Any gastric operation for obesity is major surgery and carries with it the risks associated with any complex operation. Although the Lap-Band® procedure is minimally invasive surgery, it is not without its own risks (laparoscopic surgery risks include: spleen, liver, or intestinal damage; damage to major blood vessels, lung problems, blood clots, esophagus/stomach perforation).

In very rare cases, the Lap-Band® surgery cannot be performed using the less invasive laparoscopic approach. For example, if unforeseen problems arise while attempting to position the band, surgeons may have to switch to an open method. In addition, later there can be serious complications that may warrant deflation or the removal of the Lap-Band® including:

• - Slippage of additional stomach tissue under the band

• - Erosion of the band into the stomach (the Allergan Advanced Platform System® 360 degree Omniform technology which places soft, even pressure around the entire stomach, decreasing the incidence of erosion

• - Infection and/or breakage of the injection port

• - Esophageal dilation

• - Band Deflation - the Allergan Lap-Band® comes with a lifetime warranty from the manufacturer for mechanical defects with the band

• -Obstruction of the stomach, nausea or vomiting may occur

While removal of the band can often be done laparoscopically, in some cases it may require open surgery. Serious problems such as peritonitis, infection, leaks, and long-term nutrition problems such as iron and vitamin deficiencies that are seen with gastric bypass surgery do not occur with the Lap-Band® as there are no alteration of your digestive system other than placement of the band around the upper stomach.. Re-operation rates for gastric bypass are significantly higher due to leaks, bowel blockages, outlet scarring, ulcers, bleeding, and pouch dilation

The Lap-Band® does not hamper physical activity including aerobics, stretching and strenuous exercise.

Adjustments are frequently done with x-ray. They are done with x-ray so that the access port can be clearly seen. Sometimes adjustments can also be done an by "palpation" not requiring x-ray. Local anesthesia is not required. A fine piercing, noncutting needle is passed through the skin into the access port to add or subtract saline. The process most often takes only a few minutes and most patients say it is painless.

There are no restrictions based on the access port. It is placed under the skin and fat, sewn to the muscle of the abdominal wall. Once the incisions have healed it should not cause discomfort or limit any physical exercise. The only sensation you may experience from the port occurs when you go in for adjustments. If you feel persistent discomfort in the port area, talk to your doctor.

Although the Lap-Band® System is a long-term implant and not meant to be removed. It can be, in most cases, be removed laparoscopically if desired by the patient or medically indicated. Surgeons report that the stomach generally returns to its original shape once the band is removed. After the removal, though, you may soon go back up to your original weight. You may also gain more.

That is not always the case. As a rule, plastic surgery will not be considered for at least a year or two after the operation as, sometimes the skin will mold itself around the new body tissue. Give the skin the time it needs to adjust before you decide to have more surgery. The slower weight loss associated with the Lap-Band® makes skin revision less likely to be needed than with the gastric bypass.

Order only a small amount of food, such as an appetizer. Eat slowly. Finish at the same time as your table companions. You might want to let your host or hostess know in advance that you cannot eat very much. Dr. Collier will provide you with a identification card indicating that you have had a gastric restrictive procedure. This is accepted by a growing number of restaurants, allowing you to oder half order portions or perhaps off of the children's menu. Many patients will simply split an order with a companion or have have half of the order placed in a "to go box" while placing their order.

After your stomach has healed, you may eat most foods that don’t cause you discomfort. However, because you can only eat a little it is important to include foods full of important vitamins and nutrients, as advised by your surgeon and/or dietitian. If you eat foods that contain lots of sugar and fat or drink liquids full of “empty” calories, such as milkshakes, the effect of the Lap-Band may be greatly reduced or even cancelled.

The mortality rate is extremely low for Lap-Band® surgery, less than 0.05%.

No, most of the time blood loss is minimal.