Having LAP-BAND Surgery

Pre-op

Typical steps you may need to take prior to LAP-BAND surgery include:

• Attend an informational seminar
• Insurance pre-approval (we will help you with this)
• Call the office for an appointment: 800-979-8982
• Completion of Northwest Weight Loss Surgery paperwork:
• Patient Registration & Medical History Form
• Health screening to determine appropriate candidates for surgery
• Education visit & nutrition screening
• Consultation with surgeon
• As needed: pre-op labs, chest x-ray, EKG, sleep apnea screening, Echocardiogram (if previous Phen-Fen use and cardiac symptoms)
• Psychological evaluation
• We ask our patients to lose 10-30 pounds prior to surgery to shrink the size of the liver.  This makes the surgery, easier, safer, quicker, and lowers the chances of complications.
• Stop estrogen and hormone replacement therapy one month prior to surgery
• Stop NSAID's (ibuprofen, motrin, Aleve, aspirin, etc) one week prior to surgery
• Surgery

You will need the Adobe Reader to download and view the PDF files below.

Pre-op Instructions

-Downlodable PDF

Losing ten pounds before surgery will shrink your liver, decrease surgery time, lower risks and decrease bleeding.

You may have nothing to eat or drink after midnight on the night before surgery. For example, if your surgery is on a Monday, you can have nothing to eat or drink after midnight on Sunday night. If your surgery is on a Thursday, you can have nothing to eat or drink after midnight on Wednesday night.

You may take needed medications (such as heart or blood pressure medications) with sips of water the morning of surgery.

Do not take any aspirin, Advil, Nuprin, Aleve or any other non-steroidal anti-inflammatory medication for 7 days prior to surgery. These medications cause unnecessary bleeding during surgery. This includes baby aspirin and most arthritis medications. If you are not sure, please check with your surgeon. For headache or minor pains, you may use Tylenol. You may restart these medications the next day after surgery.

Do not take estrogen, progesterone or hormone replacement medications for one month prior to surgery, one week at a minimum. This helps reduce the risk for blood clots.

Do not take any herbal medications for 7 days prior to surgery.
Please bring your medications in properly labeled pharmaceutical bottles for documentation of dosages.

Sugar-free hard candy is very comforting after surgery so you may want to have it available when you come home.

You will need to arrange for someone to drive you home after discharge from the hospital or surgery center.

You will be on a liquid diet for two weeks after surgery. Stock up on sugar-free liquids, Crystal Light, fruit juices, applesauce, yogurt, sugar-free pudding, sugar-free gelatin desserts, thin soups and caffeine-free teas. If you do not like the flavor of chicken broth, make chicken noodle soup and strain out the solids. Avoid carbonated beverages (they fill the stomach with gas). Avoid sugar (extra calories that fight against weight loss). Caffeine makes you urinate more and can lead to dehydration. If you drink caffeinated beverages, be sure to drink plenty of liquids.

You will need to drink plenty of liquids to prevent dehydration after surgery. Sport drink bottles with measurements on the side will help make sure you are drinking enough liquid. You will need to drink at least 64 ounces (four 16 ounce bottles) per day to prevent dehydration. You will not be able to gulp liquids so you will want to drink small amounts throughout the day.

If your insurance company has agreed to cover your surgery, you will need to contact them prior to entering the hospital. They may have special requirements you need to fulfill prior to your surgery.

If you will be in the hospital after surgery, you may want to bring bottled water, sugar-free hard candy and comfortable shoes.

For added pain relief after surgery, it is a good idea to take ibuprofen 400mg (two 200mg tablets) every 4 to 6 hours for the first 3 days.

Start taking your daily Flintstones vitamin before surgery. Any multi-vitamin is fine, but large pills are difficult to take after band surgery. Some patients prefer Costco chewable vitamins, Centrum chewable vitamins, other children’s vitamins, liquid vitamins or breaking a normal vitamin pill in half.

For questions, please call the Center at 800-979-8982.

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Post-op Instructions

- Downlodable PDF

Discharge Instructions Adjustable Gastric Band (LAP-BAND)

Please call 800-979-8982 for any questions or concerns.

Call the office if you experience any of the following:

• Shortness of breath
• Fever greater than 101 degrees
• Pus draining from incisions
• Redness around incisions bigger than a dime

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What to expect after surgery

Most patients say that they feel much better after three days, because the soreness is decreasing and their energy level is returning to normal. Most patients return to work in 3-7 days. The port incision (the biggest incision) is typically the sorest because the port is stitched to your muscle. Once this heals, you will not have that discomfort.

