What to Expect
The LAP-BAND® procedure usually requires only a 24 hour hospital stay. The procedure itself takes less than an hour and results in very little post-operative pain. In fact, most patients who undergo the lap-band procedure do not need to take prescription pain medicine - Tylenol or Advil usually is enough.
The process begins with an informational seminar and a pre-operative visit with your surgeon. At the seminar, you will receive more information about the process and have a chance to ask the surgeon any questions that you may have
Seminars are held from 4-6 p.m. the third Monday of the month (with the exception of Passover and Easter) in the Sinai Guild Medical Office Building on the hospital’s campus.
2012 Seminar Dates:
February 13, 2012
March, 19, 2012
April 16, 2012
May 21, 2012
June 18, 2012
Please call, (248) 413-2670 to register.
Most insurance companies require a thorough pre-operative evaluation before they will authorize LAP-BAND® Surgery. This evaluation includes a medically supervised diet for six months as well as other tests. The necessary steps vary from insurance. We can help work directly with you insurance to figure out what process is required by your carrier.
After your surgery is scheduled, you will be given instructions on a pre-operative diet. This diet is designed to shrink your liver to decrease the risks of this very safe surgery even further. The length and extent of the diet depends on your pre-operative weight.
All operations are performed at Huron Valley-Sinai Hospital (click here for a maps and driving directions). We recommend a follow up visit approximately one week after surgery. Your first band adjustment appointment is typically anywhere from four to six weeks after the operation. At each subsequent adjustment (usually a total of two to five post-operative adjustments are necessary), your surgeon will review your diet and your medical health and make any changes necessary to ensure your weight loss success.
You will follow up with your surgeon monthly in the first phase of your weight loss to help ensure success.
How LAP-BAND® Works
The LAP-BAND® Adjustable Gastric Banding System reduces the amount of food your stomach can hold at one time. This affectively helps you to gradually lose weight and keep it off as well.
Done without any stomach cutting or stapling, the LAP-BAND® System reduces your stomach’s capacity, thus restricting the amount of food you are able to eat at one time. This is done by placing the LAP-BAND® System around the upper portion of the stomach. There is no permanent change made to your stomach and leaves your digestive tract completely intact.
Once ingested, food slowly moves through the band slowly, causing you to feel full after even small amounts of food. The speed the food flows through this channel is controlled by adjusting the diameter of the actual band. The band is connected to a port that is secured to the abdominal wall deep underneath the skin.
LAP-BAND® Step by Step
The LAP-BAND® System is put into place during a laparoscopic procedure, using general anesthesia. The procedure is performed using long, thin instruments inserted through a few tiny incisions (1/2 inch in size).
Step One: Your surgeon implants the LAP-BAND® System around the upper part of your stomach, much like a belt.
Step Two: A tube is then connected from the LAP-BAND® System to a small access port, which is fixed beneath the skin of your abdomen.
Step Three: After the first four to six weeks, adjustments to the LAP-BAND® System are made through the access port. This is done as needed — more frequently in the first year and almost never afterward — to maintain optimal weight loss.
Risks of Surgery
One advantage of gastric banding is that the stomach is not cut, stapled, or entered. While the LAP-BAND® System is less invasive than other surgical weight loss procedures, it’s important to note that all surgical procedures have risks.
Before you decide on any procedure, it’s important to know what the risks are. Talk with your surgeon in detail about the risks and complications that might arise during your LAP-BAND® System procedure. Surgery should not be considered until you and your doctor have evaluated all other options.
Huron Valley-Sinai Hospital has an excellent track record for safety. In fact, Huron Valley-Sinai has been named a Top Hospital by the Leap Frog group for safety and quality, a distinction less than two percent of hospitals in the nation obtain.
Talk to your physician if you experience any of the following after your surgery:
- Ulceration
- Gastritis (irritated stomach tissue)
- Gastroesophageal reflux (heartburn)
- Dysphagia (difficulty swallowing)
- Dehydration
- Constipation
Do I Qualify?
Huron Valley-Sinai Hospital uses the following criteria to determine whether or not you qualify for the lap band procedure:
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Age greater than 18 years
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Body Mass Index (BMI) of over 40 or BMI of over 35 and have one or more of the co-morbid medical conditions associated with increased weight
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Well motivated and well informed about the significant lifestyle changes necessary
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No active substance abuse problems within the last year
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Are medically healthy enough to tolerate the procedure
Most insurance companies require written evidence that they are unable to achieve a healthy body weight for a sustained period of time through medically supervised dieting.
The highly qualified staff at your surgeon’s office will work with you and your insurance carrier to determine whether or not you meet the necessary qualifications.
Hospital Stay
Patients are admitted the same day of their procedure. The procedure itself takes approximately one hour. The hospital stay is considered a "23 hour admission", meaning that patients will stay overnight in a hospital room for observation. Most patients are able to walk the halls quite comfortably immediately after the surgery. You will be started on a "clear liquid" diet as soon as you are awake enough to drink.
During your hospital stay you will meet with a nutritionist for detailed information regarding your post operative dietary restrictions. Additionally, your surgeon will counsel you on the next steps after the operation and answer any questions you may have. You will also be provided a detailed handout with post operative information to make your recovery a smooth and comfortable experience.
You will be sent home with only a prescription for pain medicine. Less than half of patients need to fill this prescription since Tylenol or Advil usually suffices for pain control.
Life After Surgery
Surgery is not the end of your LAP-BAND® journey. Post operative follow up and frequent adjustments of the device are necessary throughout the first year. After the first year, visits are less frequent.
Although weight loss of up to three pounds a week is possible, on the LAP-BAND® System you can expect to see a healthy one to two pound reduction each week. Once you meet your target weight, you should be able to maintain.
Going Back to Work after Surgery
Your ability to resume normal levels of activity will vary according to your physical condition and the nature of the activity. Many patients return to full pre-surgery levels of activity within two to three weeks.
Insurance and other Payment Options
Most insurance policies will cover the lap-band surgery. Health insurance can be extremely complicated and just because you and your neighbor both have "Aetna" does not mean that you both are covered for the procedure. Since most health insurance policies are purchased by your employer, each employer may purchase a different package - your employer may elect Aetna with weight loss surgery coverage, while your neighbor's employer may elect Aetna without weight loss surgery coverage. The first step to determining whether or not your insurance carrier will cover the procedure is to call the phone number on the back of your insurance card and ask whether or not your policy will cover the lap-band surgery.
As a general guideline, these patients will not be able to acquire coverage for a lap band procedure:
- BMI between 30-35
- Age >65
- Those patients whose insurance policies do not cover weight loss surgery
Self Pay
There are self pay/cash packages available to patients whose insurance policy does not cover the surgery. Huron Valley-Sinai remains one of the most affordable hospitals in the state in regards to LAP-BAND® procedures. Please speak with a coordinator in your surgeon’s office regarding self pay options.