Medical Weight Loss Centre

It is the most commonly asked question off the site, and also one of the hardest to accurately answer.

There are a number of factors that impact on the ultimate cost. Not only do you need to pay for a surgeon, you will also need to budget for hospital fees, and anesthetist fees. Some of that cost may be refunded to you by your insurer and Medicare, which can significantly reduce the burden. The refunds may be less than you expect, so it is important to check with your insurer and Medicare regarding what level of cover they provide.

Ultimately, the surgery should also save you money. Your future medical bills and general cost of living will be reduced. This long term positive effect can balance out the short term costs relatively quickly.

We strongly recommend that you contact us for a detailed quotation that takes into account your full medical circumstances. However, as general guidance, we suggest that uninsured patients with no private cover will probably need to budget for around $14,000 of up-front expenses for the procedure itself.

If you have private health insurance, out of pocket expences of roughly $4000 can be expected.

The Laparoscopic ASGB System Lap Band was developed to improve the gastric banding procedure and to allow the procedure to be conducted laparoscopically through 6 small puncture wounds. This results in less post operative pain and more rapid recovery. The Lapband can be adjusted without requiring another operation.

The Lapband is approximately 1.2 cm wide. It is made of soft, silicone rubber with an internal Dacron material to prevent it from stretching. The Lapband has an inflatable section which is connected by tubing to an injectable reservoir. This band is place around the stomach in such a way that the stomach is divided into two parts: a small 25ml capacity pouch above the band with the remaining stomach below the band. The silicone band also creates a small opening 1.3cm in diameter that is adjustable between the two parts of the stomach for the passage of food. The reservoir will be located below the left rib cage and buried in the abdominal wall muscles. The inflatable section will enable the surgeon to adjust the size of the opening after surgery, by inserting a needle, perhaps under x-ray control, through the skin whether removing or injecting saline.

1. Be more than 50% above your ideal weight;
2. Be at least 16 years of age;
3. Have been obese for at least 5 years;
4. Have been unable to lose weight by other non-surgical methods, such as supervised diet or behaviour modification programs;
5. Have no medical problems that are causing your obesity;
6. Be willing to accept significant changes in eating habits;
7. Be willing to participate in post-operative follow-up visit at your Surgeon’s office and to have 6 monthly blood tests.

You may initially be nauseated but this usually settles within 48 hours. You may feel some pain in the shoulder (from the gas), again this is normal and should settle in a day or two.
You may feel a little gassy in the stomach, moving around i.e. gentle walking should help to settle this.

If all is well you will be discharged before lunch the day after surgery.

The dietitian will have given you instructions on the fluids and pureed phases, it is important to follow this information carefully.

The lap band is initially placed without any fluid added, this is to allow the rapid recovery and fluid will be added at around 4 weeks post op, with further adjustments as necessary

The Lap Band is initially placed loosely around the stomach to allow for rapid recovery. It is not, therefore, restrictive initially, it is adjusted 4 weeks after surgery if necessary and adjustment repeated until optimum restriction is reached.

Successful weight loss is dependant on the patient adopting proper eating techniques, making nutritious food choices and accepting dietary restrictions.

PATIENTS MUST GIVE SERIOUS CONSIDERATION AS TO WHETHER THEY FEEL THEY WILL BE PREPARED TO ACCEPT THE RESTRICTIONS IMPOSED ON THEM BY THE SURGERY BEFORE THEY COMMIT TO A BAND.
A band will reduce the volume of food you can fit into your stomach, or now “pouch” at any one time.

Meal sizes are that of a childs meal served on a bread and butter sized plate, or eaten out of a small bowl.  Modification to your food choices i.e. nutritious low calorie foods are best choices, and eating habits i.e. eating slowly and chewing well, may be required and all of these should be considered before undertaking the procedure.

Our Dietitian will explain the 5 dietary phases to you in detail.

