Faqs


Preparing for a Consult

  • What is "laparoscopic" surgery?
    Laparoscopic surgery, also known as laparoscopy or "key-hole" surgery, is a minimally-invasive method of performing surgery, commonly associated with abdominal operations. A series of tiny incisions (about the size of a key-hole) are made in order to insert miniature cameras and special instruments that can be manipulated by the surgeon externally. The result? Less scarring from incisions, a shorter hospital stay, and a greatly reduced recovery time.
  • Am I a candidate for laparoscopic surgery?
    If you qualify for most elective surgeries, you qualify for laparoscopy. Indeed, if you’re an active adult who doesn’t want to spend much time away from work or family, laparoscopy should be your preferred method of surgery.
  • If I am allergic to some medication, does this affect my eligibility?
    Generally, no, although our doctors should be provided with your complete medical history, including all allergies.
  • What type of tests are required before surgery?
    A consultation, an examination of your medical history, and a series of blood tests are required before surgery. The blood tests must be completed a month before surgery.

    The doctor or anesthesiologist may also require a sleep test, which can take three to four weeks. It’s important that all tests be completed before the date of surgery.
  • Where can I have these tests done?
    The blood tests can be completed at any blood clinic, and must be completed at least one month before surgery. Ask the blood clinic to fax their results to our office at (416) 920 4484 or 1 800 409 8169. You should give your TLBC coordinator the phone numbers as well so that we can contact them if necessary.
  • How long is the wait for the surgery?
    We can schedule your surgery as early as a month after your initial consultation, provided you complete all required tests and submit your results to the centre.
  • How long is the procedure? Will I have to stay overnight?
    The adjustable gastric banding procedure itself takes approximately one hour, and is performed right in the Centre, where we have comfortable facilities for the few hours of clinic stay you’ll need post-op. Band surgery is usually performed as a day surgery, and usually doesn’t require an overnight stay.

Results

  • How much weight will I lose?
    Weight loss depends on the patient. Immediately following surgery, you may find that you lose weight fairly quickly, but when normalized, (which is to say, when you’re back to eating solid foods) you should lose between one and two pounds every week. It’s important that the band be properly adjusted, and that you follow TLBC’s recommendations so you can lose those excess pounds and achieve your goal weight.

    Ultimately, the amount of weight you’ll lose depends on you. It’s important to keep in mind that the band is a tool, and that it’s only as good as the person using it. If you make the appropriate adjustments to live comfortably and safely with the band, you’ll lose most, if not all, of your excess weight over the next few years. It’s not about losing the weight quickly – it’s about keeping it off, for good.
  • Can I expect to gain weight after a few years, even with the LaparoscopicBAND?
    If you maintain your new dietary habits, exercise regularly, and have your band routinely adjusted, you shouldn’t be gaining weight back, even years after the surgery. When using the band properly, weight loss is a long-term and sustainable process.

Coverage and Financing

  • What's covered in the TLBC program?

    The LaparoscopicBAND Centre's program includes:

    • the LaparoscopicBAND
    • the LaparoscopicBAND procedure
    • 4 years of adjustments to the band
    • follow-up support group meetings
    • follow-up nutritional consultations (group or one-on-one)
    • seminars on nutrition, fitness,
    • group and one-on-one behaviour coaching sessions
  • How can I pay?
    The Centre accepts cash, money order, certified cheque, credit cards and financing by Credit Medical Corporation.
  • I can finance my surgery?
    Absolutely. We can negotiate financing with you through Credit Medical Corporation, a Canadian company (with offices at the Prince Arthur Medical Centre, alongside TLBC) who provides financing for elective medical surgeries. Their application process is quick, simple, and painless.

    CMC provides a variety of monthly-payment plans, and there’s no need for down payments or collateral. You can choose a term from six months to four years to cover any part of the cost of the surgery. Loans are open and can be repaid at any time.

