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What Your Patient Can Expect

Pre-operative Care

The LAP-BAND^® System surgeon's practice has a multidisciplinary team of healthcare professionals who care for your patient during the six to eight weeks prior to LAP-BAND^® System surgery. Your patient will undergo nutritional, medical, and financial assessments to ensure that he or she is fully prepared for surgery and has secured insurance approval or financing to cover any out of pocket costs. The multidisciplinary team usually includes:

Surgeons
Nurses
Physician's assistants
Psychologists
Dietitians or nutritionists
Physiotherapist
Billing and insurance manager

Surgical Care

Patients are generally admitted on the day of surgery and normally stay in the hospital for less than 24 hours. The actual procedure takes approximately one hour¹⁰⁹ and is performed under general anesthesia (DFU). After surgery, tests are performed to confirm proper band placement and that there are no immediate complications. Once these tests are performed, the bariatric surgeon will release the patient.²¹

Post-operative Care

Consistent follow-up with the LAP-BAND^® System is vital to successful weight loss outcomes. Patients who do not return for regular follow-up lose less weight, and should therefore be counseled as such.²²

The bariatric practice will provide your patient with a comprehensive diet plan, to successfully transition the patient to new eating habits. These nutritional guidelines will assist your patient in getting the most nutritional value out of smaller portions. The bariatric practice will provide support immediately after surgery and through the continuum of care.

On-going follow-up is usually scheduled at six weeks after surgery. Adjustments will be made by the bariatric surgeon or by his or her trained staff after consulting with the patient on weight loss, eating habits, and expectations. As patients lose weight and greater restriction is needed to maintain satiety, the LAP-BAND^® System will need to be adjusted by the addition and/or subtraction of saline as needed. A healthy rate of weight loss is approximately 1.5 - 2.0 lbs/week.

Overview of the Basic Post-Op Nutritional Guidelines:

Post-operative Stage	Diet	Guidelines To provide your patient with dietary guidelines to follow after surgery, click here
Early (< 5 days)	Clear liquids, non-carbonated; no calories No sugar or caffeine	Swallow test for leaks Patients should consume 48 – 64 ounces of non-carbonated fluids per day
< 14 days	Liquid diet Only thin liquids tolerated	Stay hydrated by drinking small amounts of water frequently
< 4 weeks	Introduction of soft, diced, ground or pureed protein sources is tolerated Foods in this stage may include: pureed skinless chicken or fish mashed potatoes peas low-fat yogurt or pudding	Protein food choices chewed thoroughly prior to swallowing Wait 30 minutes after each meal before resuming fluids
Later (4 – 5 weeks)	Advance diet as tolerated; add well-cooked, soft vegetables and peeled fruit	Adequate hydration is essential and a priority; avoid rice, bread, and pasta Do not drink during meals, and avoid highly caloric liquids such as milkshakes and smoothies

Reference

National Heart, Lung, and Blood Institute Web site. The practical guide: identification, evaluation, and treatment of overweight and obesity in adults. Available at: http://www.nhlbi.nih.gov/guidelines/obesity/prctgd_c.pdf. Accessed March 27, 2009.

American Obesity Association. Obesity in the U.S. Available at: http://www.obesity.org/information/what_is_obesity.asp. Accessed March 27, 2009.

Sturm R, Ringel JS, Lakdawalla DN, et al. Obesity and disability: the shape of things to come. RAND Corporation Web site. Available at: http://www.rand.org/pubs/research_briefs/2007/RAND_RB9043-1.pdf. Accessed March 27, 2009.

Spanakis E, Gragnoli C. Bariatric Surgery, Safety and Type 2 Diabetes. Obes Surg 2009;19:363-368.

Maggard MA, Shugarman LR, Suttorp M, et al. Meta-analysis: surgical treatment of obesity. Ann Intern Med 2005;142:547-559.

Sears D, Fillmore G, Bui M, et al. Evaluation of Gastric Bypass Patients 1 Year After Surgery: Changes in Quality of Life and Obesity-Related Conditions. Obes Surg 2008;18:1522-1525.