Phase 1  7 days pre surgery meal replacement program
Phase 2 4 days post surgery liquids
Phase 3 7 days pureed diet
Phase 4 7 days soft diet
Phase 5 full diet

If all is well you will start on a fluid diet the day following surgery and then progress through the phases

The success of your band depends upon HOW YOU MANAGE THE BAND and the following are all important components

• Understanding which foods to choose and being very cautious with foods that may be problematic i.e. doughy breads – your dietitian will cover foods choices with you in detail after the surgery
• Modify HOW you eat, those used to eating quickly, not chewing food well, grabbing a snack on the run will need to learn how to modify these habits so as to reduce the likelihood of foods getting stuck and causing vomiting.
• Being careful with food quantities, especially in the first 4 weeks after surgery the pouch may be distended by over eating, this may cause the band to slip down the stomach causing vomiting and at worst necessitate further surgery to correctly position the band.
• Choose nutritious healthy foods.  Your food volume is restricted so it is important to choose quality foods when quantities will be small.
• Avoid foods and liquids high in calories - milk shakes, ice creams, chocolates will all go through the band easily and will slow down rate of weight loss if consumed in quantities.
• Alcohol and fizzy drinks will not be well tolerated; indeed fizzy liquids should be avoided for at least 6 months post surgery.
• Look after your bowels –constipation can be an issue whilst following the post surgery diet and you may need to take a supplement such a Metamucil
• Ensuring adequate fluid intake, at least 1.5 litres daily is also important to help reduce the problem of constipation
• You will need to take a multi vitamin for the rest of your life and blood tests for iron, Vitamin B12 and folic acid should be undertaken each 6-12 months for the first 2 years.

The role of the band is to reduce food volumes, by reducing stomach size.  As hunger receptors are located on the lining of the stomach wall you will have less of them thus feel less hungry.  Indeed if well managed you should feel reduced hunger levels.

The exception to this can occur at around 4 weeks when you may be ready for your first top up.  You may indeed feel quite hungry and if this is the case a discussion with Dr Baxter or our dietitian can provide you with tips to help you manage this.

Fluid is added at 4 weeks, then as necessary –It is important to keep the band tight enough as to provide restriction of volume but not too tight that it will not allow adequate nutrition.  Your surgeon and dietitian will guide you as to when these tops ups are required.  These tops ups are conducted in Dr Baxter’s rooms and there will be a fee which there is a rebate from Medicare.

If you cannot attend please contact us and let us know how you are managing.

If you are having any problems it is important to notify us at an early stage, do not wait until your condition deteriorates if you are unwell.

As mentioned regular follow up is important and you do need to be monitored regularly – studies show those patients monitored regularly have by far the best outcomes.

The following information is a general guide and gives advice on what to do if you have problems between adjustments.

1. After you have had a top up (adjustment) of your band, have a drink of water before you leave the surgery to make sure fluids go down easily.  You are encouraged to stick to fluids for the next 12-24 hours (shakes, soups etc).  This gives the fluid in the band a chance to settle down around the band.  You can then start back on your normal diet.  Remember to start out slowly, take your time and sit down to eat, and chew your food well until you are comfortable with your band adjustment.

2. If after your adjustment you run into problems, e.g. develop gastroenteritis (tummy bug) or can’t get solids or fluids down and continue to vomit, STOP all solid foods to give your stomach a chance to rest.  Stick to fluids only until you can get an appointment with our rooms. When taking fluids take small sips or even suck ice.  If you have problems early in the week, please don’t wait until Friday to try and have fluid out, there is not always a Doctor on duty in our rooms on Fridays. If problems occur over the week end and you can’t keep any fluids down you will need to present to either -

• Nambour General Hospital –Present to the emergency department. PLEASE when presenting to any hospital outside our care make sure the Doctors use a NON-CORING port-a-cath needle, this is very important as the use of a normal needle may core a hole in your port.

• Wesley Hospital (Brisbane)- They are familiar with band patients but always remember to mention the use of a non-coring port-a-cath needle.

If fluid is taken out due to complications, it is advisable to wait at least two weeks before putting fluid back in.