LAP-BAND® Surgery and LAP-BAND® Discussion Forum - View Single Post

Wendell Edwards · 09-12-2007, 04:59 PM

Quote:

Originally Posted by ARMKAM

I am in the same place as you all. I've had 4 fills and am up to 2 cc's , only half full. But , after the 4th fill last month, I've seemed to lose almost all restriction and can even eat bread , which I hadn't done yet in 6-1/2 months.I've only lost 1 or 2 lbs also. I am scheduled for fill #5 next week , and I think I'll ask the Dr. to pull out what's in there to make sure the lack of restriction is from losing weight and not from a leak. I do know that he really had to tug to get the needle out at the last fill. ??????? It gets frustrating !

It sounds to me that you are losing a lot of the residual fat-pad around the stomach, which would account for the loose band.

This may help you in understanding the restrictive mechanism of a Lap-Band®. The INAMED protocol for Lap-Band® fills calls for a six-week delay after surgery, prior to any fills. The purpose for the six-week delay is for the patient’s stomach to heal from the surgery, as well as allowing time for the Lap-Band® to “Seat” or “Nestle” into the fat pad between the stomach wall and the interior wall of the Lap-Band®. Prior to receiving an EFFECTIVE fill, it is VERY uncommon to have any restriction from a Lap-Band®. Some patients will NOT lose weight, or may even GAIN weight until they have received an effective fill in their Lap-Band®. Normal weight loss with a properly restricted Lap-Band® is between 1 and 2 pounds per week.

The normal cycle of fills, restriction and weight loss is as follows:

1. The patient's Lap-Band® constricts when the patient receives a fill. Swelling for a few days after receiving a fill is very common. Many doctors require a patient to go on a liquid diet for a day or two after receiving a fill. A fill may have a “Delayed Action” of up to two weeks. A “Delayed-Action” means that the fill may not become effective for up to two weeks after the fill. That is why the INAMED protocol states that fills should not be performed on patients who will not have access to medical care for at least two weeks after a fill.

2. The patient's stomach capacity is lessened as a result of the restriction caused by the Lap-Band®.

3. The patient loses weight because they cannot eat as much food.

4. The residual fat-pad between the inside of the Lap-Band® and the outside of the patient's stomach reduces in size because of the overall weight loss in the patient.

5. The reduction of the residual fat-pad causes the Lap-Band® to become loose again.

6. At that point, the patient needs another fill, because the Lap-Band® is loose, and the patient has a loss of restriction, which allows the patient to eat larger amounts of food.

7. The patient receives another fill and the process starts all over again.

Most Lap-Band® patients receive several fills to adjust the Lap-Band® as their weight loss progresses, and there is less and less residual fat-pad between the inside of the Lap-Band® and the exterior of the stomach wall. Once a patient has lost all of their residual fat-pad, fills become less common. As the Lap-Band® patient progresses in their weight loss, the effect of very tiny fills (Less than .2ccs) becomes greater and greater. It is not uncommon for a late-stage Lap-Band® patient to experience a significant difference in restriction with as little as .05cc of fill.