Dávila-Cervantes A, Borunda D, Domínguez-Cherit G, et al. Open Versus Laparoscopic Vertical Banded Gastroplasty: A Randomized Controlled Double Blind Trial. Obes Surg 2002;12:812-818.

Mechanick JI, Kushner RF, Sugerman HJ, et al. American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery Medical Guidelines for Clinical Practice for the Perioperative Nutritional, Metabolic, and Nonsurgical Support of the Bariatric Surgery Patient. Surg Obes Relat Dis 2008;4:S109-184.

Cunneen SA, Phillips E, Fielding G, et al. Studies of Swedish adjustable gastric band and Lap-Band: systematic review and meta-analysis. Surg Obes Relat Dis 2008;4:174-185

10.

American Heart Association Web site. Obesity and Overweight. AHA Scientific Position. Available at: http://www.americanheart.org/presenter.jhtml?identifier=4639. Accessed on October 16, 2009.

11.

O'Brien PE, McPhail T, Chaston TB, et al. Systematic review of medium-term weight loss after bariatric operations. Obes Surg 2006;16:1032-1040.

12.

Data on file, Allergan, Inc. June 2010.

13.

Ponce J, Paynter S, Fromm R. Laparoscopic adjustable gastric banding: 1,014 consecutive cases. J Am Coll Surg 2005;201:529-535.

14.

Dixon JB, Chapman L, O'Brien P. Marked improvement in asthma after LAP-BAND^® surgery for morbid obesity. Obes Surg 1999;9:385-389.

15.

Dixon JB, O'Brien PE. Health outcomes of severely obese type 2 diabetic subjects 1 year after laparoscopic adjustable gastric banding. Diabetes Care 2002;25(2)358-363.

16.

Dixon JB, Schachter LM, O'Brien PE. Sleep disturbance and obesity: changes following surgically induced weight loss. Arch Intern Med 2001;161:102-106.

17.

Dixon JB, O'Brien PE. Gastroesophageal reflux in obesity: the effect of Lap-Band placement. Obes Surg 1999;9:527-531.

18.

Sugerman HJ. The pathophysiology of severe obesity and the effects of surgically induced weight loss. Surg Obes Relat Dis 2005;109-119.

19.

Wang Y, Beydoun M. The Obesity Epidemic in the United States—Gender, Age, Socioeconomic, Racial/Ethnic, and Geographic Characteristics: A Systematic Review and Meta-Regression Analysis. Epidem Rev 2007;29(1)6-28.

20.

Kaplan LM, Fallon JA, Mun EC, et al. Coding and reimbursement for weight loss surgery: best practice recommendations. Obes Res 2005;13:290-300.

21.

Fielding GA, Allen JW. A step-by-step guide to placement of the LAP-BAND adjustable gastric banding system. Am J Surg 2002;184:26S-30S.

22.

Shen R, Dugay G, Rajaram K, et al. Impact of Patient Follow-up on Weight Loss after Bariatric Surgery. Obes Surg 2004;14:514-519.

23.

Singhal R, Kitchen M, Bridgwater S, et al. Metabolic Outcomes of Obese Diabetic Patients Following Laparoscopic Adjustable Gastric Banding. Obes Surg 2008:18:1400-1405.

24.

Ponce J, Haynes B, Paynter S, et al. Effect of LAP-BAND^® Induced Weight Loss on Type 2 Diabetes Mellitus and Hypertension. Obes Surg 2004:14:1335-1342.

25.

Bult MJF, van Dalen T, Muller AF. Surgical treatment of obesity. Eur J Endocrin 2008:158(2)135-145.

26.

Elder KA and Wolfe BM. Bariatric Surgery: A Review of Procedures and Outcomes. Gastroent 2007;132:2253-2271.

27.

Centers for Disease Control and Prevention Web site. 2007 National Diabetes Fact Sheet. Available at: http://www.cdc.gov/diabetes/pubs/general07.htm. Accessed April 2, 2009.

28.

Centers for Disease Control and Prevention Web site. Sleep and Sleep Disorders. Available at: http://www.cdc.gov/sleep/disorders.htm. Accessed April 2, 2009.

