How the Lap-Band actually works, fills and refills

[Wendell Edwards 73]

This may help you in understanding the restrictive mechanism of a Lap-Band.

The ALLERGAN protocol for Lap-Band fills calls for a six-week delay after surgery, prior to any fills. The purpose for the six-week delay is for the patient’s stomach to heal from the surgery, as well as allowing time for the Lap-Band to “Seat” or “Nestle” into the fat pad between the stomach wall and the interior wall of the Lap-Band.

Prior to receiving an EFFECTIVE fill, it is VERY uncommon to have any restriction from a Lap-Band. Some patients will NOT lose weight, or may even GAIN weight until they have received an effective fill in their Lap-Band.

Normal weight loss with a properly restricted Lap-Band is between 1 and 2 pounds per week.

The normal cycle of fills, restriction and weight loss is as follows:

1. The patient's Lap-Band constricts when the patient receives a fill. Swelling for a few days after receiving a fill is very common. Many doctors require a patient to go on a liquid diet for a day or two after receiving a fill. A fill may have a “Delayed Action” of up to 4 weeks. A “Delayed-Action” means that the fill may not become effective for up to 4 weeks after the fill. That is why the ALLERGAN protocol states that fills should not be performed on patients who will not have access to medical care for at least two weeks after a fill.

2. The patient's stomach capacity is lessened as a result of the restriction caused by the Lap-Band.

3. The patient loses weight because they cannot eat as much food.

4. The residual fat-pad between the inside of the Lap-Band and the outside of the patient's stomach reduces in size because of the overall weight loss in the patient.

5. The reduction of the residual fat-pad causes the Lap-Band to become loose again.

6. At that point, the patient needs another fill, because the Lap-Band is loose, and the patient has a loss of restriction, which allows the patient to eat larger amounts of food.< /span>

7. The patient receives another fill and the process starts all over again.

Most Lap-Band patients receive several fills to adjust the Lap-Band as their weight loss progresses, and there is less and less residual fat-pad between the inside of the Lap-Band and the exterior of the stomach wall. Once a patient has lost all of their residual fat-pad, fills become less common. As the Lap-Band patient progresses in their weight loss, the effect of very tiny fills (Less than .2ccs) becomes greater and greater.

It is not uncommon for a late-stage Lap-Band patient to experience a significant difference in restriction with as little as .05cc of fill.

[faithmd 14]

Thanks for posting this, Wendell. It is GREAT information to have. Maybe it will become a Sticky.

[BANDEDON810 0]

Beautiful post and to the point I love it and it is the best

[Lianna170 2]

Thank you for posting this information Wendell. An informed lapbander is a happier lapbander!

[Barkeep 1]

Wendell, how far are you from your goal weight?

[Wendell Edwards 73]

Wendell, how far are you from your goal weight?

I use a goal size, not a goal weight.

My goal size is 38-inch slacks and a man's extra-large shirt.

[new2tch 2]

I am glad I read your thread Wendell. I have not had my first fill yet and I was discourage. I would gain 3-4 pounds, lose 3-4 pounds. People who knew I had the surgery would ask, "how is it going?" because they could see I am not loosing any weight. I was hoping to go from a size 22 to 18 by the winter holidays. Thanks for the reassurance.

Cyndi

[pjrugby 1]

thanks for explaining all about the fills. can i ask you a question.. at any stage in the process did you ever think the band wasn't working.. i have just had my 3rd fill - its early days. but the medics have said i have a 6 mls capacity ,swedish band, and there is no more room in it. so they can't add anymore saline.. they say its now got 10.25mls in it.. i feel a bit tighter when i drink ,but haven't tried a proper meal as yet, as am worried i won't feel restriction and i will be so upset.. i never pb'd .. or anything, i am worried this band has been a waste of time and money

well done on your success

[Wendell Edwards 73]

thanks for explaining all about the fills. can i ask you a question.. at any stage in the process did you ever think the band wasn't working.. i have just had my 3rd fill - its early days. but the medics have said i have a 6 mls capacity ,swedish band, and there is no more room in it. so they can't add anymore saline.. they say its now got 10.25mls in it.. i feel a bit tighter when i drink ,but haven't tried a proper meal as yet, as am worried i won't feel restriction and i will be so upset.. i never pb'd .. or anything, i am worried this band has been a waste of time and money

well done on your success

Thank you for the compliment.

Yes, before I obtained effective restriction with fill number 4, which was given 24 weeks after surgery, I thought that my Lap-Band did not work and that the entire thing was a cruel joke at my expense.

I don't know anything about the Swedish Band, but I do know that a Band that would not provide restriction when filled to capacity is exceptionally rare.

Best wishes on your journey.

[coolrn2000 2]

Wonderful info. I will get my first fill on Tues. and started to get a little discouraged. Again because of the wicked wicked scales. Your post lifted my spirits.

[short c 1]

I just had my first fill this past monday and have experienced 3 pb's so far- not chewing enough!!!!! Very not fun!

but I also don't have a sense of a smaller stomach, in that if I chew well I can still eat a good amount of food- almost as much as before the band. I have 2.5 ccs in a 4cc /10cm inamed band. My weight loss has stalled since I went onto solids.

[BrownSuga 0]

My doctor told me after surgery that he put 3 cc's in with the surgery. He said that this is something that they are staring to do with the new surgeries when the capacity is 10 cc's and above. Has anyone else had this.

[Wendell Edwards 73]

Wonderful info. I will get my first fill on Tues. and started to get a little discouraged. Again because of the wicked wicked scales. Your post lifted my spirits.

scales are a tool for weight loss, but the problem is that most people who are starting out with a Band are too emotionally fragile to deal with the normal ebb and flow of fluctuating weight.

Confidence that the Band actually works for us takes time, and in my opinion, based on the hundreds of posts that I have read over the last 4 years, weighing in the post-op period is not a good idea for most people, because it leads to stress, anger and frustration due to a lack of understanding that even small fluctuations in a person's weight can wipe out what is, in reality, a good month of weight loss for the average Band patient.

[CallMeJim 2]

When I lose weight even my fingers get skinnier and my ring gets loose. When I gain (I am pre-band) my ring can get so tight it won't budge. Sounds like the fat pad on my stomach works the same way and band fills serve to fill in where the fat used to be. Interesting. Thanks for the info.

Jim

[Oregondaisy 2,021]

Isn't there a way to keep this post front and center? I don't want it to get buried. All the newbies need to have easy access to this post.