Approaches to Adjustments

1. The office adjustment. Involves making adjustment decisions on the basis of weight loss and the symptoms of the pacient.
2. The radiographic adjustment. Involves making decisions that also incorporate the additional information derived from barium swallow examination.

Indicators for adjustment of the LAP-BAND in the office

Consider adding fluid

• Inadequate weight loss
• Rapid loss of satiety after meals
• Increased volume of meals
• Hunger between meals

Consider removing fluid

• Vomiting, heartburn, reflux
• Difficulty coping with broad range of foods
• Maladaptive eating behavior*

*Usually characterized by the consumption of high-calorie liquid or very soft foods, and is often induced by an overly tight band.

Copyright 2007 Luis Zarate