29.

Centres for Disease Control and Prevention Web site. High Blood Pressure: Facts and Statistics. Available at: http://www.cdc.gov/bloodpressure/facts.htm. Accessed April 2, 2009.

30.

Nugent C, Bai CH, Elariny H, et al. Metabolic Syndrome After Laparoscopic Surgery. Obes Surg; 2008:18:1278-1286.

31.

National Heart Lung and Blood Institute Web site. Metabolic Syndrome. Available at: http://www.nhlbi.nih.gov/health/dci/Diseases/ms/ms_whatis.html. Accessed April 2, 2009.

32.

Testa MA and Simonson DC. Assessment of quality of life outcomes. N Engl J Med 1996;334:833-40.

33.

Kolotkin RL, Crosby RD, Kosloski KD, et al. Development of a Brief Measure to Asseess Quality of Life in Obesity. Obes Res 2001;9(2)102-111.

34.

Mathus-Vliegen EM, de Weerd S, de Wit LT. Health-related quality-of-life in patients with morbid obesity after gastric banding for surgically induced weight loss. Surg 2004;135(5)489-497.

35.

Rakel RE. Clinical and Societal Consequences of Obstructive Sleep Apnea and Excessive Daytime Sleepiness. Postgrad Med 2009;121(1)86-95.

36.

Spivak H, Hewitt MF, Onn A, Half EE. Weight loss and improvement of obesity-related illness in 500 U.S. patients following laparoscopic adjustable gastric banding procedure. Am J Surg 2005;189:27-32.

37.

Ahroni JH, Montgomery KF, Watkins BM. Laparoscopic adjustable gastric banding: weight loss, co-morbidities, medication usage and quality of life at one year. Obes Surg 2005;15:641-647.

38.

Centers for Disease Control and Prevention Web site. About High Blood Cholesterol. Available at: http://www.cdc.gov/cholesterol/about.htm. Accessed April 6, 2009.

39.

Centers for Disease Control and Prevention Web site. About Heart Disease. Available at: http://www.cdc.gov/heartdisease/about.htm. Accessed April 6, 2009.

40.

Pontiroli AE, Folli F, Paganelli N, et al. Laparoscopic gastric banding prevents type 2 diabetes and arterial hypertension and induces their remission in morbid obesity – A 4-year case-controlled study. Diab Care 2005;28(11)2703-2709.

41.

Tolonen P, Victorzon M, Niemi R, et al. Does gastric banding for morbid obesity reduce or increase gastroesophageal reflux? Obes Surg 2006:16(11)1469-1474.

42.

Summary of Revisions for the 2009 Clinical Practice Recommendations, American Diabetes Association, Diabetes Care. 2009 Jan;32 Suppl 1:S3-5.

43.

Centers for Disease Control and Prevention Web site. Arthritis Basics. Available at: http://www.cdc.gov/arthritis/arthritis/osteoarthritis.htm. Accessed April 6, 2009.

44.

Kleinman NL, Melkonian A, Borden S, et al. The Impace of Morbid Obesity and Bariatric Surgery on Comorbid Conditions: A Comprehensive Examination of Comorbidities in an Employed Population. JOEM 2009;51(2)170-179.

45.

American Society for Reproductive Medicine Web site. Patient's fact sheet: weight and fertility. Available at: http://www.asrm.org/Patients/FactSheets/weightfertility.pdf. Accessed April 6, 2009.

46.

Agbaje IM, Rogers DA, McVicar CM, et al. Insulin dependant diabetes mellitus: implications for male reproductive function. Hum Reprod 2007;22(7)1871-1877.

47.

American Heart Association. Obesity: Impact on Cardiovascular Disease. Circulation. 1998;98:000-000.

48.

Dixon JB, Bhathal PS, Hughes NR, et al. Nonalcoholic Fatty Liver Disease: Improvement in Liver Histological Analysis With Weight Loss. Hepatology 2004;39(6):1647-54

49.

