Post Operative Management of Your Lap Band

1. Your lap band was inserted at surgery and has been placed in good position. It is now ready to be used when the time comes but may or may not have any noticeable effect for the first 4 to 6 weeks after surgery.
2. On the first day after your operation the Wakefield Hospital Dietician will visit and provide you with some information to revise that you will be having 2 weeks of fluids, and subsequently 2 weeks of mashed food before resuming your intake of 3 normal solid meals a day at the 4 week mark post operatively.
3. On the first day after your operation you will also have a special x-ray (barium swallow), designed to ensure the lap band is in correct position and is complication free. This involves swallowing a cup full of chalky dye, which is generally very well tolerated. When the ward nursing staff receive a report from the Radiologist stating that this examination was normal, you can essentially begin having the fluid diet that you will be having for the next 2 weeks. However, until we receive this information (which can be late in the day) the ward staff will restrict you to 50 to 100ml of clear fluids every hour.
4. We encourage you to get up and walk around the room (and even the hospital) during the course of the day and would prefer it if you do not spend long periods of time in bed. Certainly feel free to take a nap in the morning and afternoon if you are tired, but if you are reading or watching television you would be better out of bed sitting in a chair.
5. Please report any nausea immediately to the nursing staff so that they can take appropriate steps to arrange an anti-nausea injection for you. For this reason we will leave the intravenous cannula in your arm or hand until just before you are discharged from hospital.
6. The AOS/Innovations Healthcare lap band nurse will visit you in hospital and provide you with an information sheet on which all your bookings with the Adelaide Obesity Surgery team for the 4 to 6 week mark have already been made for you. Please feel free to change these timings if the dates are inconvenient but this booking sheet will give you an idea of when our team members would like to see you post operatively. The whole team will see you every 3 months for the first year and every 6 months thereafter.
7. If you remain stable and well then you will be discharged at 10.00am on the second day after surgery and are free to go home. We would encourage country and interstate patients to remain in Adelaide over the weekend and to return home on Monday providing that they feel perfectly well. Should any issues arise over the weekend then please contact Dr Bessell on 0419 886490 or our answering service in the office on 8359 2411.
8. During the 4 weeks when you are on the fluids and mashed food phase, our team will leave you undisturbed. During this period the lap band will just be settling into good position and will not exert a great effect. However once you start back on normal solid food at the 4 week mark then we will want to see you to advise you on long term management and how to look after the band properly whilst eating solid food. When you do start eating solid food it is important to stick to only 1 cup full/1 lap band plate-size/1 entree plate-size of food at each of your 3 solid meals, as chronically overeating more than this can stretch the pouch up above the band and move the band possibly resulting in the need for a second operation. Therefore adherence to the recommended portion size is your responsibility. Our responsibility is to adjust the band so you feel satisfied with this smaller amount of food. This is the predominantly mechanism by which we reduce your calorie load and aid your long term weight loss.
9. You will need between 0 - 8 band adjustments in the first year post operatively, with an average of 4. These are normally performed a week or two apart, starting at the 4 week post operatively. Please do not be concerned if it takes up to 3 months to get the hunger-killing effect absolutely optimal for your individual situation. It is important to allow this process to unfold but you should notice it becoming easier and easier to manage.
10. Please be reminded that you have free lifetime email and telephone support with our whole team and if we do not hear from you during the period you are on fluids and mashed food we will presume everything is going well! If you do have any questions however, we would very much like to hear from you. You can contact us through our office on 8359 2411 or send us an email via our website.
11. Please register with our office for our bi-monthly email newsletter which contains information about the free services provided by Adelaide Obesity Surgery to assist with your post operative management, in particular our patient support group post operative seminar series each Wednesday once a month and our regular newsletters.
12. It is vitally important that with a lapband in place that you do not vomit. Should you get an attack of gastro or for some other reason become nauseated it is very important that you ring Dr Bessell immediately on his mobile phone, or contact the answering service in our office so that we can arrange for you to seek immediate medical attention and have an anti-vomiting injection. Please do not wait to see if the nausea passes off or take anti-vomiting tablets as these are frequently ineffective and merely just delay your presentation to effective medical care.

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