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Adjustable Gastric Band Surgery

AMBULATORY CARE:

What you need to know about gastric band surgery:

Gastric banding is a type of weight loss surgery. An adjustable band is placed around the top part of your stomach. This divides the stomach into one small pouch and one large pouch. Food collects in the small pouch when you eat. You will feel full quickly because the pouch is very small. An opening in the smaller pouch allows food to pass into the larger pouch. Between meals, the food moves slowly into the larger pouch and is digested normally. Your healthcare provider can tighten or loosen the band as needed after the surgery.

Digestive Tract

What you need to know before you have an adjustable gastric band:

  • You will work closely with a dietitian before and after surgery. Your dietitian will talk to you about nutrition and what you should eat and drink before and after surgery. You may need to follow a very low-calorie diet for several weeks before surgery. This will help you lose some weight before surgery. Weight loss will help your liver handle anesthesia better. It will also help you create healthy nutrition and activity habits.
  • Your surgeon will talk to you about self-care and follow-up activities you will need after surgery. You will need to come in often to have your progress checked. Your band may need to be tightened or loosened during each visit.
  • If you are a woman of childbearing age, your surgeon will talk to you about pregnancy. He or she may recommend that you do not get pregnant for 12 to 18 months after surgery. Then your pregnancy will be monitored for your safety and the safety of your baby. Your band will need to be adjusted during pregnancy. This helps your baby get enough calories and nutrition to develop properly. If you want to prevent pregnancy, healthcare providers will help you choose the right kind of birth control.

How to prepare for surgery:

  • Your surgeon will talk to you about how to prepare for surgery. He or she may tell you not to eat or drink anything after midnight on the day of your surgery. Arrange to have someone drive you home after you are discharged.
  • Tell your surgeon about all medicines you currently take. He or she will tell you if you need to stop any medicine for surgery, and when to stop. He or she will tell you which medicines to take or not take on the day of your surgery.
  • Tell your surgeon about all your allergies, including to anesthesia or antibiotics. You may be given an antibiotic to help prevent a bacterial infection.
  • You may need a fasting blood test to check your lipid (fat) levels, or other blood tests. Your heart may be checked to make sure it is healthy enough for surgery. You may also need tests to check your digestive system.
  • If you have diabetes, healthcare providers will help you schedule meals and medicines before surgery. Your A1c level may also be checked.
  • If you currently use tobacco products, you will need to quit before you have surgery. It is best to quit at least 1 year before surgery. You must quit at least 6 weeks before surgery. Talk to your surgeon or other healthcare providers if you need help quitting.

What will happen during gastric band surgery:

  • You may be given general anesthesia to keep you asleep and free from pain during surgery. Your surgeon will make small incisions in your abdomen. He or she will place the gastric band around the top part of your stomach. The gastric band may be attached to stomach tissue to hold it in place.
  • An injection port will be under your skin. Healthcare providers can use the port to add or remove saline (salt water) to make the band tighter or looser. Your surgeon may inject saline (salt water) into the gastric band, or he or she may leave the band empty. The incisions will be closed with stitches or medical tape.

What will happen after gastric band surgery:

  • You may need to walk around within 6 to 12 hours after surgery. This helps prevent blood clots. You will sip water or chew on ice chips after surgery when your healthcare provider says it is okay. The next step is to drink clear liquids. Examples of clear liquids are broth, gelatin, 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.
  • As you begin to eat differently, you may begin to lose weight. Your weight loss will depend on how well you follow your diet and exercise plans. It may take 18 to 24 months to reach a healthy weight.

Risks of gastric band surgery:

You may bleed more than expected or get an infection. Your esophagus or other organs may be injured during surgery. You may develop a life-threatening blood clot. The gastric band may slip out of place, break, or leak. The band may scar or erode (move) into the stomach tissue. You may need a larger incision than expected during laparoscopic surgery. After surgery, you may not lose any weight. You may lose weight and then gain it back.

Call your local emergency number (911 in the US) for any of the following:

  • You feel lightheaded or short of breath, or you have chest pain.
  • You cough up blood.

Seek care immediately if:

  • Your arm or leg feels warm, tender, and painful. It may look swollen and red.
  • Blood soaks through your bandages.
  • Your stitches or incisions come apart.
  • You cannot stop vomiting.

Call your doctor or surgeon if:

  • You have a fever higher than 100°F (37.8°C).
  • You have pain or pressure in your abdomen or back, hiccups, and you feel restless.
  • You have redness, swelling, or pus coming from your incisions.
  • You have nausea and are vomiting.
  • You feel your heart beating faster than usual.
  • You have questions or concerns about your condition or care.

