One of the surgical advantages of the LAP-BAND System is that it can be adjusted after surgery to individualize patient care without additional surgery. The tissue trauma and fold-flaw failures caused by triangulating designs are eliminated altogether with the LAP-BAND System's unique pre-shaped circular inflation membrane.

How Frequent?

During the first 2-3 weeks after surgery, the patient with a Lap-Band will experience temporary edema (inflammation) and a sensation of early satiety (fullness) will be present. This is one of the reason why we leave the Lap-Band system empty at the time of surgery. The inflammation will disappear at the end of the first month. The patient can schedule the first adjustment 6 weeks after surgery.

Afterwards we adjust the system, without a predetermined schedule, only if the patient stops losing weight (in the absence of dietary problems) or need additional nutrition (pregnancy, serious medical illness, etc.). In case of problems (vomiting, obstruction, etc.) the band can be deflated by aspirating the fluid from the system.

How Are Adjustments Made?

We strongly believe that the first adjustments should be performed under fluoroscopy X-ray control with a barius swallow to asses the stomach pouch and the passage of the contrast medium through the stomach.

First, we localize the access port under fluoroscopy and mark the skin, the prep the skin with Betadine and infiltrate local anesthetic to avoid pain.

Second, access of the port with special Huber needle and inject saline solution into system.

Third, the patient swallows contrast solution (Barium) to visualize the stomach pouch above the Lap-Band.

Finally, the needle is removed. The process most of the time is very simple.

How Much Fluid Is Placed?

In the first adjustment, no more than 1.5-2.0 cc of saline solution. In the case of additional adjustments we never inject more than 1.0 cc at a time. We prefer to have the patient adapt slowly to the new restrictive situation. If the injected amount turns out not to be sufficient a further adjustment is done 4-6 weeks later.