Lap Band Adjustments: Principles and Approaches to Adjustments

Lap Band Adjustment Principles

  • The level of adjustment should be sufficient to achieve a prolonged sensation of safety in the patient.
  • Weight loss should be steady and progressive, with the early rate of weight loss ideally being >0.5 Kg but < 1 Kg/week.
  • Adjustment should induce no restrictive symptoms, ie, heartburn, vomiting, discomfort, excessive difficulty with eating a normal range of food.
  • Loss of excess weight should be planned to occur gently over a period of 18 months to 3 years, depending on initial weight.

Schedule of adjustments

  • At 6-8 weeks - initial adjustment.
  • Review every 4-6 weeks. Assess weight and clinical status.
  • The fills will be scheduled according to your needs.

Approaches to Lap Band Adjustment

There are two approaches to lap band adjustment:
  1. The office adjustment. Involves making adjustment decisions on the basis of weight loss and the symptoms of the patient.
  2. The radiographic adjustment. Involves making decisions that also incorporate the additional information derived from barium swallow examination.

Indicators for Lap Band Adjustment in the Office

Consider adding fluid:

  • Inadequate weight loss
  • Rapid loss of satiety after meals
  • Increased volume of meals
  • Hunger between meals

Consider removing fluid:

  • Vomiting, heartburn, reflux
  • Difficulty coping with broad range of foods
  • Maladaptive eating behavior*

*Usually characterized by the consumption of high-calorie liquid or very soft foods and is often induced by an overly tight lap band.