Frequently Asked Questions
1. What tests are needed before surgery?
2. What if I have heartburn or reflux?
3. Do I need a referral from a General Practitioner?
4. Is gastric banding always performed by laparoscopic (keyhole) Surgery?
5. Will I be in a lot of pain?
6. How long do I have to stay in the hospital?
7. Will I have a drain after the surgery?
8. What can I expect when I wake up in the recovery room?
9. How soon will I be able to walk?
10. How soon can I drive?
11. What is done to minimize the risk of blood clots (DVT or PE)?
12. What should I bring with me to the hospital?
13. Will I be vomiting or have nausea after the operation?
14. How long will it take to recover after surgery?
15. How much weight will I lose?
16. How does the gastric band compare with the gastric bypass or the sleeve gastrectomy?
17. Why are frequent clinic visits necessary after surgery?
18. Does the gastric band limit any physical activity?
19. How is the band adjusted?
20. Do I have to be careful with the access port just underneath my skin?
21. Can the band be removed?
22. Will I need plastic surgery for the surplus skin when I have lost a lot of weight?
23. Is it true that the gastric band seems “tighter” in the morning?
24. Will I feel hungry or deprived with the gastric band?
25. What will happen if I become unwell from something else?
26. What about pregnancy?
27. Will I need to take vitamin supplements?
28. What about other medication?
29. What if I go out to eat?
30. Can I still enjoy a glass of wine?
31. Can I eat anything in moderation?
32. Will I be constipated?
33. Will I still be able to eat whilst flying in a plane?
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What tests are needed before surgery?
At OClinc, we like to make your surgery as safe and predictable as possible. We routinely perform a blood test on all patients before surgery- This includes a full blood count, blood group, cholesterol levels, kidney, liver and thyroid function, and a diabetes screening test. A chest Xray or an ECG is often also be required.
Sometimes a referral to another specialist such as an endocrinologist, cardiologist, or respiratory physician may be made. This will be determined at your initial consultation with Dr Taylor. If you already have other specialists involved in your care, we will correspond with them.
What if I have heartburn or reflux?
Heartburn occurs when stomach acid refluxes back into the oesophagus and burns its sensitive lining. Obesity itself is a risk factor for this. Another common reason to have heartburn is if you have a hiatus hernia- a common condition in obesity. A hiatus hernia occurs when the normal opening in the diaphragm for the oesophagus becomes stretched and enlarged, allowing the upper part of the stomach to slide up into the chest. This causes the one-way valve between the oesphagus and stomach to become faulty.
We routinely look for and repair a hiatus hernia if found during your gastric banding surgery (at no additional cost)- as a result it is usually possible to get rid of your heartburn completely. Many of our patients who have suffered from years of heartburn requiring medication to control and have had their symptoms alleviated as soon as they awake from surgery, and no longer need medication.
Do I need a referral from a General Practitioner?
Yes. A referral from a GP is a requirement under Medicare. We would also like to keep your GP informed about your management and subsequent progress- it’s a team approach.
Is gastric banding always performed by laparoscopic (keyhole) Surgery?
Yes. Nowadays it is extremely rare to require conventional open surgery to perform gastric banding- indeed Dr Taylor has never had to convert to a major incision during a gastric banding procedure, even in patients who have had multiple previous abdominal operations. The benefits of laparoscopic surgery include less discomfort, shorter hospital stay, earlier return to work, less abdominal adhesions, and reduced scarring.
Will I be in a lot of pain?
Whilst significant pain is rare, some temporary discomfort in the upper abdominal area and/or shoulder tip is quite common, usually in the first 24-72 hours. You will be provided with adequate analgaesia, both in hospital and after discharge, to make sure you are comfortable.
How long do I have to stay in the hospital?
The vast majority of patients feel well enough to be discharged within 24 hours of the procedure- this usually means staying overnight in hospital. However everyone heals at different rates, and surgery can vary in its complexity depending on a patient’s past medical history. You will be allowed home when you feel ready- no-one is ever pushed out of hospital.