Medicines:

You may need any of the following:

  • Medicine may be given to lower the amount of stomach acid, or to relieve heartburn.
  • Nausea medicine may be needed to help decrease nausea and prevent vomiting.
  • A multivitamin may be recommended by your healthcare provider or dietitian. This will help replace vitamins and minerals you may lose from eating less food.
  • Acetaminophen decreases pain and fever. It is available without a doctor's order. Ask how much to take and how often to take it. Follow directions. Read the labels of all other medicines you are using to see if they also contain acetaminophen, or ask your doctor or pharmacist. Acetaminophen can cause liver damage if not taken correctly. Do not use more than 4 grams (4,000 milligrams) total of acetaminophen in one day.
  • Prescription pain medicine may be given. Ask your healthcare provider how to take this medicine safely. Some prescription pain medicines contain acetaminophen. Do not take other medicines that contain acetaminophen without talking to your healthcare provider. Too much acetaminophen may cause liver damage. Prescription pain medicine may cause constipation. Ask your healthcare provider how to prevent or treat constipation.
  • Blood thinners help prevent blood clots. Clots can cause strokes, heart attacks, and death. The following are general safety guidelines to follow while you are taking a blood thinner:
    • Watch for bleeding and bruising while you take blood thinners. Watch for bleeding from your gums or nose. Watch for blood in your urine and bowel movements. Use a soft washcloth on your skin, and a soft toothbrush to brush your teeth. This can keep your skin and gums from bleeding. If you shave, use an electric shaver. Do not play contact sports.
    • Tell your dentist and other healthcare providers that you take a blood thinner. Wear a bracelet or necklace that says you take this medicine.
    • Do not start or stop any other medicines unless your healthcare provider tells you to. Many medicines cannot be used with blood thinners.
    • Take your blood thinner exactly as prescribed by your healthcare provider. Do not skip does or take less than prescribed. Tell your provider right away if you forget to take your blood thinner, or if you take too much.
    • Warfarin is a blood thinner that you may need to take. The following are things you should be aware of if you take warfarin:
      • Foods and medicines can affect the amount of warfarin in your blood. Do not make major changes to your diet while you take warfarin. Warfarin works best when you eat about the same amount of vitamin K every day. Vitamin K is found in green leafy vegetables and certain other foods. Ask for more information about what to eat when you are taking warfarin.
      • You will need to see your healthcare provider for follow-up visits when you are on warfarin. You will need regular blood tests. These tests are used to decide how much medicine you need.
  • Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him or her if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Follow your nutrition plan:

Ask your dietitian or nutritionist any questions you have about your nutrition plan. The plan will include which foods to eat and how much of each to eat during a meal.

  • Eat slowly. Chew your food well before you swallow. Large bits of food may cause choking or may block your stomach. You may vomit or have abdominal pain or heartburn if you eat too quickly. You may also develop a stomach ulcer. Food that is not chewed well enough may get stuck in the opening between the small and large stomach pouches.
  • Eat 3 small meals each day. You may stretch out your stomach pouch if you often eat too much. Do not eat snacks between meals unless your healthcare provider says it is okay. Stop eating when you feel full, even if you have not eaten all of your meal.
  • Eat nutritious foods. Eat plenty of protein. Foods that contain protein include chicken, fish, eggs, and dairy products. You may need protein drinks for the first week after surgery. Avoid candy, cookies, ice cream, and fried foods.
  • Drink liquids between meals. Wait at least 1 to 2 hours after a meal before you drink liquids. Do not drink liquids with meals. Drink water, diet drinks, or other drinks that have few or no calories. Do not drink carbonated liquids, such as soft drinks.

Self-care:

  • Care for your wound as directed. When you allowed to bathe, carefully wash the wound with soap and water. Dry the area and put on new, clean bandages as directed. Change your bandages when they get wet or dirty.
  • Do activity or exercise as directed. Aim to get at least 150 minutes of physical activity each week, or 30 minutes on most days. You can break the 30 minutes into shorter periods of activity throughout the day. Ask your healthcare provider about the best exercise plan for you.
    Walking for Exercise
  • Go to therapy. Therapy may include working with a counselor to understand your reasons for overeating. You may want to join a support group to talk with others who have had gastric band surgery.

Follow up with your doctor or surgeon as directed:

You will need to return in 1 to 2 weeks and then regularly for support and to have your gastric band checked or adjusted. Write down your questions so you remember to ask them during your visits.

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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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