Lap-Band fills and adjustments in Rancho Cucamonga

Lap-Band fills and adjustments in Rancho Cucamonga

A Lap-Band fill, also called an adjustment, changes how tight the band is by adding or removing sterile salt water (saline) through the access port under your skin. According to the FDA labeling, it is usually done during a routine office visit, takes only a few minutes, and needs no overnight stay. To book one in Rancho Cucamonga, call and say whether you need it tighter, looser, or checked.

What happens during a fill or unfill

The band has an inflatable inner lining connected by thin tubing to the port, which is usually fixed to the muscle wall of your abdomen. Nothing is cut. The FDA labeling describes the visit in a few steps:

The port is located. If it is hard to feel, an x-ray technique called fluoroscopy can be used to see it and guide the needle. After a lot of weight loss, the port can often be felt by hand.
The skin is cleaned, and local anesthetic may be used to numb it.
A fine, special needle (a non-coring "Huber" needle) goes through the skin into the port. The labeling warns that ordinary hypodermic needles can damage the port and cause leaks.
A small amount of saline is added to tighten the band or withdrawn to loosen it.
If fluid was added, you drink water before leaving. The labeling says that if you cannot swallow, some fluid should be removed and the check repeated.

At the Rancho Cucamonga office, fills are done under x-ray guidance (fluoroscopy), so the port and band can be seen while the fill is made. The office will tell you which days fills are scheduled when you book.

How the amount of fluid is decided

There is no standard fill volume. The FDA patient guide says the exact amount needed is different for each person, and that the band should not be tightened too fast or too far to speed up weight loss, because this can enlarge the stomach pouch or the esophagus (the tube between your mouth and stomach).

The labeling suggests the first adjustment about four to six weeks or more after surgery, then regular reviews every four to six weeks while you are losing weight. At each review your surgeon considers your weight trend, your hunger, how much you can comfortably eat, and how much fluid is already in the band. The patient guide says people may need anywhere from one to ten adjustments in the first year, and that later it could be months or years between adjustments. The ASMBS likewise notes that a band may need several adjustments and monthly office visits in the first year, and the NIDDK says band patients need several follow-up visits to adjust the opening.

The labeling also gives a caution worth knowing: poor weight loss is not always a loose band. It can come from an enlarged pouch, a leak in the system, or a slipped band, and in those cases adding more fluid is not appropriate. That is why a fill that stops working after a few weeks is a reason for a closer look, not just another fill. Our page on Lap-Band adjustments and tightness explains the signs of a band that is too tight or too loose in more detail.

What to bring to an adjustment

Your photo ID and insurance card.
Your fill history, if you have it: the dates of recent fills and the total amount of fluid in the band. The labeling advises reviewing total band volume and recent adjustments before any fill.
The band model and size if you know it. The labeling lists the LAP-BAND AP Standard band with a fill range of 0 to 10 cc and the Large band with 0 to 14 cc.
A list of your medicines and supplements, including any weight-loss medication.
Notes on what you have been eating, any food getting stuck, night cough, or heartburn.

If your band was placed by another surgeon, read our guide for patients transferring their band care before your first visit.

After the fill

The FDA labeling requires that a physician familiar with adjustments be available for several days afterward to loosen the band if it blocks. In practice, this means you should know how to reach the office after a fill. Follow the eating plan the office gives you for the first day or two. Never try to adjust the port yourself: the labeling reports that self-adjustment has caused infection and wrong tightness.

When to call

Call the office

Food or saliva comes back up after most meals.
Night cough or heartburn that is new since the fill.
You are hungry again within a couple of hours of a solid meal, weeks after the fill.
Soreness at the port that lasts more than a few days.

Go to an emergency room or call 911

You cannot keep water or liquids down.
You vomit blood or have black stools.
Severe chest or abdominal pain.
Fever with redness, heat, or swelling over the port.

Do not wait for an appointment with these symptoms. Our guide to Lap-Band emergency warning signs covers them in more depth.

Frequently asked questions

How much fluid goes in at one fill?

It varies. The FDA labeling gives 3 to 4 cc as a usual starting amount for the first adjustment of the LAP-BAND AP band, with later changes made in small increments. Later fills are often a fraction of a cc. The amount depends on your symptoms, weight trend, and the fluid already in the band, so your surgeon decides at each visit rather than following a fixed schedule.

How do I know whether I need a fill or an unfill?

The FDA patient guide lists signs of a band that may be too loose: no weight loss for more than three weeks, a bigger appetite, or feeling hungry again less than four hours after a meal. Signs it may be too tight include bringing food back up, discomfort while eating, and a night cough. Describe these when you call, and the surgeon will decide.

Does a band fill hurt?

You will feel the needle go through the skin, similar to having blood drawn, and the area can be tender for a day or two. The FDA patient guide notes that local anesthetic may be used to numb the skin around the port. If the port is deep or hard to reach, the visit may take a little longer while it is located.

Should my band be loosened before I have another operation?

The FDA labeling advises considering elective deflation before general anesthesia, during pregnancy or significant illness, and before remote travel or travel to areas where food or water contamination is common. Tell the office about planned operations or trips early, so any unfill and later refill can be scheduled around them.

Book an adjustment with Dr. Davtyan in Rancho Cucamonga

Dr. David G. Davtyan, MD, FACS, FICS, FASMBS, is a bariatric surgeon who has a Lap-Band himself. Call Davtyan Medical Weight Loss & Wellness at 909-355-2525 or toll free 877-9-BE-SLIM (877-923-7546); the office is at 8330 Red Oak Street, Suite 201, Rancho Cucamonga, CA 91730, and Spanish is spoken. You can also reach us through the contact page, and the Rancho Cucamonga Lap-Band guide covers other band questions.

Lap-Band fills and adjustments in Rancho Cucamonga