Will I have a drain after the surgery?
No.
What can I expect when I wake up in the recovery room?
Although you will be awake in the recovery room, it is common to still feel a little drowsy. Our anaesthetists are here to ensure your comfort- and may use a variety of medication to make sure you are not in pain. Occasionally this may include a Patient Controlled Analgesia (PCA) or a self-administered pain management system. Because your procedure is performed laparoscopically, any initial discomfort quickly passes, and virtually all patients feel completely awake, alert and able to have a normal conversation within an hour or two.
How soon will I be able to walk?
As soon as you feel up to it. In fact we encourage you to get up and walk about the ward that afternoon- it helps avoid problems like blood clots and chest infection. On leaving the hospital, you should be able to care for all your personal needs, but may need a little help with shopping, lifting and transport for the first few days.
How soon can I drive?
It is illegal to drive within 24 hours of a General Anaesthetic- therefore it is important that you arrange for someone to pick you up from hospital. Most patients feel ready to drive again after 3 days- however for your own safety, you should not drive until you have stopped taking narcotic medications.
What is done to minimize the risk of blood clots (DVT or PE)?
All patients receive a number of treatment measures to reduce the risk of blood clots- these include being given injections of heparin during and after surgery, special leg stockings (TEDS), and the sequential calf compressing device (SCD) whilst on the operating table. As a result of these measures we have a 0% incidence of blood clots at OClinic.
Any patient who is at high risk of a blood clot (such as a history of blood clots or clotting disorders) may be asked to continue heparin (Clexane) injections for 10 days after the surgery in addition to the other measures. This can be done at home, and we will show you how.
Early mobilization is another major preventive measure- that’s why we strongly encourage you to get moving and out of bed as soon as possible after the operation to restore normal blood flow in the legs.
What should I bring with me to the hospital?
A hospital representative will call you the evening before your admission and advise you on everything you need to know. Generally only a few things are required- personal toiletries and clothing for your stay that are easy to put on and take off. Don’t forget to bring any Xrays and other important medical documents that may be relevant to your surgery.
Will I be vomiting or have nausea after the operation?
Nausea or regular vomiting are not a normal part of life with a band. If you feel nauseated or sick on a regular basis, it may mean that you are not chewing your food well or that you are not following the diet rules properly. However, it could also mean that your band is too tight, or that it has slipped- we are here to support you so you should never hesitate to contact us if this problem persists. Vomiting should be avoided as much as possible as it can cause the small stomach pouch to stretch.
How long will it take to recover after surgery?
Patients typically spend less than 24 hours in the hospital. We recommend taking a week off work (and will provide you with a work certificate) to recover properly at home. Most patients feel back to their normal selves after about 2 weeks. Gentle exercise such as walking can be restarted straight away, but you should wait 4 weeks before resuming swimming or more vigorous activities such as the gym or boot camp.
How much weight will I lose?
Whilst weight-loss results vary from patient to patient, most patients lose between 0.5kg and 1kg per week. Whilst this may not sound very fast at first, when you consider how much weight this equates to over 12 to 24 months it can amount to substantial weight loss indeed. A slow but steady rate of weight loss gives your body time to catch up. In fact, it is unsafe to lose weight too fast- any faster than 1kg per week may lead to hair loss, sunken complexion, lethargy, disruption to normal menstrual cycles, and problems with redundant skin.
The overall amount of weight you will lose depends on several things. The band needs to be in the right position, and you need to be committed to your new lifestyle and eating habits. The Gastric Band is not a miracle cure, but rather a powerful tool that will allow you to take control of your appetite. At Oclinic we pride ourselves on being able to help our patients achieve some of the best results in the industry- 70% of excess weight loss on average. The best results are consistently seen in patients who view their relationship with our team as a partnership and attend all aftercare appointments.
How does the gastric band compare with the gastric bypass or the sleeve gastrectomy?