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Pain Control

For the first three days, please take ibuprofen 400mg (two 200 mg over-the-counter tablets) every four to six hours to stay on top of the pain. If you cannot take ibuprofen, then take two extra-strength (two 500 mg tablets) Tylenol (acetaminophen) tablets every four hours instead. Use the narcotic prescription [Lortab elixir (acetaminophen and hydrocodone)] only as needed. After three days the pain should be easily managed by an occasional Tylenol (acetaminophen) or Motrin (ibuprofen) as needed. Try to not take ibuprofen on an empty stomach and make sure you are well-hydrated. You should not take ibuprofen if you get dehydrated or if you have a history of stomach ulcers. If you have trouble swallowing pills, you can use an equivalent amount of liquid ibuprofen or acetaminophen (liquid Motrin or liquid Tylenol). It is not unusual to have some shoulder pain after surgery. This pain is from irritation to the diaphragm during the surgery. A heating pad on your shoulder blades or the upper abdomen may help. This pain, if you have it, should gradually subside over several days.

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Vitamins

You need to take a daily multi-vitamin. The easiest is Flintstones chewable vitamins. Any multi-vitamin will do, but keep in mind that it will be hard to take large pills. Some patients prefer liquid adult vitamins, chewable adult vitamins or breaking regular vitamins in half.

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Constipation

If you go more than a day without a bowel movement, it is time to get things moving. Over-the-counter stool softeners (Colace, DSS, or docusate sodium) are mild and a good first choice. If this doesn’t work, take Phillips Milk of Magnesia, two tablespoons once or twice per day. This tends to work very efficiently so make sure you have ready access to a bathroom. Once you are eating regular food it will be important to have plenty of fiber in your diet to promote good bowel function.

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Bleeding from Incisions

Due to the blood thinners you received before surgery to prevent blood clots, it is common and normal for the small incisions to ooze blood and clear or yellow fluid for several days after surgery. Consequently, bruising around the incisions is normal as well. This will resolve on its own. This is caused by tiny vessels under the skin. If blood is continuously dripping out of an incision, apply firm pressure to it with a gauze or paper towel for five minutes and then leave an ice pack on it for several hours and it should stop. If this happens, switch from ibuprofen to acetominophen as well.

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Bandages

Leave the round plastic band-aids and steri-strips (small white tapes) in place. If the bandages are still on in two weeks, you may remove them. If they fall off on their own, this is okay. You have dissolving sutures (stitches) that do not need to be removed. To minimize scarring, once the steri-strips and band-aids are off, apply Vitamin E oil or Scar Guard to the incisions twice daily for two months. You can get Vitamin E oil by poking a hole in the end of a gel Vitamin E capsule and squeezing the oil onto the incision. Vitamin E oil is very sticky. Scar Guard should be available by asking your pharmacist. It does not require a prescription.

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Activity

It is a good idea to try to get in some walking or other physical exercise every day. Start out slowly and build up gradually. A simple walking program is a good place to start if you have not been physically active before surgery. Start out walking for 5 or 10 minutes and build gradually to 30 minutes per day. We will give you more information about becoming physically active at the support group meetings.

Most people go back to work within 1 to 5 days, depending on the type of job they have. You can resume sexual activity in 3 to 5 days or whenever you feel ready. You can begin exercising moderately after a week or 10 days.
There are no restrictions on lifting, but take it easy for a week or two or you will cause more pain in the incisions. Typically the port incision is the most tender because the port is stitched to the muscle. This pain will resolve with time.

Showers are okay. Do not rub the bandages vigorously with a washcloth. Blot the bandages dry with a towel after a shower. No underwater submersion of the incisions or swimming for two weeks. Sitting in the tub with the incisions above water is okay.

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Vomiting

Try to avoid all vomiting. Vomiting increases the slippage and erosion rate of the band. If you are nauseated from the medications or anesthesia, take the prescribed anti- nausea pills. If you were not given a prescription for nausea medicine, call the clinic and we will call it in to your pharmacy. If you are vomiting after eating too much food then change your eating habits to smaller amounts of softer foods or liquids.

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Appointments

Please call the office to schedule a post-op appointment for one to two weeks after surgery.

Plan to have your first band adjustment 6 weeks after surgery.

Please attend the monthly patient support group meetings. Call the office for times and locations.

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