    You can learn more about financing options and Credit Medical at their website: creditmedical.com.

Post-Op Care

  • How long will I be away from home? How long will I have to be away from work?
    With most procedures, patients are home the same day as the surgery (after a few hours recovery time at the clinic). Because the band is inserted laparoscopically, through key-hole incisions, you should be able to get back to work after a week. However, if your job is physically demanding or high-stress, we recommend a two-week recovery period.
  • How much pain will I experience after surgery?
    You can expect mild discomfort and some pain in the abdominal region immediately following surgery. We prescribe pain medication (Demerol® or Tylenol®) for the first few days immediately after the procedure.
  • How much swelling or bruising should be expected after surgery?
    You can expect some mild swelling around the port site, and the incisions, accompanied by mild bruising, but this should subside in a week or two. We recommend that you apply a warm compress for 20 minutes several times a day for the first few days post-op. If you’re concerned about any swelling or bruising that you might be experiencing, please contact the Centre.
  • Do I have to be careful with the access port?
    The port is placed under the skin, near the abdominal wall. After the incision sites have completely healed, and any swelling or bruising has subsided, you shouldn’t notice the port at all, nor will it limit your physical activity. If there is any discomfort in the port area (other than for the first few days post-op, or immediately following a band adjustment), please notify the Centre.
  • Will I be able to see the access port?
    Since the access port is placed under the skin, you won’t be able to see it. However, as you lose most of your excess weight, you may notice a small lump.

Adjustments and Fills

  • How is the band adjusted?
    When the band needs to be tightened, a doctor inserts a hypodermic needle, filled with saline solution, into the port, and inserts the solution into the laparoscopic band. This IS called a “fill”. A “de-fill” is simply the opposite – using a needle, the doctor removes some of the saline solution, thus loosening the band. The procedure only takes a few minutes, and can be performed right at the Centre.

    Occasionally, an x-ray machine is used so that the doctor can clearly see the position of the port and the band.
  • How many fills will I need?
    The number of required fills largely depends on the patient. Some patients feel that the band is properly adjusted after their first fill session. Usually, three or four fills are required before the patient feels completely comfortable. An unlimited number of fills within 4 years is included with the TLBC program. Patients can make appointments for fills by calling the Centre’s number at (416) 920 4480 or 1 800 409 8151 (ext 337) or via e-mail at fillnurse@tlbc.ca.

    We also provide information for “remote fills”, if you live out of the Toronto area, or if you prefer that your family doctor perform the fills. We’ll provide you with a DVD and an information sheet that will instruct your doctor on how to find the access port, how to perform fill/de-fill adjustments, and how much saline solution to add or remove from the band.
  • How often should I come back to the centre after surgery?
    We recommend you to have the band adjusted every few weeks, until you feel that you’re able to eat comfortably yet feel a restriction. After that, we encourage you to come in every six to twelve months, for a check-up and regular weigh-in, and to monitor your progress. You can schedule these appointments through our Fill Nurse at (416) 920 4480 or 1 800 409 8151, extension 337.