Patient’s tend to lose weight more rapidly with gastric bypass and sleeve gastrectomy, but there is no way of controlling this rate. The risk of serious complications and death is much higher (ten times higher in fact) with these procedures, and they are not reversible. Whilst the weight loss is safer and more gradual with gastric banding, the overall amount of weight shed still appears to be the same in a number of studies that look beyond 5 years. Improvement in associated medical problems and quality of life are also equal. That is why gastric banding is our preferred procedure at OClinic- permanent weight control the safe way.
Why are frequent clinic visits necessary after surgery?
The OCare total care program has been carefully designed to allow you to get the most out of you band- both in terms of weight loss and freedom from problems. As you lose weight, the amount of fat around your stomach will shrink, and your band will need to be adjusted in size to maintain the same feeling of hunger control. These regular visits will also provide an opportunity to check your band is functioning properly, and assist you with dietary advice and band support. Once your goal weight has been reached (usually around 18 months after surgery), appointments can then be scaled back to once per year.
Regular check-ups are a normal and a very important part of gastric banding follow-up. It is totally unethical for gastric banding surgery to be offered by any surgeon or clinic without also providing a clear and comprehensive aftercare program.
Does the gastric band limit any physical activity?
No. After the initial recovery period you are free to do any physical activity you choose including aerobics, stretching and strenuous exercise.
How is the band adjusted?
Adjustments are performed in our clinic by our doctors and surgeons. Occasionally they are done under Xray but this is seldom necessary. Local anaesthesia is available but is usually not needed as the fine needle is passed through the scar (which is usually numb) over the access-port. When saline is added, the band becomes tighter, and vica versa. The process usually only takes a few minutes, and most patients say it is virtually painless. Whilst adjustments may be performed at any time, the majority are needed in the first 18 months or so, as the fat around the stomach diminishes.
Do I have to be careful with the access port just underneath my skin?
There are no restrictions based on the access port. It is placed well under the skin, on the outer layer of the abdominal muscles. It is usually invisible, and may even be difficult for you to feel. Once the incisions have healed it should not cause discomfort or limit your movements or any physical exercise. The only sensation you may have from the port is when you go in for adjustments. If you feel persistent discomfort in the port area, let us know as soon as possible.
Can the band be removed?
Yes. Although the gastric band is designed for long-term use, it is quite simple and quick to have it removed if desired (this will still involve a laparoscopic procedure and a general anaesthetic though). The stomach then generally returns to its original shape once the band is removed. This reversibility is a key advantage of the gastric band over other weight loss procedures, and appeals to many patients. If removed though, your hunger and appetite usually return to their previous level, and as a result you weight may then go back up.
Will I need plastic surgery for the surplus skin when I have lost a lot of weight?
Very rarely. As a rule, plastic surgery should not be considered for at least a year or two after the operation, as your skin usually continues to contract long after you have reached your goal weight. Most patients find that, given sufficient time, skin trimming surgery is unnecessary. Regular exercise also helps remold your skin. If excess skin does persist, we can refer you to a plastic surgeon for an opinion.
A safe, non-surgical way of reducing excess skin is Thermage. Much like using an ultrasound probe over the skin, Thermage delivers radiofrequency energy to stimulate collagen remodelling. A single treatment is often sufficient, and it is particularly well suited to treating skin laxity under the arms, inner thighs, and abdomen. As well as being non-invasive, it is generally far less expensive than cosmetic surgery. Click here to read more about Thermage.
Is it true that the gastric band seems “tighter” in the morning?
Yes. This is a fairly common (and normal) feeling, especially for people with bands that are quite tight already, or just after an adjustment. During the daytime, the water distribution in the body moves with gravity toward the feet, but at night whilst sleeping this fluid is redistributed back to the rest of the body, including the stomach. When you wake up, the band feels tighter as your stomach wall has become slightly thicker. This is why many patients with a band don’t feel very hungry first thing in the morning. Some women have also noticed that the gastric band feels tighter during, or just before, menstruation as a result of fluid retention.
Will I feel hungry or deprived with the gastric band?
No. The band works by making you feel full and satisfied- in much the same way as you feel now after a meal, but achieves this with less food. Most patients say they actually enjoy their meals more. Taste is heightened, and food is now consumed for pleasure rather than to satisfy hunger. Bulk quantity consumption is replaced with quality eating.
