fruits, vegetables, and whole grains.

Change the dressings (bandages) every day until your doctor says you do not need to use them anymore. Change them more often if they get dirty or wet. Gently wash the wound areas with mild soap and water. Pat them dry with a clean towel. Do not rub them dry.

You may remove the wound dressings and take a shower if sutures (stitches), staples, or glue were used to close your skin.

• If tape (Steri-Strips) was used to close your skin, you may want to cover the wound with plastic wrap for the first week before taking showers. Tape the edges of the plastic well to keep water from leaking in.
• Do not try to wash off or peel off the Steri-strips or glue. They will come off fall off on their own.

Do not soak in a bathtub, swimming pool, or hot tub until your doctor tells you it is okay.

You will have several visits with your doctor, nurse, and dietitian in the first year after surgery.

• You will probably have a visit with your doctor in the first month after your surgery. Your doctor will check your wounds and see how your diet is going.
• After this, your visits will probably be every 1 to 2 months.
• Your goal for weight loss will be about 2 to 4 pounds a week.

The band around your stomach is filled with saline (saltwater). It is connected to a container that is placed under your skin in your upper belly. Your surgeon can make the band tighter or looser by increasing or decreasing the amount of saline in the band. To do this, your surgeon will insert a needle through your skin into an “access port” in the container.

Your surgeon can make the band tighter or looser any time after you have this surgery. It may be tightened or loosened if you are:

• Not losing enough weight
• Having problems eating
• Vomiting after you eat

Call your doctor or nurse if:

• Your temperature is above 101 °F.
• Your incisions are bleeding, red, warm to the touch, or have a thick, yellow, green, or milky drainage.
• You have pain that your pain medicine is not helping.
• You have trouble breathing.
• You have a cough that does not go away.
• You cannot drink or eat.
• Your skin or the white part of your eyes turns yellow.
• Your stools are loose, or you have diarrhea.
• You are vomiting after eating.

Lap-Band - discharge; LAGB - discharge; Laparoscopic adjustable gastric banding - discharge; Bariatric surgery - laparoscopic gastric banding - discharge

Buchwald H, Estok R, Fahrbach K, Banel D, Sledge I. Trends in mortality in bariatric surgery: a systematic review and meta-analysis. Surgery, 2007;142:621-632.

Leslie D, Kellogg TA, Ikramuddin S. Bariatric surgery primer for the internist: keys to the surgical consultation. Med Clin North Am. 2007;91:353-381.

Townsend Jr. CM, Beauchamp RD, Evers BM, Mattox KL. Townsend: Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders; 2008.

Updated by: Crystine Lee, MD, Department of Surgery, Marin General Hospital, Greenbrae, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.