It is important to understand the 3 phases of the LAP-BAND® experience: Pre-op preparation, the "immature" LAP-BAND®, and the "mature" LAP-BAND®.  Special dietary considerations are required for each phase.

1 - Pre-op Phase

In order to accomplish placement of the LAP-BAND®, a space in front of the stomach must be created by elevating the liver.  Normally, the liver acts as a storage organ.  As a three dimensional organ the liver enlarges both top to bottom and front to back.  The front to back dimension can be problematic during laparoscopy if the liver cannot be elevated off the stomach because the abdominal wall limits the amount of elevation.  Therefore, we required our patients to maintain a high protein/low carbohydrate diet prior to LAP-BAND® surgery.  Specifically, this means no bread, no pasta, no rice, no potatoes.  The duration of the diet depends on the BMI: 7days for BMI's under 40, 10 days for 40-50, 14 days for BMI's over 50.

2 - The "Immature" LAP-BAND® Phase

The "immature" phase starts with placement of the band.  The band is placed but is not filled with saline.  If the stomach slides under the band and piles up above the band, this is called slippage.  A surgical procedure may be required to reverse the slippage.  Therefore, at the time of band placement, sutures are placed in the stomach below the band to stomach above the band in order to prevent slippage of the stomach.  It takes 3 weeks for soft tissues to heal.   During this period vomiting or dry heaves could cause the sutures to tear through the stomach muscle. 

In the first 24 hours post-op, patients are at risk for vomiting because of the anesthetic agents used in addition to swelling of the stomach from being manipulated during the procedure.  The swelling usually resolves over 4-5 days.  Clear liquids are recommended during this early "immature" phase.  Protein shakes and soups are acceptable.  Gradually over time, using just common sense, the diet is advanced to so-called full liquids (oatmeal, yogurt)  are  used.  Solid foods prepared in a food processor are allowed into the LAP-BAND® diet during this phase.  Patients should focus on foods with high nutritional value rather than foods that contain a lot of sugar or “empty calories.” Then soft foods such as fish can be tried.  The goal during this phase is "Not to Vomit" so the stomach heals and slippage is avoided.

3 - The "Mature" LAP-BAND® Phase

The "Mature" phase begins with the first fill.  Saline is injected through the port into the band and the passage way through the band is narrowed.  Solid foods are then encouraged so the food stays in the pouch longer and the patient feels satisfied.  Each patient will have to determine by trial and error  the capacity of their pouch.  Vomiting may occur but now the stomach is healed so tearing of the stomach muscle is unlikely.

4 - Guidelines for the "Mature" LAP-BAND®

Eat when you are hungry; don't eat if you are not hungry.  Avoid opportunity eating (because food is there or because it's noon time).  Avoid useless calories which go through the band without creating a full feeling. Most important to the LAP-BAND® diet, stop when you are full.