Need Info: Details for Lap band and Stomach's mechanics and physiology

[TN-Vol-Man 4]

I am pre-surgery...no date set yet. Need to get my head wrapped around the mechanics of the stomach after it is banded. I have watched and read many things but most are high-level. What I am looking for is a description of what happens within the esophogus and stomach from the bite until the meal is finished. I am trying to understand how long it takes to process a bite and the meal without stretching the stomach and causing a slippage. They say timingn is everything, and I guess that is true while eating when banded. Second, question is related to something I heard a doctor mention on some video post (lost that link) about the importance of staying on the liquid/soft diet early after surgery due to the stomach's getting use to the band around it to allow it to form something like scar tissue around the area of the band. Any doctors and really sharp gurus out there that can help answer these?

[Mikee57 699]

TN-Vol-Man, I am new at this as well and have had to learn from a lot of these post, but mostly by mistake. I have learned to eat really slow taking 1 minute in-between bites, chew, chew, chew and then swallow. I take about 15 to 20 minutes to eat a meal...usually 3 to 4 oz of Protein (meat) and 1/2 cup of veggies. I also drink Protein Shakes (usually one a day) since I sometimes cant get my protein in during the day or a Protein Bar (according to how far I'm off from my protein intake (shakes are usually alot less than the bars). I'm not sure how long it takes food to get to the stomach...would only probably know if they did some sort of swallowing test for that. for the first two fills that I have, there has been no restriction so I merely am watching portion size until I get to the point where I feel that satiety feeling folks talk about on here. so I wish you my best wishes and hope to see you on here after your surgery. take it slow and heal that first month and don't kick yourself if things don't just fall into place...it is a learning process for sure!!! Take care talk with you soon...I hope.

[2muchfun 8,927]

You may be over-thinking this a little? Here are 4 videos that fully explain how this works. Keep in mind Dr. O'Brien's protocol may differ from your own surgeons?

And the purpose of the liquid diet is to make sure your stomach remains fairly quiet during the healing stage. Your stomach is pulled up over the band and sutured into place. Excess stomach movement such as vomiting and food getting stuck could cause the sutures to tear away. There are many youtube videos demonstrating this if you're interested?

http://www.youtube.com/watch?v=Qa3Lwt6ElIs&list=UL Part 1

http://www.youtube.com/watch?v=K4jYJipQ7vc part 2

http://www.youtube.com/watch?v=Wbdhf44ZweI&feature=relmfu Part 3

http://www.youtube.com/watch?v=KF3TCKUn3YI Part 4

[Bandarella 223]

This is what I know:

The band is placed 2-3cm below the gastro-esophageal junction and a flap of stomach tissue is brought up and over it and sutured with about 3 stitches.

The capacity of the pouch is about 2 tbs. This is why we are told to cut food into tiny 1/4 inch bites and chew 15-25 times before swallowing and eat no more than 1/2-1 cup of food per meal over 20-30 min. If you put your fork down between bites, it helps to reinforce this. I practiced this during my 3 month pre-op supervised diet and it really helped to have this established as a habit before surgery. If you eat too fast, or eat too big of bites, you will back food up into the esophagus, causing possibly irreparable damage and risk losing your band.

I suggest an esophageal manometry test preop to rule out a tendency towards achalasia or preexisting esophageal motility issues, which almost guarantee incompatibility with Lapband.

Hope this helps!

Edited April 21, 2014 by Bandarella

[TN-Vol-Man 4]

I appreciate everyone's comments...good thoughts all. I possibly am overthinking this some...but Im a data person...ESTJ in the Myers-Briggs personality types.

[TN-Vol-Man 4]

You may be over-thinking this a little? Here are 4 videos that fully explain how this works. Keep in mind Dr. O'Brien's protocol may differ from your own surgeons?

And the purpose of the liquid diet is to make sure your stomach remains fairly quiet during the healing stage. Your stomach is pulled up over the band and sutured into place. Excess stomach movement such as vomiting and food getting stuck could cause the sutures to tear away. There are many youtube videos demonstrating this if you're interested?

http://www.youtube.com/watch?v=Qa3Lwt6ElIs&list=UL Part 1

http://www.youtube.com/watch?v=K4jYJipQ7vc part 2

http://www.youtube.com/watch?v=Wbdhf44ZweI&feature=relmfu Part 3

http://www.youtube.com/watch?v=KF3TCKUn3YI Part 4

This information from Dr O'Brien was very informative. This will be very helpful for me as and anyone else with, or contemplating the band.

[2muchfun 8,927]

Just keep in mind that every doctor has their own idea of how this all should work. For instance, most doctors don't want you drinking anything 30 minutes before a meal, no drinks during a meal and not for 30-60 after a meal. Dr. O'Brien is only one in a handful of surgeons who allow drinking while eating a meal.

Your surgeon may have other ideas?

It's hard to say why most slips occur. Violent vomiting episodes is one. Poorly placed or sutured bands by lousy surgeons could be another. Here's a short study on slips: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3038361/

I wish I'd been more of a information geek before my surgery but I'm one of those that learns on the go I guess. Contact me if you have more questions?

[Mikee57 699]

thanks again 2muchfun for your help on this one too...those videos really made a change on how I do things.