What You Can Expect Before the LAP-BAND Procedure

     Before the Operation
After we jointly make the decision to go ahead with the procedure we will arrange for you to have some preliminary tests that are needed to document your general state of health. We may also do some specific measures of your current health problems and we will do some further tests that will minimize any risks associated with anesthesia. You will generally come into the hospital either the afternoon before the procedure or the morning of the procedure. The operation is performed under a general anesthetic and takes about 1 hour.

The Operative Procedure
The operation is almost always done laparoscopically. That means that we do not make any large incision. We pass fine tubes through the skin into abdominal cavity. Mostly these are 0.2 in (5 mm) across, about as wide as a pencil. A special telescope is placed through one of these tubes. It has a camera attached to it so that we can see the inside of the abdomen by looking at a video screen. We pass surgical instruments through the other tubes to do the operation and we watch what we are doing on the video screen.

The band is placed around the upper part of the stomach to create a very small stomach above the band, with the rest of the stomach lying in its normal place below the band. Al the food that you eat will go into this small stomach initially and then will empty slowly through the space left within the band into the rest of the stomach and onwards through the small and large bowel as normal.

An access port is placed in the abdominal wall, usually slightly to the left of center, at about the belt line. We can put a needle through the soft center of the access port to add saline to tighten the band. To place the access port we make a small cut in the skin, which measures 1.5 in (4 cm) in length. Therefore, at the end of the operation, you will note this small cut and also access the ports passed through the skin. As the other ports are about as thick as a pencil, these incisions are quite small and, after healing, leave very little scarring.

Occasionally, the operation cannot be performed laparoscopically. This may be because the liver is too larger or there has been a previous surgery in the area and there are too many adhesions. Sometimes, although we start to do the procedure laparoscopically, it may be more appropriate to change to an open operation. This may occur if a significant amount of bleeding happens or if there are difficulties in passing the band around the stomach. You won't know that we have had to do this until after the completion of the operation, and you have to go into the operation recognizing that this may happen. On current experience, this will occur with less than one in 500 operations if there has been no previous surgery in the region
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If we need to do an open operation, generally you will have more discomfort after the operation, and you will need to stay in hospital a day or two longer. Also, it will be a longer period before you are able to return to your normal activities. However, the procedure itself is done in essentially the same way and the end result is the same.

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