Ballantyne GH, Belsley S, Stephens D, et al. Bariatric Surgery: Low Mortality at a High-Volume Center. Obes Surg 2008;18:660-667.

50.

Hooper MM, Stellato TA, Hallowell PT, et al. Musculoskeletal findings in obese subjects before and after weight loss following bariatric surgery. Int J Obes 2007;31(1)114-120.

51.

Zhao Y, Encinosa W. Statistical Brief #23—Bariatric surgery utilization and outcomes in 1998 and 2004. Healthcare Cost and Utilization Project (HCUP) Web site. Available at: www.hcup-us.ahrq.gov/reports/statbriefs/sb23.jsp. Accessed April 8, 2009.

52.

Adapted from ASMBS and SAGES. Guidelines for laparoscopic and open surgical treatment of morbid obesity. Obes Surg 2000;10(4)378-379.

53.

Phelan S, Wadden TA, Berkowitz RI, et al. Impact of weight loss on the metabolic syndrome. Int J Obes 2007;31:1442-1448.

54.

Ogden CL, Carroll MD, McDowell MA et al. Obesity Among Adults in the United States – No Statistically Significant Change Since 2003-2004. NCHS Data Brief No.1, November 2007

55.

O'Brien PE, Dixon JB, Brown W, et al. The laparoscopic adjustable gastric band (Lap-Band^®): a prospective study of medium-term effects on weight, health and quality of life. Obes Surg. 2002;12:652-660.

56.

Peck P. High-Fat Diet Ups Dangerous 'Hidden' Fat. Study Links Waist Circumference, Diet to Visceral Fat. Available at: http://www.webmd.com/heart-disease/heart-failure/news/20030331/high-fat-diet-ups-dangerous-hidden-fat. Accessed on October 16, 2009.

57.

Chapman AE, Kiroff G, Game P, et al. Laparoscopic adjustable gastric bading in the treatment of obesity: A systematic literature review. Surg. 2004. 135:3:326-351

58.

Sturm R. The Effects Of Obesity, Smoking, And Drinking On Medical Problems And Costs, Health Aff 2002;21(2)245-253.

59.

Kenchaiah S, Evans JC, Levy D, et al.: Obesity and the Risk of Heart Failure. New Eng J Med 2002;347(5)305-313.

60.

Calle EE, Thun MJ, Petrelli JM, et al. Body-mass index and morality in a prospective cohort of US adults. New Eng J Med 1999;341(15)1097-1105.

61.

Fontaine KR, Redden DT, Wang CX et al. Years of life lost due to obesity JAMA 2003;289(2)187-193.

62.

The Lancet, Early Online Publication, 18 March 2009.

63.

Chaston TB, Dixon JB, O'Brien PE. Changes in fat-free mass during significant weight loss: a systematic review. Int J Obes 2007;31:743-750.

64.

Parikh MS, Laker S, Weiner M, et al. Objective Comparison of Complications Resulting from Laparoscopic Bariatric Procedures. J Am Coll Surg 2006; 202(2)252-261.

65.

Serdula MK, Khan LK, Dietz WH. Weight Loss Counseling Revisited. AMA 2003;289(14)1747-1750

66.

Das SK and Farooqi A. Osteoarthritis. Best Prac & Rsch Clin Rheumat 2008;22(4)657-675.

67.

Ahmed MH and Byrne CD. Current treatment of non-alcoholic fatty liver disease. Diab Obes & Metab 2009;11:188-195.

68.

Sugerman HJ, Sugerman EL, Wolfe L, et al. Risks and Benefits of Gastric Bypass in Morbidly Obese Patients With Severe Venous Stasis Disease. Ann Surg 2001;234(1)41-46.

69.

Klein S, Wadden T, Sugarman HJ. AGA technical review on obesity. Gastroenterology. 2002;123:882-932.

70.

American Society of Metabolic and Bariatric Surgery Clinical Issues Committee Web site. ASMBS position statement on sleeve gastrectomy as a bariatric procedure.Approved by the ASMBS Executive Council June 2007. Available at: http://www.pugetsoundsurgicalcenter.com/sleeve_statement.pdf. Accessed June 3, 2009.

