Adjustable Gastric Banding

WHAT YOU SHOULD KNOW:

Adjustable Gastric Banding (Inpatient Care) Care Guide

Gastric banding is a type of weight loss surgery. During surgery, caregivers put a soft band around the top part of your stomach. This divides the stomach into one small pouch and one large pouch. When you eat, food collects in the small pouch. Because the pouch is very small, you will feel full quickly. There is a small opening in the smaller pouch that allows food to pass into the larger pouch. Between meals, the food moves slowly into the larger pouch and is digested normally. Over time, you may lose weight because you feel full sooner and cannot eat as much food during a meal. Your caregiver can tighten or loosen the band as needed after the surgery.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

  • You may bleed too much or get an infection. You may get blood clots. Your esophagus or other organs may be injured during surgery. The gastric band may slip out of place, break or leak. The band may cause a scar or may erode the stomach tissue. You may have problems during laparoscopic surgery that cause you to need a laparotomy (open surgery). After surgery, you may lose weight and then gain it back. You may not lose any weight. If you get pregnant while you are quickly losing weight, this could harm you and your unborn baby.

  • If you often eat too much and do not follow instructions, you may stretch out your stomach pouch. If you eat too much, too fast, or do not chew well enough before swallowing you may have other problems. These problems include feeling sick to your stomach, having a stomachache, and throwing up. You may get acid reflux (heartburn) or a stomach ulcer. Food that is not chewed well enough may get stuck in the opening between the small and large stomach pouches. You may not get enough protein and vitamins from your diet, especially if you vomit a lot. This may lead to some hair loss, anemia or other medical problems. You may need another surgery later. As in any surgery, you may even die from complications.

  • It is important to follow your weight loss team or caregiver's instructions for the rest of your life. This includes changing your eating habits and lifestyle, taking vitamins and supplements, and going to regular medical appointments. If you do these things, you will decrease your risk of having problems after surgery.

WHILE YOU ARE HERE:

Before surgery:

  • Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

  • Heart monitor: This is also called an ECG or EKG. Sticky pads placed on your skin record your heart's electrical activity.

  • An IV is a small tube placed in your vein that is used to give you medicine or liquids.

  • Pressure stockings: These are long, tight stockings that put pressure on your legs to promote blood flow and prevent clots. You may need to wear pressure stockings before or after surgery or if you have poor circulation (blood flow).

  • Pneumatic boots: Inflatable boots are put on your legs. The boots are connected to an air pump. The pump tightens and loosens different areas of the boots. This helps improve blood flow to prevent clots.

  • Pulse oximeter: A pulse oximeter is a device that measures the amount of oxygen in your blood. A cord with a clip or sticky strip is placed on your finger, ear, or toe. The other end of the cord is hooked to a machine. Never turn the pulse oximeter or alarm off. An alarm will sound if your oxygen level is low or cannot be read.

  • Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.

  • Pre-op care: You may be weighed and asked to change into a hospital gown. You may be given medicine in your IV to make you feel sleepy and more relaxed. You will be taken on a cart to the room where your surgery will be done. Your caregiver will help you get comfortable on the bed. Belts may be put over your legs for safety. If you get cold, ask for more blankets.

  • General anesthesia will keep you asleep and free from pain during surgery. Anesthesia may be given through your IV. You may instead breathe it in through a mask or a tube placed down your throat. The tube may cause you to have a sore throat when you wake up.

During surgery:

Small incisions (cuts) are made in your stomach. A laparoscope (tube with a camera on the end) and other instruments are put through the incisions. Caregivers use them to place a gastric band around the top part of your stomach. The band is connected to a long, hollow tube and a port. The port is a small hollow pillow that is attached under your skin in your upper stomach. Caregivers may stitch the gastric band to the stomach tissue to hold it in place. They may inject salt water into the gastric band, or they may leave the band empty. Caregivers will close your incisions with stitches or staples.

After surgery:

You will be taken to the recovery room. You will stay there until you wake up. You will then be taken back to your room. Do not get out of bed until your caregiver says it is OK. Bandages will cover your incisions. These bandages keep the areas clean and dry to help prevent infection.

  • Activity: You may need to walk around the same day of surgery, or the day after. Movement will help prevent blood clots. You may also be given exercises to do in bed. Do not get out of bed on your own until your caregiver says you can. Talk to caregivers before you get up the first time. They may need to help you stand up safely. When you are able to get up on your own, sit or lie down right away if you feel weak or dizzy. Then press the call light button to let caregivers know you need help.

  • Deep breathing and coughing: This will help decrease your risk for a lung infection after surgery.

    • Hold a pillow tightly against your incision when you cough to help decrease pain. Take a deep breath and hold it for as long as you can. Deep breaths help open your airways. Let the air out and follow with a strong cough. Spit out any mucus you cough up. Repeat the steps 10 times every hour.

    • You may be given an incentive spirometer to help you take deep breaths. Put the plastic piece into your mouth and take a slow, deep breath. Let out your breath and cough. Repeat the steps 10 times every hour.

  • Eating: You will start eating by sipping water or chewing on ice chips. Then you will be started on a clear liquid diet. Examples of clear liquids are broth, jello, and clear juice. You may only be able to eat a few teaspoons of food at the beginning. Stop eating when you feel full, even if you have food left on your plate. Next, you will be given soft, blended foods. You may be able to eat only a few bites of this food before you feel full. In time, you should be able to eat about one-half to three-fourths cup of food during each meal.

  • A Foley catheter is a tube put into your bladder to drain urine into a bag. Keep the bag below your waist. This will prevent urine from flowing back into your bladder and causing an infection or other problems. Also, keep the tube free of kinks so the urine will drain properly. Do not pull on the catheter. This can cause pain and bleeding, and may cause the catheter to come out. Caregivers will remove the catheter as soon as possible to help prevent infection.

  • Medicines:

    • Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.

    • Antinausea medicine: This medicine may be given to calm your stomach and to help prevent vomiting.

    • Blood thinners help prevent blood clots. Blood thinners may be given before, during, and after a surgery or procedure. Blood thinners make it more likely for you to bleed or bruise.

    • Pain medicine: Caregivers may give you medicine to take away or decrease your pain.

      • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.

      • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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