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Post Surgery: Why Am I Seeing More And More Surgeons Put Saline In The Band At The Time Of Surgery?



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It's not a HUGE deal...but I've noticed Dr. Kuri (an experienced surgeon in Tijuana) is now banding people and putting saline solution in during surgery. A guy I talked to here on the forum said that Dr. Kuri put 3CC's in his band at the time of surgery and he had no complaints.

For me ....the thought of having 3CC's in my band (at the time of surgery) is refreshing because of the following reasons:

1) You don't have to go through Banster Hell (haha...no pain)

2) Since the surgery will be in Mexico....the closest doctor I found for a fill (and follow-up) is 4 hours away from where I live.

3) Saves me potentially $350-$500 from the first post op fills (including roundtrip money for gas)

Needless, I LOVE the idea....but why are more and more doctors putting fills in at the time of surgery? Easier transition for the patient? Patient gets to avoid banster hell ?

Thoughts?

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My doctor says that is a very risky move. The procedure causes everything to swell up. If he "filled" the band there is a possibility that combined with the swelling it could close off completely. And since there is no way to predict how much a person will swell up from surgery nor how much restriction that person will need, it is a very risky move----one he'd rather avoid.

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My doctor puts a very small amount. I went through bandster hell so it mustve been a small amount.

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I was banded right here in the USA and at my first fill my surgeon told me he had put in 2.7cc during surgery. It worked well for me and I didn't question his reasoning. He is the surgeon and has done many many successful surgeries. The weight melted off me and I reached my sweet spot with fill number 2.

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My dr. put in 3cc during surgery...funny thing was I had no idea that this happened. I just thought that the "full" feeling immediately after surgery was just part of the post surgery swelling. I was surprised when, at my first fill, the nurse removed 3 cc from the band (she "removed it" so that she could determine how much if anything was added during surgery and they we can add from there). To be quite honest...I am glad that I had the 3cc fill....it really wasn't much, but it did get me started in the right direction. I would definately tell people, if given the option, to have the dr. give a slight fill...it isn't enough to limit you...but is enought to get you headed in the right direction from the start.

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I was banded in the US and my surgeon also added 3cc at the time of surgery. But I'm sorry to report that you still go through bandster hell. At least I did.

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I didn't know until my first fill on August 1 that my surgeon had put 4 cc's in my 10 cc band during surgery. On August 1 I got a 1 cc fill and today got another 1 cc fill so I'm up to 6 cc...so far so good.

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My surgeon didn't do that because he was concerned that saline in my band combined with surgical swelling would create problems for me. But I've been hearing about surgeons giving "primer" fills for about 4 years now. It makes sense because if you put (for example) a 10cc band in 3 different patients, each with a unique stomach anatomy, the fit of that band may need to be tweaked a bit for each patient using saline.

The general purpose answer to your question is that some surgeons are more aggressive about fills than others. It's a matter of their philosophy and their own experience with patience outcomes in their patient population.

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Wow....interesting feedback here everyone !

Anybody else care to chime in with your experience and experience?

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I didn't know this until I had emergency surgery (not band related) 2 1/2 weeks ago and they to empty my band for it, but apparently my surgeon put in 1cc during surgery. I had thought that whole time I had 4cc in my band but I actually had 5cc in it.

I was told it was a "primer fill" and standard for their practice.

I currently have 4cc back in and will definitely getting another 1cc next month. I was in the perfect Green Zone before surgery so I'm confidant 1cc more will put me back there again.

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I didn't know this until I had emergency surgery (not band related) 2 1/2 weeks ago and they to empty my band for it, but apparently my surgeon put in 1cc during surgery. I had thought that whole time I had 4cc in my band but I actually had 5cc in it.

I was told it was a "primer fill" and standard for their practice.

I currently have 4cc back in and will definitely getting another 1cc next month. I was in the perfect Green Zone before surgery so I'm confidant 1cc more will put me back there again.

Thanks for chiming in.

All I know is I'm seeing more and more people getting surgeries with the fills in them. I'm sure...research and experienced lapband doctors are noticing it is MORE beneficial to give a fill while doing the surgery.

Otherwise....they wouldn't be doing it. I would like to know though if there is any research indicating this as this could be a new trend emerging with this surgery.

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I would like to know though if there is any research indicating this as this could be a new trend emerging with this surgery.

As far as I'm concerned, it's not a new or emerging trend. It's been going on for at least the 4 years I've been paying attention to patient anecdotes. You might be able to find some abstracts of research about the benefits of primer fills by searching at http://www.ncbi.nlm.nih.gov/pubmed/. There also may be information about primer fill research done in the UK, Europe, Australia and New Zealand, where the band has been in use a lot longer than here in the USA. You could also ask your own bariatric surgeon about it (assuming you have one).

Ethicon Endo's practice tools for surgeons ony give ranges for initial fills (for example, 3-4 cc for a 9 cc Realize band) and don't specify whether the initial fill should be performed at the time of band placement or in the post-op period, but they stress the importance of evaluating the patient's eating behaviors and other criteria before determining when and how much saline should be added. To me, that implies a preference for post-op versus operative fills, so surgeons who add saline during Realize band placement surgery may be doing so under their own initiative.

North American surgeons I spoke to about the Lap-Band while I was researching Bandwagon told me that Allergan doesn't dictate rigid protocols regarding things like how to select an appropriate size band for a particular patient or at what rate/timing to add saline, but you could call 1-800-LAP-BAND and see if you can coax some comments about it out of Allergan.

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My Dr. put saline in my band during surgery. Don't know how much. Didn't have bandster hell. In fact, when I went to my Dr. just to meet him they filled me, but had to take it all out.

I'm doing good!

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My Dr. put saline in my band during surgery. Don't know how much. Didn't have bandster hell. In fact, when I went to my Dr. just to meet him they filled me, but had to take it all out.

I'm doing good!

Why did they take some of the fill out? ....I'm curious!

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As far as I'm concerned, it's not a new or emerging trend. It's been going on for at least the 4 years I've been paying attention to patient anecdotes. You might be able to find some abstracts of research about the benefits of primer fills by searching at http://www.ncbi.nlm.nih.gov/pubmed/. There also may be information about primer fill research done in the UK, Europe, Australia and New Zealand, where the band has been in use a lot longer than here in the USA. You could also ask your own bariatric surgeon about it (assuming you have one).

Ethicon Endo's practice tools for surgeons ony give ranges for initial fills (for example, 3-4 cc for a 9 cc Realize band) and don't specify whether the initial fill should be performed at the time of band placement or in the post-op period, but they stress the importance of evaluating the patient's eating behaviors and other criteria before determining when and how much saline should be added. To me, that implies a preference for post-op versus operative fills, so surgeons who add saline during Realize band placement surgery may be doing so under their own initiative.

North American surgeons I spoke to about the Lap-Band while I was researching Bandwagon told me that Allergan doesn't dictate rigid protocols regarding things like how to select an appropriate size band for a particular patient or at what rate/timing to add saline, but you could call 1-800-LAP-BAND and see if you can coax some comments about it out of Allergan.

VERY informative post Jean. Many thanks for your contribution. Didn't know that fills (during surgery) has been going on for 4 years. To me (when I get my surgery in Tijuana with Dr. Kuri), I'm going to want him to give me a fill -- barring he thinks its beneficial ...which I wouldn't assume he wouldn't because he apparently has given them to his other patients.

Thanks again for chiming in !

Blessings !

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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
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      1. summerseeker

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