71.

Chapman A, Game P, O'Brien P. Laparoscopic adjustable gastric banding for the treatment of obesity: update and re-appraisal. ASERNIP-S Report No.31, Second Edition. Adelaide, South Australia. ASERNIP-S, June 2002

72.

O'Brien PE, Dixon JB. Weight loss and early and late complications – the international experience. Am J Surg. 2002; 184:42S-45S.

73.

Fisher B, Schauer P. Medical and surgical options in the treatment of severe obesity. Am J Surg. 2002; 184:9S-16S.

74.

Lalor PF, Tucker O, Szomstein S, Rosenthal RJ. Complications after laparoscopic sleeve gastrectomy. Surge Obes Relat Dis. 2008;4:33-38.

75.

LAP-BAND^® Adjustable Gastric Banding System [directions for use]. Irvine, CA:Allergan, Inc, 2008.

76.

Ferraro DR. Management of the bariatric surgery patient. Clin Rev. 2004;14:73-79.

77.

Aggarwal S, Kini SU, Herron DM. Laparoscopic sleeve gastrectomy for morbid obesity: a review. Surg Obes Relat Dis. 2007;3:189-194.

78.

Allen, JW. Laparoscopic Adjustable Gastric Band Complications. Med Clin North Am. 2007.

80.

Abu-Abeid S, Keidar A, Gavert N, et al. The clinical spectrum of band erosion following laparoscopic adjustable gastric banding for morbid obesity. Surg Endosc. 2003.

81.

Shore S. Obesity and Asthma: Possible Mechanisms. J Allergy Clin Immunol 2008;121(5):1087-93.

82.

Maniscalco M, Zedda A, Faraone S, et al. Weight loss and asthma control in severely obese asthmatic females. Resp Med 2008;102:102-8.

83.

Brancatisano A, Wahlroos S, Brancatisano R. Improvement in comorbid illness after placement of the Swedish Adjustable Gastric Band. Surg Obes Relat Dis 2008;4:S39-46.

84.

Dixon J, O’Brien P. Changes in comorbidities and improvements in quality of life after LAP-BAND placement. Am J Surg 2002;184:S51-4.

85.

Kim T, Daud A, Ude O, et al. Early U.S. outcomes of laparoscopic gastric bypass versus laparoscopic adjustable silicone gastric banding for morbid obesity. Surg Endosc 2006;20:202-9.

86.

Korenkov M, Shah S, Sauerland S, et al. Impact of Laparoscopic Adjustable Gastric Banding on Obesity Co-morbidities in the Medium- and Long-Term. Obes Surg 2007;17:679-83.

87.

Cunneen S. Review of meta-analytic comparisons of bariatric surgery with a focus on laparoscopic adjustable gastric banding. Surg Obes Relat Dis 2008;4:S47-55.

88.

Brancatisano A, Wahlroos S, Matthews S, Brancatisano R. Gastric banding for the treatment of type 2 diabetes mellitus in morbidly obese. Surg Obes Relat Dis 2008;4:423-9.

89.

Mittermair R, Weiss H, Nehoda H, et al. Laparoscopic Swedish adjustable gastric banding: 6-year follow-up and comparison to other laparoscopic bariatric procedures. Obes Surg 2003;13:412-7.

90.

Dixon J, Dixon M, O’Brien P. Quality of life after lap-band placement: influence of time, weight loss, and comorbidities. Obes Res 2001;9:713-21.

91.

Buchwald H, Avidor Y, Braunwald E, et al. Bariatric Surgery: A Systematic Review and Meta-analysis. JAMA 2004;292:1724-37.

92.

Melissas J, Kontakis G, Volakakis E, et al. The Effect of Surgical Weight Reduction on Functional Status in Morbidly Obese Patients with Low Back Pain. Obes Surg 2005;15:378-81.

93.

Kannan H, et al. Presented at the Obesity Society's 2009 Annual Scientific Meeting (October 26^th – Washington, DC)

94.

Kuruba R, Almahmeed T, Martinez F, et al. Bariatric surgery improves urinary incontinence in morbidly obese individuals. Surg Obes Relat Dis 2007;3:586-90,

95.

