The REALIZE Band Adjustments

You might be asking yourself, what sizes does the REALIZE Adjustable Gastric Band come in? Simply stated, one size fits all. That’s right, because it’s an adjustable band, it can be tailored to your individual needs.

The purpose of an adjustment is to ensure that you feel satisfied when you eat and that you are losing weight gradually, about 1-2 pounds per week.

The adjustments are done by your doctor or another healthcare professional by adding sterile saline to the band through the port. Adjustments can also involve removing saline from the band through the port.

When filling the band, saline travels from the port through the tube and into the band, making the band fit more snugly around your stomach.

Here is some additional information you should know about adjustments:

• Because your doctor wants to make sure that your stomach completely heals from the surgery, your first band adjustment won’t usually occur until 4-6 weeks after your surgery.
• Adjustments do not require more surgery. In fact, an adjustment can be made in a doctor’s office or a clinic, and usually only takes 5-10 minutes.
• An adjustment when fluid is added is referred to as a “fill”. Fills tighten the band around the stomach so you’ll feel full sooner and longer than you did before the fill, because the food will empty from your upper stomach more slowly.

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The Four Steps to an Adjustment

1. Preparing for an adjustment: You will need to have an empty stomach each time you have a band adjustment. For this reason, you should not eat any soft or solid food for at least two hours before an adjustment. You will not be asked to change into a hospital gown, so wear clothing that will allow you to easily show your abdomen.

2. Locating the REALIZE Injection Port: The clinician uses one of two methods to locate the port. Sometimes a special video image, called fluoroscopy, is used. Other times, the clinician will find the port by gently pressing on your abdomen. The REALIZE Injection Port usually takes a minute or less to locate this way.

3. Inserting (or removing) saline: The clinician will disinfect your skin. He or she will insert a fine needle through your skin down into the port. The REALIZE Injection Port’s large septum improves the clinician’s ability to locate the septum with the needle. During a fill, a specific amount of saline, usually 0.5cc to 1.0cc, will be injected into the port (as shown in the picture on the opposite page). Saline is safe and is a substance that occurs naturally in your body. The REALIZE Injection Port has puncture-resistant protection near the tubing connection. This minimizes the risk of needle puncture at the tubing.

4. Checking band tightness: Finally, the clinician will check your band tightness. You may be asked to drink one full swallow of barium while a technician takes a fluoroscopic image of your stomach; or you may simply be asked to take small sips of water to make sure you can swallow. A word of caution: If you regurgitate within 48 hours after a fill, or if food gets stuck in your upper stomach, you will need to contact your surgeon right away. These symptoms may indicate your band is too tight.

Glossary Terms

• Clinician: A healthcare professional such as a surgeon, physician, nurse, dietician, or X-ray technician.
• Fluoroscopy: A video image similar to an X-ray that shows real-time movement of internal organs.
• Barium: A compound that shows up on X-ray and fluoroscopy. When you swallow a drink that contains barium sulfate, a fluoroscope tracks the barium’s path through your digestive system.