13 January 2021


Section 20: Frequently asked questions


Where will the port be sited? 

 

The port is usually positioned in the centre of the abdomen, below the “V” where your ribs meet; it is stitched to an abdominal muscle. Sometimes, it is placed on the left-hand side, about 10cm below the rib cage.  You can discuss this with your surgeon if you are concerned, but remember that the position could alter on the day of surgery depending on your anatomy. 

 

What if my port can’t be accessed? 

 

Occasionally, your practitioner may not be able to access your port. If this is the case, you will be referred to an alternative practitioner in the first instance (sometimes requiring you to attend an alternative clinic). If the second practitioner is unable to access the port, we may consider referral for an x-ray guided banded adjustment (please note, charges may apply). If your port is inaccessible while under x-ray, a surgical procedure is usually required to reposition the port (charges may apply).  

 

What if my port is visible after I have lost weight? 

 

Sometimes, the port can be visible through your skin as a raised lump once you have lost weight. This is normal, and not of medical concern as it is important that we are able to access your port to adjust the band as required. In addition, it is not a concern for the majority of patients either.  

 

The only way to rectify any raised lump is to remove the port and band.. 

 

Why can’t I have fluid added to the band whenever I want? 

 

We do not perform adjustments unless they are genuinely needed. We will always carefully review your status before deciding on adding fluid to the band because the aim of the band is to reduce your appetite and portion size, not completely restrict you.  

 

Remember - problems related to the band such as pouch dilatation, band slippage and erosion are often associated with it being over-tightened. It is important that you keep in regular contact with a dietitian, especially in the early stages so that you can gain a full understanding of the types of foods that work best with the band and the required eating technique. You need to be completely sure that you are doing everything you can to make the band work before you consider having fluid added to the band. 

 

 

 

 

What if I need an x-ray or other investigative procedure? 

 

An x-ray is clinically indicated when we suspect that you might have one or more of the following complications: 

 

  • Tubing puncture
  • Tubing fracture/disconnection
  • Band slippage
  • Band unclipping

 

You might need an endoscopy if we suspect that you might have band erosion. Surgeons may also recommend other investigative procedures or tests, such as a CT scan or ultrasound. While we review each case on an individual basis, charges may also apply for such investigations/procedures and if you request an investigation but it is not clinically indicatedcharges will apply. 

 

What if I need more surgery? 

 

As mentioned in Risks of surgery / potential complications and side effects, further surgery is sometimes needed.  Again, we review each case on an individual basis, but charges may apply. 

 

Is pain on my left hand side normal after surgery? 

 

Pain on your left hand side can be related to wind pain. During surgery, some gas is pumped into the abdomen to increase the area inside and allow the surgeon to see clearly. Whilst most of the air is removed at the end of the operation, some can still remain. This can produce ‘referred’ pain which radiates to your left shoulder because of the way that the nerves are connected to your diaphragm. Wind remedies may be effective i.e. peppermint tea, gripe water, Deflatine/Wind-eze 

 

When can I introduce meat, bread and rice? 

 

From 4 weeks after the operation onwards, but as these foods can be more difficult to tolerate with a band, it is best to introduce them gradually. Always remember the ‘20/20/20/20’ rule 

 

I feel hungry and my portions are increasing, is the band working?  

 

This is a sign that you may need your next band adjustment. Hunger and portions increasing can signify you are in the yellow zone (see Gastric Band Adjustments). A  diet predominantly comprising soft food and liquids could  be another reason why you are experiencing these symptoms, due to the nature of how the band works (see How the Gastric Band works).  

 

Why does my band feel tighter when I haven’t had an adjustment? 

 

A number of external factors can affect the band, causing it to feel tighter. Hot temperatures, stress or anxiety, being at high altitude, illness or infection and menstruation can all make a difference to how it feels.  

 

Can I have fizzy drinks? 

 

Avoid fizzy drinks for the first 4 weeks, and limit your consumption of them thereafter as the gas cannot be easily expelled and can cause discomfort and bloating. Some surgeons believe that this difficulty in expelling the air can cause distension of the stomach wall, which could lead to potential complications such as pouch/oesophageal dilatation and band slippage (see Risks of surgery, potential complications, side effects). 

 

We consider there to be little risk in consuming fizzy drinks after the first 4 weeks, providing you follow these guidelines: 

 

  • You may consume ‘diet’ or ‘sugar-free’ fizzy drinks occasionally – once or twice a week. Do not have them regularly. Avoid sugary fizzy drinks.  
  • You must sip fizzy drinks slowly; never gulp. Gulping could cause the drink to be held above the band for too long, potentially disturbing the sensitivity of the stomach above the band. This could cause the area to stretch,  reducing the band’s ability to reduce your appetite and therefore portion size. This could also lead to pouch dilatation and slippage. 
  • If you feel any discomfort and/or experience excessive burping from consuming a fizzy drink, you should stop and avoid fizzy drinks permanently. Many patients find that this is the case once their band is optimally adjusted. 