Diet and Nutrition

  • Do I need to follow a special diet?
    We provide dietary guidelines for patients that should be followed to avoid discomfort and complications, to ensure that your body regularly and healthily adjusts to the band, and to maximize weight-loss. Often, patients will be ready to eat regular, solid food less than a week following surgery, but it’s important to give yourself time to heal and adjust to the band’s presence.
  • Will I feel hungry or deprived with the LaparoscopicBAND?
    You’ll probably feel hungry for the first six weeks or so. This is your body’s natural response to the adjustments you’ll be making in your eating habits and patterns, and also to the post-op nutrition plan. It’s important, however, that you stick to the guidelines – the feelings of hunger will subside, and you’ll find yourself satisfied by your three small meals a day.
  • What types of food should I say away from?
    We recommend that you choose nutrient-rich food.  That means avoiding high-calorie, low-nutrient foods like milkshakes, ice cream, pudding, mashed potatoes, carbonated drinks and other junk food. Most of our patients also say that some breads and pastas often cause discomfort, so eat these in moderation.
  • Can I eat any food in moderation?
    After your recovery period, and once you’re back to eating solid foods, you can eat anything that doesn’t cause you discomfort. However, because you’ll only be able to eat in small amounts, you’ll need to be discriminating about what you eat – vitamin-rich foods, filled with nutrients, are ideal, while fatty, sugar-laden foods will greatly reduce the efficacy of the band.
  • What about dining out?
    Try to order small amounts of food, and eat slowly. Finish smaller meals at the same time as your dining companions finish their larger meals. You may want to let your host or hostess know that you can’t eat very much.
  • What about alcohol?
    Alcohol is high in calories, breaks down important vitamins, and can irritate the stomach lining. While drinking in extreme moderation (an occasional glass of wine or a beer) is fine, you should avoid alcohol as much as possible.

Exercise and Physical Activity

  • Why should I exercise?
    Exercise is an essential, fundamental part of healthy living.

    When you enter a weight loss program, you lose weight because the amount of food energy (calories) you are able to eat is much less than your body needs to operate. Your body makes up the difference by burning energy reserves or unused tissues – and that includes muscle and fat. If you do not exercise daily, your body will consume your unused muscle, and you will lose muscle mass and strength. Daily aerobic exercise for 20 minutes tells your body that you want to use your muscles, forcing it to burn the excess fat instead.

    As early as the afternoon after the procedure, you should be out of bed and walking around. You can build an exercise regime as the weeks pass. Remember, the goal isn’t to become a body-builder, or spend hours and hours at the gym – exercise is a tool to augment your weight-loss, to keep your muscles engaged, and to keep yourself fit and happy.
  • Does the LaparoscopicBAND limit any physical activity?
    Beyond the initial recovery period, the band shouldn’t hamper you physically at all.
  • When can I begin bathing and swimming again?
    You should shower (rather than take a bath) for the first four weeks following your surgery, and wait at least a month before you try swimming.

Behaviour and Coaching

  • How will I need to change my behaviour?
    Part of losing weight using the LaparoscopicBAND is eliminating those habits that contribute to weight gain in the first place. Adopting a nutrition plan and exercising regularly are necessary, but many behavioural and habitual changes have to do with the way you eat. Chewing regularly, eating slowly, focusing on your food without distraction, not drinking during meals, eating three meals regularly, stopping when full, avoiding food between meals, and only eating when you’re hungry are all important habits to develop.

    You’ll need to change or lose those behaviours and habits that cause you to gain weight, and foster those that help you to lose weight. The TLBC patient care program is dedicated to helping you figure out which is which, and guiding you to make the right choices.
  • How will I need to change my attitude?
    Changing your attitude goes in hand in hand with changing your habits. The goal is to develop an attitude that will help you lose weight, rather than gain it. You can do so by building a reliable support system of family, friends, and groups. Setting realistic goals and expectations, then committing to losing the weight is also crucial to success. By acknowledging your successes and failures, and building self-esteem, you can empower yourself to lose the weight, change those bad habits and live healthier.
  • What can TLBC do to help?
    At TLBC, we pride ourselves on our extensive support system. We have a section of our website dedicated to Bandsters, including a support forum, a calendar of upcoming events, and links to helpful articles and resources. We host support group meetings and seminars from psychiatric and weight-loss experts, and we have patient care coordinators available for consultations. We view your weight loss journey as something to be taken together, and we’re committed to helping you well beyond just a surgical procedure.
  • What’s a life coach?
    Bariatric life coaching is a partnership between a patient and a coach. A coach is a guide, dedicated to empowering, encouraging, and understanding your needs, your goals, your obstacles, and your strengths. Being coached means finding clarity about what you want to achieve, deepening your understanding about what holds you back, and acting on that knowledge to make desired, lasting changes in your life.

