• 1 out of 200 people die from Gastric Bypass
   
• 1 out of 10,000 has an ADVERSE EVENT from Gastric Banding Surgery (LAP-Band)
   
• WLS is in addition to watching what you eat and exercise ... for as long as you have it!
   
• You may not have restriction until your 3rd of 4th fill or even 6th! Do not get stressed about this. You are still healing. Your stomach is a muscle you do not want to tax it during the healing process. Follow your doctors post surgical steps to the letter.
   
• If you get an infection DEMAND an infection specialist. This is your life and your body. You only get one.
   
• Many insurance claims are rejected the first or second time. DO NOT give up! FIGHT and it's very likely you will win! Visit the Obesity Help Message boards and ask for ideas on Insurance letters and how to work with a particular agency. You can do it.
   
• Not everyone drops dramatic pounds... most (diligent) bandsters lose 1 - 2 pounds a week. studies show at the 5 year mark weight loss is the same or better than as RNY!!)
   
• Be sure to exercise even if that means walking for 15 minutes two times a day.
   
• Since we are talking about walking. During the surgery they fill you with gas in the insertion points. After surgery be sure to get up and walk every few hours. This will move the gas out and you will feel better!
   
• Let me repeat ... Many people do not have restriction until their 3rd or 4th fill. Be patient!
   
• It's not an easy overnight solution it takes time and dedication (but worth it ... read the stories link).
   
• Be sure to check your doctor out thoroughly. There are stories about doctors who have never done LAP-Band doing them for the first time without a proxy. As this surgery becomes more common more doctors will offer it. Check their history on the AMA website. (Note: That all doctors using Inameds equipment is SUPPOSED to be certified. CHECK and make sure they are. There are some that have NOT go through the certification process. Call Inamed if you can't get confirmation.).
   
• Inameds bands are the only US based approved bands. Other countries have other options. You can go to Mexico and get the French and Australian bands.
   
• Some people after a 3rd or 4th fill hit their "sweet spot" feel more "tight" in the mornings. This subsides.
• Ask many questions this is your body and your life.
   
• Get details of post op care in writing and ask about any associated costs (don't get caught by surprise! - some horror stories about this!).
   
• Get all the information upfront as to what your Insurance agrees to pay for. Some people have found out that THEY have to pay for fills. GET EVERYTHING IN WRITING.
   
• Don't be afraid to ask questions and ask for anything they say in writing. I know you want this more than anything but don't get jammed up  down the road.
   
• Think twice about the people you tell about your surgery (not everyone reacts positive and may try to bring you down.).
   
• After surgery you may not feel normal for up to 6 weeks. Don't get down. Everyone goes through this phase and nearly everyone is 100% happy they did it!
   
• Join a support group OH (ObesityHelp.com) is great but an in person meeting can be better.
   
• Prepare to be out of work from 1 - 2 weeks depending on how well you "bounce back". Talk to your Doctor. Some people have gone back in 3 days ! The author of this site went back in 9 days ... but she wishes she had stayed home for 2 full weeks!
   
• Any signs of advanced pain see a doctor. (pain scale 1 - 10 ... anything above a 6 see the Doc! Even on the weekends!)
   
• If you are unable to swallow or can only partially swallow call your doctor!
   
• When in doubt call your doctor!! - this is your life not theirs - and don't be afraid to call - that is what they are there for. If you do not get help and are still ill go to the ER. Do not mess with your health.
   
• Do not rely on you medical from people on the internet. See a Doctor if something doesn't "feel right". An ounce of prevention is worth a pound of cure.

1. An article at : http://www.journalacs.org/article/PIIS1072751505005351/abstract said “Change from perigastric to pars flaccida technique reduced slippage rate.” Can you explain this? *
    
2. What should I do about my current Meds?
    
3. Can I get my surgery meds pre filled?
    
4. When will I know if my insurance will approve me? What can I do to speed up the process?
    
5. How is it determined what size band I need?
    
6. How is it determined when I need a fill?
    
7. Port placement. I sleep on my stomach. What options are there?
   • There is a recent study showing that port placement under the right breast onto of the rib cage has a faster healing time, shorter cable and drops down was weight comes of. Has this been your experience? What are you thoughts?
      
8. I have a dental appointment the day before or a few days before the surgery. Any issues?
    
9. Are there any issues if I get my period the day of surgery?
    
10. What have you heard about the gastric pacer versus the band?
     
11. I've heard that gas pains can be a problem right after surgery. How can I minimize this? Please explain the difference between belching pains and surgical gas pain? How can I minimize the potential of pain in my shoulder?
     
