Gastric band adjustment

What is a gastric band adjustment?

Your surgeon has inserted an adjustable band around the upper part of your stomach to limit and control the amount of food you eat. There is a small port attached to the band. This port is just under the skin which you may be able to feel. Fluid can then be injected or withdrawn to adjust the size of the band. This enables you to feel full sooner, and the feeling lasts longer.

Your band is usually adjusted 6–8 weeks after surgery, then as needed after that. You may need a number of visits to the X-ray department before the band is adjusted to the right tightness for you.

Risk and benefits

The benefit of this procedure is that it will help you lose weight without requiring further surgery. You should ideally be achieving a weight loss of 1 kg (2.2 lb) each week. You should reach your target weight over a period of 2 years.

It is a safe and quick procedure and does not require admission to hospital.

This procedure can also be used to check if there are any problems, such as an enlarged gastric pouch, or whether the band has slipped or is leaking. There are no major risks to this procedure. Sometimes the band is unable to be tightened because the port has moved into a position that can’t be accessed. If the band is too tight you may vomit or feel that the food gets stuck. If the band is too loose, you may notice that you are not losing much weight.

There is a very small risk of infection at the port site which can usually be treated with antibiotics. In some cases it will require port and band removal.

Day of the procedure

You must not have any food for 4 hours before your procedure and no drink for 2 hours before your procedure. Please come to the X-ray reception (1st Floor, Lift Bank D) 15 minutes before your appointment. If you are late, it may not be possible to carry out your procedure and it will have to be rebooked.

Private patients: Please come even earlier and pay first at the private patients cashier (4th Floor, Lift Bank D). Bring the receipt with you to X-ray.

Before the procedure

In the X-ray department you will be seen by a doctor who will discuss the procedure with you. Please ask any questions you may have as it is important that you understand what is going to happen.

If you are female, you are advised not to get pregnant for 12 months after your band was inserted. However, please let us know if there is a chance you could be pregnant before your procedure. All females of child-bearing age will need to sign a pregnancy disclaimer form.

During the procedure

In the procedure room you will lie on a special X-ray table. The area over your port will be cleaned with antiseptic fluid and you will be covered with a sterile drape. The doctor will give you an injection of local anaesthetic to numb the skin over the port site. This will cause some stinging initially and then go numb. The procedure should not cause you any pain.

Using the X-ray machine, the doctor will place a special needle into the port. When the needle is in place, the doctor will ask you to drink a special drink (called barium) which will show up on the X-ray pictures. We can then see how much the band needs adjusting.

The doctor will insert some fluid through the needle into the band so that the drink will move through the band slowly. It is important to let the doctor know if you feel any discomfort while swallowing at this point. The procedure will take about 15 minutes, but may take longer.

After the procedure

You will be required to stay in hospital for about 30 minutes. During this time you will need to eat something. Please buy or bring some food from home that is of yoghurt-like consistency.

If you are struggling to swallow, please come back to the X-ray department

At home

It is important that you follow the advice from your dietitian regarding what to eat. We recommend that you eat a puréed meal the evening of your procedure. The following day you should be able to eat your normal diet.

If you are having problems with vomiting, try reducing your portion size, ensure you are chewing your food well, and eat slowly. There are some foods that you will find best to avoid. These are different for everyone.

If you are still having a problem with vomiting, your band may be too tight. Keep taking small sips of water so you don’t get dehydrated. Please ring the clinical nurse specialist on 020 3315 8604 to discuss.

If this occurs over the weekend please go to your nearest A&E. 

Contact information

Interventional Radiology Department
Chelsea and Westminster Hospital
369 Fulham Road
London
SW10 9NH
T: 020 3315 8570/8582 

Nuala Davison
Bariatric Clinical Nurse Specialist
T: 020 3315 8604