Medications and Vitamin Supplements

  • Will I need to take vitamin supplements?
    We recommend that you take some form of vitamin supplement, as it is difficult to get a complete dosage from your three small meals a day. It’s best to take chewable or liquid vitamins, to prevent blockage of the band.
  • What about other medication?
    Prescribed medication won’t interfere with band, although you may want to cut larger pills in half, or try dissolving your medication in water. Consult your doctor or pharmacist before taking medication in anything other than the prescribed way, to make sure that cutting or dissolving won’t hamper the effect of the medicine.
  • Are there any medications I shouldn’t take?
    You may want to avoid (if possible) any medications that irritate the stomach, like acetaminophen (aspirin) and non-steroidal anti-inflammatory medicine. Always consult your doctor or the Centre for a better overall analysis of your general health.
  • What happens if I become ill?
    If you require a greater food intake to help recover from a serious illness, the band can be loosened or adjusted appropriately. Once you’ve recovered, and are ready to get back on the program, it’s a simple matter of having the band re-filled. If loosening isn’t enough, the band can also be removed.

Complications

  • Will I be sick often after the procedure?
    The band shouldn’t negatively affect your health, if you are making the necessary adjustments to your eating habits. If you find yourself getting sick or nauseous on a regular basis, it may be that you’re not chewing properly, that you’re drinking while eating, that you’re eating too quickly, or that you need a small de-fill. Vomiting can cause problems for the band, so be sure to adjust your eating habits or consult your doctor if you find it a constant problem.
  • Will I suffer from constipation?
    Given the decrease in food intake, you can expect less bowel movement. If difficulties arise, check with your family doctor. A mild laxative and plenty of water usually does the trick. You can also ask our Nutritionist about fibre supplements that are recommended for weight loss surgery patients.
  • Will I need plastic surgery to get rid of excess skin?
    Because the weight loss associated with laparoscopic banding is steady and relatively gradual, excess skin is usually not a major concern, but may, of course, be present, as you will be losing a significant percentage of your excess weight. Plastic surgery is a viable option, but isn’t recommended until you’ve had a few months to adjust to the band and your new lifestyle.
  • Can I expect any discharge or bleeding from my incision sites?
    There may be some initial discharge or minor bleeding from the port site, but it should stop after 24 hours. The bandages placed over the incisions will fall off after 7 – 10 days. If you have any concerns, or there’s an abnormal amount of discomfort or bleeding, contact the Centre right away.
  • What if I develop an infection at the port site?
    Most infections, rare as they are, can be treated with antibiotics. If the port needs to be replaced, relocated, or adjusted, the procedure can be performed under a local anesthetic.
  • What can happen if I begin eating solids too soon after surgery?
    Eating solid foods before your body is adjusted to the band can induce vomiting, and can distend the upper gastric pouch. Although it is rare, it can also result in slippage of the band. It’s important to introduce solids into your diet gradually.
  • How will I know if there is a slippage of the LaparoscopicBAND?
    There are a number of symptoms that might indicate slippage of the band: acute pain, bloating, vomiting, difficulty swallowing, and a failure to lose weight. If you’re regularly experiencing any of these symptoms, contact the Centre as soon as possible.
  • Are there complications during pregnancy?
    If the band can be loosened during pregnancy, your stomach will function just like it was never banded. This allows you to eat as much food as you and your baby need, minimizing the risk of complications during that time. Plus, after birth, you can simply re-adjust your band to lose the weight you’ve gained during your pregnancy.
  • Is the LaparoscopicBAND reversible? Can it be removed?
    The band can be removed laparoscopically. Usually, the stomach will revert to its original shape. However, the band is intended as a long-term weight-loss tool, and removal is only recommended in the event of extreme complication or illness. Once the band’s been removed, it’s possible that’ll you’ll to or exceed your original weight.