12. How many surgeries have you done?
     
13. When and where were you certified?
     
14. What can I expect for post care and follow-ups?
     
15. Can I get post care follow-up care in writing?
     
16. Can I get the post op diet in writing?
     
17. Do I have to pay for fills? if so how much are they?
     
18. I live in another state how can I find a "fill" doctor in my area?
     
19. What is the pre and post surgery diet?

• Restriction = When you have a fill and your band is tightened you will feel restriction. This replicates a "full" feeling and "restricts" you from eating.
   
• PB = Productive Burping. This happens when you eat too much and your esophagus "burps" the food back up.
   
• Slimeing = When you eat too much food it backs up into your esophagus and your body produces saliva/mucus to help move it into your stomach. Because you have the band it doesn't move into your stomach and you end up spitting up the "Slime".
   
• "Dumping syndrome" = Whereby stomach contents move too rapidly through the small intestine. Symptoms include nausea, weakness, sweating, faintness, and, occasionally, diarrhea after eating, as well as the inability to eat sweets without becoming so weak and sweaty that the patient may have to lie down until the symptoms pass. DOES NOT HAPPEN TO LAP-BANDSTERS!
   
• Malabsorption = Impaired intestinal absorption of nutrients, causing food to be poorly digested and absorbed. THIS DOES NOT HAPPEN WITH LAP-BAND!!
   
• Hernia = The protrusion of a loop of an organ or tissue through a weakened opening. 10 to 20 percent of patients who have weight-loss surgery develop a hernia.
   
• Panniculectomy = The removal of the tissue and skin from the abdomen; a tummy tuck. (Never use the term “tummy tuck” when communicating with an insurance company. They like to deny this surgery!). Also as soon as your skin starts to get lose and hang down you will want to indicate to you doctors and RNs during you follow up visits that you are experiences uncomfortable itching, rashes in the area sensitivity etc. Having a record of issues to show your insurance company will make reimbursement or full insurance coverage considerably easier.
   
• Laparoscopic = Abbreviated “Lap.” Operation performed using a laparoscope, a thin fiber-optic scope introduced into a body cavity through 4 or 5 small stab incisions.
   
• Incentive Spirometry = After surgery, you will be given a small plastic device with a flexible hose attached to it (kind of like a snorkel). The nurses will teach you how to suck air in through the device to exercise your lungs. This will help you to avoid atelectasis and pneumonia following surgery. You should take your incentive spirometer home with you, so that you can continue your breathing exercises at home.
   
• Gastric Banding = A restrictive operation in which a plastic band is placed around the upper portion of the stomach. Recently, adjustable gastric bands have become available that can be placed laparoscopically.
   
• RGB = Roux-en-Y gastric bypass
   
• VBG = Vertical banded gastroplasty
   
• Bariatric Surgery = The word "bariatric" comes from the Greek word baros, meaning weight. Bariatric surgery is another word for weight loss surgery, which is surgery designed to treat severe obesity.

Obes Surg. 2005 Aug;15(7):1050-4.

Reduction in slippage with 11-cm Lap-Band and change of gastric banding technique.

Wolnerhanssen B, Kern B, Peters T, Ackermann C, von Flue M, Peterli R.

Surgical Clinic, St. Claraspital, Basel, Switzerland.

BACKGROUND:

Slippage occurs after 2-18% of gastric bandings performed by the perigastric technique (PGT). We investigated the slippage-rate before and after the introduction of the pars flaccida technique (PFT) and the 11-cm Lap-Band, and the long-term results of the re-operated patients. METHODS: Between Dec 1996 and Feb 2004, 360 patients with a mean BMI of 44 kg/m2 were operated. The PGT (n=168) and PFT9.75 (n=15) groups received the 9.75-cm Lap-Band, and the PFT11 group (n=177) received the new 11-cm Lap-Band. Follow-up rate was 99%. RESULTS: Slippage occurred in a total of 31 patients from all groups (PGT, n=28, or 17%; PFT9.75, n=1, or 7%; PFT11, n=2, or 1%). Average yearly re-operation rate for slippage in the first 3 years postoperatively was 3.8%, 2.2% and 0.9%, respectively. Laparoscopic re-banding was necessary for posterior (n=19) or lateral (n=12) slippage. The late postoperative course after re-banding was: uneventful 58%, weight regain 35% and/or esophageal motility disorder 23%, secondary band intolerance 20%, and one persistent posterior slippage. 8 patients (26%) needed biliopancreatic diversion.

CONCLUSION: Since the introduction of the PFT and the 11-cm Lap-Band, we observed a significant reduction in slippage rate and no posterior slippage. Re-banding had a less favorable long-term result than did first-procedure banding.