 

Can I drink alcohol?  

We recommend you completely avoid alcohol initially after surgery, as you are not consuming solid food. Your tolerance levels will be greatly reduced, and its dehydrating effects will be magnified. Once you are back eating normally, if you drink alcohol the government guidelines recommend for both men and women no more than 14 units per week (best spread over 2-3 days or more).  However, remember that alcohol adds calories to your diet and ultimately increases your appetite, whilst reducing your will power.  

 

Can I have chewing gum? 

We recommend you avoid chewing gum as the action of chewing can create trapped wind, which can be uncomfortable. More importantly, should you accidentally swallow the gum, this could get stuck and cause problems. 

 

Where can I get extra support? 

Our philosophy is to treat every patient as an individual. Once we are confident that you have a good understanding of how the band works and what you need to do to make it work, we tend to ask that you contact us as and when you feel you need support and advice. This could be once a month or every 6 months – everyone is different. If you need extra support, contact us! We won’t know you are struggling unless you tell us. 

 

Should I join a slimming club like Weight Watchers or Slimming World? 

The gastric band is merely a tool you can use to help you to lose weight and keep it off. So long as you follow the required eating behaviours, eat a well-balanced diet and exercise, there should be no need to join a slimming club. On the other hand, some patients find that attending a regular group weekly can really help their motivation and help them stay on track with an overall healthy mind set.   

 

What if I want to go on holiday and forget about the band for a while? 

Whilst the gastric band is adjustable, we do not advise that you have the band loosened purposefully so that you can eat more, for instance if you are going on an all-inclusive holiday. Remember that a well-adjusted band should allow you to eat a wide variety of textured foods; life should not be miserable with a gastric band! 

 

Can I have the band removed? 

The band may be removed, but unless medically indicated, this is not recommended. Charges may apply to have the band removed, especially if it is not medically indicated. Studies show that people who have the band removed usually go on to regain all the weight that they lost with the band. 

 

Will I lose too much weight and become too thin? 

The operation is designed to reduce your food intake, improve your food choices and alter your eating habits, leading you to a healthy weight. Your body will soon adjust to your new regime, weight and metabolic rate whilst your dietary intake and activity levels adjust accordingly. The specialist nurse and dietitian will monitor your progress and guide you throughout your weight loss journey.  

 

If you follow our guidance, you should not lose too much weight. Once you reach your goal weight, your weight should stabilise; if it doesn’t, you may wish to consider having a small amount of fluid removed from the band to allow you to eat a little bit more for weight maintenance. Our aim is to assist you to a healthy weight and improve any obesity-related comorbidities; the band is NOT a tool to enhance the chances of an ultra-low Body Mass Index! 

 

Does the gastric band limit physical activity?  

It is important to start getting up and moving around as soon as possible after surgery. This will help reduce the risk of blood clots in your legs (deep vein thrombosis - DVT) and will encourage build up strength in your muscles.  

 

Keeping yourself mobile can also help alleviate trapped wind, which is common after surgery. Gentle walking is encouraged and should be done as soon as you feel appropriate. Most people feel ready to start increasing their activity 2 weeks after surgery. Ensure your wounds are fully healed and that you feel well in yourself before doing so.  

 

However, please note that we recommend no heavy lifting or strenuous activity for 6 weeks after the operation. Most people are able to return to work a couple of weeks after surgery. If you have had a hiatus hernia repair, you will need to avoid lifting heavy weights for 3-4 months. Speak to your GP if you are worried about increasing your levels of physical activity. 

 

One thing to consider is that the band may feel tighter when you are taking part in high altitude sports e.g. skiing, hiking, rock-climbing or if you go scuba diving. Consider a small aspiration of the band prior to taking part in any of these activities if you are experiencing discomfort or pain on eating and/or regurgitation more than once a week, as this may indicate that you are more likely to experience discomfort whilst at high altitude or under water. 

 

See Physical activity for more advice. 

 

Can I extend my aftercare? 

We realise that having Weight Loss surgery is a lifetime commitment, and that some patients need and want ongoing support once their initial aftercare package has expired. We offer pay-as-you-go band adjustments and dietitian appointments along with a range of packages to suit your requirements. Please contact our Weight Loss Surgery Support team with any queries. 

 

What supplements should I be taking? 

A multivitamin and mineral supplement once a day. See Recovery 

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