LAP-BAND® Surgery and LAP-BAND® Discussion Forum - View Single Post - How the Lap-Band® actually works, fills and refills

DrWatkins · 12-19-2007, 03:46 PM

Quote:

Originally Posted by Denise822

Hi Dr. Watkins, First I would like to say how much we appreciate that you come here and are so informative and helpful. We are lucky to have you here!

I read on another post where you were talking about a leak. I am afraid I have one. I got a fill and it was too much, so my doctor said he was going to take some out and leave 2.75 cc's in a 4cc band.

I just got another one last week ( 2 months later,) and he was only able to pull out 2.0 before he did the fill. He said it does not necessarily mean I have a leak. I had great restriction the first few days after this last fill. Now, not so much. Is it because when you get a fill, there is some swelling?

Is there any way to find out if I have a leak other than the next time I go for another fill and check and see what's left in there? That is how I got overfilled to begin with. He thought I had a leak so he put me up over 3.0 and I was miserable. That was when he moved me down to 2.75. He was able to pull out all of it out that time, when he left the 2.75 in there.

Is there any other way that he is not able to pull all of it out, rather than some of it leaked out? Is it possible to not get the entire fill in the band when doing a fill?

I could really test it out and try to eat something that I can't normally eat with a good fill, but I don't want to do that and risk throwing up. __________________
banded 12-29-06 by Dr. Steven Tersini in Coos Bay Oregon

If your band held 2.0cc for 2 months it seems unlikely that you had a leak then. The question is if you have a leak now. The best way to determine if you have a leak or not is to have them do a "fluid test" at each fill, i.e. draw back all of the fluid and see how much is there.

Most leaks will drain all of the fluid out within 3 days. Occasionally we'll see a slow leak that takes a week, but if your band has the majority of the fluid in after a week then there's no leak (hey, that rhymes).

Also, sometimes we think we add fluid to the port but it doesn't get into the port, etc. Sometimes we think there's a leak but over time we determine that there isn't one. I've seen everything.

I would advise that if the band isn't tight enough (full on small meals, not hungry, easily lose 1-2 pounds per week) then have them add some more saline and do a fluid check. If the fluid is repeatedly at zero, have them replace the port. Replacing the port cures 99% of fluid leaks. I've seen a few patients that had needle injuries to the tubing but that's rare.

And leaks are not a problem in the sense that we use sterile saline which is the same stuff in intravenous fluid they give you in the emergency room if you're dehydrated. It doesn't hurt to have a few milliliters of saline leak out. Your body just absorbs it.

And it goes without saying that fills should always be done with a Huber non-coring needle. Regular needles can cause leaks in the system. (So can Huber needles, but much less of a chance).

hope that helps

brad