Remember though that the band is a tool rather than a magic wand- you are still physically able to eat more than you need to if you ignore the feelings of fullness, and/or consume large amounts of liquid calories. We are here to help and guide you to allow you to get the most out of your band.
What will happen if I become unwell from something else?
One of the major advantages of the band is that it can be adjusted. If your illness requires you to eat more, the band can be loosened by removing saline from it. When you have recovered from your illness and want to lose weight again, the band can be tightened by increasing the amount of saline.
The band will allow you to comfortably drink plenty of fluids, so there should not be any risk of becoming dehydrated.
What about pregnancy?
Becoming pregnant is often easier as you lose weight. Your menstrual cycle may become more regular, and reduced fertility due to Polycystic Ovary Syndrome improves. Pregnancy is also usually a lot easier after weight loss, and the risk of developing gestational diabetes and pre-eclampsia is reduced.
The adjustability of the gastric band is a key advantage over other weight-loss procedures for women who might become pregnant, as it can be loosened as the pregnancy progresses to allow sufficient calorie intake. After the pregnancy, the band may be made tighter again, and you can resume losing weight. At OClinic we have a number of patients who are pregnant, and are familiar to adjusting the band appropriately. We will correspond with your obstetrician and GP throughout.
Will I need to take vitamin supplements?
The gastric band does not cause malabsorption of nutrients- another advantage over other weight loss procedures. However we do recommend taking a daily mulitvitamin tablet to ensure you still receive your daily vitamin and mineral requirements given that you will be eating less.
What about other medication?
You will still be able to take prescribed medication. Large tablets may need to be broken in half or dissolved in water so they do not get stuck, however most of the common tablets for high blood pressure, diabetes, etc are fine.
What if I go out to eat?
Eating out is no problem with a gastric band. Order only a small amount of food, such as an entree. Eat slowly, and don’t forget to chew well. Finish at the same time as your table companions. Never feel compelled to eat the same amount of food as the others.
Can I still enjoy a glass of wine?
Gastric banding is all about achieving better quality of life- A glass of wine with a meal is for many people a quintessential part of living well, and there is no reason why you cannot continue to enjoy this. An occasional glass of wine or other alcoholic beverage is not considered harmful to weight loss. Moderation is the key- just be aware that alcohol contains a high number of calories.
Can I eat anything in moderation?
The aim of the gastric band is not to reduce your range of food choices, just the quantity you need to feel full. Provided you chew well and eat slowly, band patients can eat almost anything. There are a couple of problem foods- fresh white bread and chewy steak can get stuck, and are probably best avoided. However wholemeal bread, toast, crackers, soft red meats, mince, chicken, fish, pasta, rice, salads, etc, are generally fine for most patients. Just ask our dietitians- we’re here to help.
Be aware that liquids and soft foods that are high in calories including chocolate, icecream, milk shakes, soft-drinks, etc slip past the band very easily, and do not provide the same sense of satisfaction that solid foods do. Your weight loss may be greatly reduced or cancelled if you regularly consume these types of foods. We encourage you to eat real solid food, which will provide the best results.
Will I be constipated?
No. However you may notice some reduction in the volume of your stools, which is normal after a decrease in food intake because you are eating less. It is important to maintain adequate fibre intake, and our dietitians will assist you in this. We recommend taking soluble fibre such as Benefibre in the liquid phase after surgery to help maintain normal bowel movements. If difficulties do arise, just let us know.
Will I still be able to eat whilst flying in a plane?
As the band is filled with saline rather than air, it shouldn’t change in size with altitude. However in practice a few little bubbles often get inside the band, and these may expand temporarily. It’s usually not enough to be noticeable, but sometimes the band can feel a bit tighter whilst flying. Either way everything returns to its normal size once the plane descends. Airline travel in general becomes more comfortable however as fitting into seats, overcoming jet-lag, and moving about the airport carrying luggage becomes far easier.
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