FillCenters USA: Offering Accessible Professional Support to Gastric Banding Patients

[JR Stratton 0]

Next to laparoscopic technology, gastric banding has been a great leap forward in bariatric surgery. Up until the early 1990s, gastric bypass was the most common procedure performed in the United States to treat morbid obesity. But the development of laparoscopic adjustable gastric banding system in 1993, and its FDA approval in June 2001, presented another surgical option in battling obesity. Gastric banding has appealed to a large population mainly because of a myriad of advantages it provides such as adjustability, reversibility and fewer risks of complications and side effects.

Generally, adjustments enable the surgeons to alter the size of the stoma by changing the amount of saline in the band’s inner balloon via an access port, thereby changing the tightness of the band according to the patient’s needs and preferences. The band’s adjustability serves as a remarkable benefit, but it also demands that the patients receive regular follow-ups and professional coaching to ensure its long-term effectiveness. One of the most common problems many gastric banded patients face today is a lack of access to proper after-care programs. In some cases, patients travel away from their homes to have their surgery. And although, having these follow-up visits is almost as important as the procedure itself, most patients eventually stop the visits because of the inconvenience.

As Dr. Ross Fox, a bariatric surgeon in Tacoma, Washington states, “We have to realize that the adjustable band is merely a tool, and it will not be effective, if it is not used properly.” Dr. Fox, who is one of the first surgeons in the U.S. to implant gastric bands, believes that currently the majority of band patients are not receiving the proper knowledge in how to use this tool effectively. “We have ‘orphan’ patients in our office regularly; they are patients with bands that we haven’t placed initially. They haven’t had any coaching or adjustments and therefore haven’t been able to lose any weight,” he said.

As prominent bariatric surgeons with extensive experience in gastric banding surgery, Dr. Fox and his colleagues, Dr. Ariel Ortiz and Dr. Lee Grossbard had recognized the need for a comprehensive and accessible program that could help to educate gastric banded patients. So, when Iris Stratton, a friend and colleague, expressed her plan to establish a large number of Fill Centers throughout the United States, and asked them to join the organization as advisors and educators, they accepted her proposal wholeheartedly.

For Iris Stratton, however, recognizing this vacuum and establishing Fill-Centers USA has been a natural development. A state-certified nutritionist and a state board-certified fitness instructor for over 30 years, Iris had always felt passionate about her work and strived to help her clients with their weight issues. But when her daughter’s struggle with weight escalated to the point of mental and physical anguish, Iris was compelled to explore their surgical options more extensively. “It was devastating to see my young daughter lose interest in school, her friends and eventually in life,” she expressed. “I had already looked into the gastric banding surgery as a phenomenal tool for weight control and weight loss. So I found a prominent surgeon who performed the gastric banding operation on younger individuals.” In just a few months, Iris was overjoyed to see the remarkable change in Dusti’s weight and her morale. But she also began to recognize her constant need for professional support and guidance in addition to the required band adjustments. The surgeon that performed her surgery was not in their local area.

“One of the most important requirements for an effective gastric band is having a quality after-care program for many years beyond surgery,” Iris said. “While most surgeons make every effort to provide wonderful after-care to their patients, there are situations where, for various causes, some patients do not receive the individualized aftercare they need for success”.

Iris began to materialize her plan in 03’ by gathering a team of renowned bariatric surgeons and a dedicated staff to provide a nationwide comprehensive program to gastric banding patients. “By establishing Fill Centers around the country, we are slowly overcoming the geographic problem, but we are also raising the bar on a variety of after-care services including monthly re-contact, diet and nutrition, exercise, supplementation, emergency care and band adjustments. We even provide healthy recipes, and a list of restaurants and what to order to this particular population,” she said.

During the recruiting process, the program directors choose qualified nurse practitioners, surgeons, and physicians, who attend an intensive training course and learn a standard protocol for band adjustment. Also, as part of their training, they are instructed on nutrition, diet, fitness as well as risks and complications that are associated with the gastric band. In order to ensure a standard quality of operation, the organization performs regular quality reviews to various individuals, who monitor the overall performance of the providers and assess their strengths and weaknesses. “As part of the medical advisory board for the company, we are in close contact with the providers both during their training and afterward, and are available should any needs arise,” said Dr. Grossbard, who is also a Lap Band patient. “We make sure that our providers follow a correct and effective protocol in every single patient to make certain that their band functions at the optimal level.”

Fill-Centers USA has a central office in Northern Arizona that oversees the function of its centers. Each center, in turn, has a sophisticated database, which enables them to network with one another and share information. “Every time a patient is taken on by one of our providers, their information is entered into the company’s central database and is accessible by other centers, our surgeons, and our corporate office.” Iris said. As she explained, if their members begin to have problems while traveling, they can call the number on their card and will be scheduled with the Fill Center nearest them at no extra cost.

Fill Centers offers different payment programs, which include a yearly payment program or a membership program where members pay $155 per fill, which includes a regular consultation. “Band adjustments currently run the range of $150 to $2000, so our prices are comparable and, in most cases, lower than what patients would pay elsewhere,” Iris said. “Experience has shown that when patients commit themselves to having regular visits for reassessment, encouragement and additional coaching, they will have higher chances of long-term success. So, we encourage our patients to participate in our membership program.”

Iris’ vision is being realized by Fill Centers impressive growth. “Helping gastric band patients across the nation on their journey to develop good habits around this amazing tool and achieve long-term weight loss has been my driving force. We are making every effort to having 50 plus Centers by the end of 08’”.

[georgebals 0]

Dear Sirs, This is very interesting. The article made me stop & think about my weight loss journey. Around 1997 I flew from Fairbanks, Alaska to Washington. I attended a weight loss seminar + talked to Dr. Ross Fox.I think this was a time before a person could get banded in U.S.A. Dr. Fox got me started on the possibility of having an adjustable gastric band. I don't remember any mention of laparoscopic surgery. I did talk to bypass patients in the hospital at Auburn. In the years since this 1st seminar, weight loss surgery and I have changed a lot. I was banded 1/15/08. lost 140 pounds. Not filled yet. Thank You Dr. Fox for getting me started.:thumbup::cry_smile: Hasta Pronto, George

[MsVetRN 41]

I'm so glad I found this post! I am having my surgery in Mexico and was wondering about the aftercare!

[Dr. Gail Altschuler MD 33]

I'm so glad I found this post! I am having my surgery in Mexico and was wondering about the aftercare!

Hi. I have been providing lap band fills for the past 2 1/2 years through Fill Centers USA. Fill Centers closed today and I would like you all to know that I'm available to continue to provide lap band adjustments at a reasonable cost as well as a full range of weight loss support services. Give me a call when you're ready for your first fill. To your success. Gail Altschuler, MD 415-897-9800 www.marinweightloss.com.