Adjustment of Gastric Band Diameter via Subcutaneous Port by Injection or Aspiration of Saline (S2083)

Name of the Procedure:

Common Name(s): Gastric Band Adjustment, Lap Band Adjustment
Technical/Medical Term: Adjustment of Gastric Band Diameter via Subcutaneous Port by Injection or Aspiration of Saline

Summary

This is a minor medical procedure used to adjust the size of a gastric band, which is a device placed around the upper part of the stomach to help with weight loss. The adjustment is done by injecting or withdrawing saline (saltwater solution) through a port located under the skin.

Purpose

Medical Conditions/Problems Addressed:
The procedure is aimed at patients who have undergone gastric band surgery for weight loss and need adjustments to optimize their results.

Goals/Expected Outcomes:
The primary goal is to control the band's tightness to ensure proper restriction of food intake, thereby aiding in weight loss. Adjustments ensure the band is neither too tight nor too loose, achieving optimal performance.

Indications

Specific Symptoms/Conditions:

• Insufficient weight loss or weight gain
• Difficulty swallowing (dysphagia)
• Persistent vomiting
• Feeling of satiety too quickly or not feeling full after eating

Patient Criteria/Factors:

• Patients with an existing gastric band
• Individuals experiencing suboptimal weight loss or complications related to the band tightness

Preparation

Pre-Procedure Instructions:

• Patients might be asked to fast for a few hours before the procedure.
• Instructions to avoid certain medications that could affect the procedure may be provided.
• A physical examination and relevant medical history review will be conducted.

Diagnostic Tests/Assessments:

• Barium swallow study (if required)
• Routine blood tests to ensure general health is stable

Procedure Description

Step-by-Step Explanation:

1. The patient lies down in a comfortable position.
2. The healthcare provider locates the subcutaneous port (a small device under the skin connected to the gastric band).
3. The port area is cleaned with an antiseptic solution.
4. A saline solution is either injected into or withdrawn from the port using a special needle, which adjusts the band's tightness.
5. The amount of saline is modified based on the patient's symptoms and feedback.
6. The needle is removed, and a small bandage is applied to the port site.

Tools/Equipment/Technology:

• Sterile needle and syringe
• Saline solution
• Antiseptic solution
• Subcutaneous port locator (if needed)

Anesthesia/Sedation Details:

• Typically, no anesthesia or sedation is required.
• A local anesthetic might be applied if the patient feels discomfort.

Duration

The procedure usually takes about 10 to 30 minutes.

Setting

Where Performed:

• Outpatient clinic
• Surgical center
• Doctor's office

Personnel

Healthcare Professionals Involved:

• Surgeon or qualified gastroenterologist
• Nurse or medical assistant

Risks and Complications

Common Risks:

• Minor bleeding or bruising at the port site
• Discomfort or pain during the adjustment

Rare Risks:

• Infection at the port site
• Damage to the port or tubing
• Over-adjustment leading to band slippage or excessive restriction

Complications Management:

• Antibiotics for infections
• Reversal of adjustments if over-tightening occurs

Benefits

Expected Benefits:

• Improved effectiveness of the gastric band for weight loss
• Alleviation of discomfort or eating difficulties

Timing of Benefits:

• Benefits are typically realized soon after the procedure, within days.

Recovery

Post-Procedure Care/Instructions:

• Patients can usually return to normal activities immediately.
• Monitor for signs of infection (redness, swelling, or pain at the port site).

Expected Recovery Time:

• Immediate; minimal downtime required.

Restrictions/Follow-Up Appointments:

• Eat soft foods initially after adjustment.
• Scheduled follow-up appointments to monitor progress and make any necessary additional adjustments.

Alternatives

Other Treatment Options:

• Lifestyle and dietary modifications
• Revisional bariatric surgery if the gastric band is not providing the desired results or causing complications

Pros and Cons of Alternatives:

• Lifestyle changes are non-invasive but may not be sufficient for all patients.
• Revisional surgery can be more effective but carries higher risks and a longer recovery time.

Patient Experience

During the Procedure:

• Patients may feel a slight pinch or pressure when the needle accesses the port.
• Most adjustments are quick and cause minimal discomfort.

After the Procedure:

• Some soreness at the port site may occur but can be managed with over-the-counter pain relievers.
• Immediate feedback on eating habits can be assessed to ensure optimal adjustment.

Pain Management and Comfort Measures:

• Local anesthesia for skin numbing if necessary
• Post-procedure instructions for managing any discomfort