Burgio K, Richter H, Clements R, et al. Chances in urinary and fecal incontinence symptoms with weight loss surgery in morbidly obese women. Obstet Gynecol 2007;110:1034-40.

96.

Laungani R, Seleno N, Carlin A. Effect of laparoscopic gastric bypass surgery on urinary incontinence in morbidly obese women. Surg Obes Relat Dis 2009;5:334-8.

97.

Favretti F, Segato G, Ashton D, et al. Laparoscopic Adjustable Gastric Banding in 1,791 Consecutive Obese Patients: 12-Year Results. Obes Surg 2007;17:168-175.

98.

Christou N, Sampalis J, Lieberman M, et al. Surgery decreases long-term mortality, morbidity, and health care use in morbidly obese patients. Ann Surg 2004;240:416-23.

99.

Adams T, Gress R, Smith S, et al. Long-term mortality after gastric bypass surgery. New Eng J Med 2007;357:753–61.

100.

Sjostrom C, Lissner L, Wedel H, Sjostrom L. Reduction in incidence of diabetes, hypertension and lipid disturbances after intentional weight loss induced by bariatric surgery: the SOS Intervention Study. Obes Res 1999;7:477-84.

101.

Lindsey M, Patterson W, Gesten F, Roohan P. Bariatric Surgery for Obesity: Surgical Approach and Variation in In-Hospital Complications in New York State. Obes Surg 2009;19:688-700.

102.

The Longitudinal Assessment of Bariatric Surgery (LABS) Consortium. Perioperative Safety in the Longitudinal Assessment of Bariatric Surgery. New Eng J Med 2009;361(5)445-454.

103.

Taylor CJ, Layani L. Laparoscopic Adjustable Gastric Banding in Patients >=60 Years Old: Is it Worthwhile?. Obes Surg 2006:16:1579-1583.

104.

Smith AM, Lopez-Jimenez F, McMahon MM, et al. Action on obesity: report of Mayo Clinic national summit. Mayo Clin Proc. 2005;80:527-532.

105.

Edwards MA, Grinbaum R, Schneider BE, et al. Benchmarking hospital outcomes for laparoscopic adjustable gastric banding. Surg Endosc 2007:21:1950-1956

106.

Frigg A, Peterli, R, Peters T, et al. Reduction in Co-morbidities 4 Years after Laparoscopic Adjustable Gastric Banding. Obes Surg 2004:14:216-223.

108.

Hansen D, Michaelson R, Ehrlich T, James S. P-15: Clinical evaluation of the Lap-Band AP^® System in the severely obese: Interim analysis of the APEX study. Surg Obes Relat Dis 2009;5(3 Suppl 1):S28-9.

109.

Gulkarov I, Wetterau M, Ren CJ, Fielding GA. Hiatal hernia repair at the initial laparoscopic adjustable gastric band operation reduces the need for reoperation. Surg Endosc. 2008;22:1035-1041.

110.

Lee WJ, Wang W, Wei PL, et al. Weight Loss and Improvement of Obesity-related Illness Following Laparoscopic Adjustable Gastric Banding Procedure for Morbidly Obese Patients in Taiwan. J Fomos Med Assoc. 2006;105(11):887-94.

111.

Dixon JB, Dixon ME, O'Brien PE. Pregnancy after Lap-Band(R) Surgery: Management of the Band to Achieve Healthy Weight Outcomes. Obes Surg 2008:11:59-65.

112.

Martin LF, Finigan KM, Nolan TE. Pregnancy After Adjustable Gastric Banding. Obstet Gynecol 2000;95(6):927-930.

113.

Weiss HG, Nehoda H, Labeck B, et al. Pregnancies after Adjustable Gastric Banding. Obes Surg 2008:11:303-306.

114.

Kral JG, Biron, S, Simard S, et al. Large Maternal Weight Loss From Obesity Surgery Prevents Transmission of Obesity to Children Who Were Followed for 2 to 18 Years. Pediatrics. 2006. 118:e1644-e1649