The first step is to call Dr. Minkin’s office at 314-965-8410 and schedule an appointment to meet with him personally. Free educational seminars with question and answer session given by Dr. Minkin are available on weekday evenings every 2 weeks and are highly recommended but not required. See the “Calendar of Events” page for available seminar dates.
After the skin has been “stretched out” for many years, rapid weight loss can result in loose skin. This can develop whether the weight is lost with dieting, medication or surgery. The amount of loose skin and where it is located will depend on many factors such as age, amount of weight lost, body weight distribution and whether or not the patient smokes. After the majority of weight is lost and if loose skin is presenting an issue, Dr. Minkin will discuss treatment options with you.
Yes, caffeine is not an issue after lap-band surgery. Carbonated beverages should be avoided however.
No. Unlike the gastric bypass surgery there is no “re-routing” of the intestinal tract and no malabsorption. Lap-Band patients should take a multivitamin and calcium supplement daily by mouth.
All patients are seen at one week and one month postoperatively. After that, patients are seen every 6 – 8 weeks for the first year. After the first postoperative year, the follow up visits are spaced out further. Of course, patients can always call with any questions and be seen at any time if there are any concerns.
Most adjustments are done in the office and take about one minute. Dr. Minkin will also selectively perform adjustments under x-ray with oral contrast if needed for more accuracy, or if direct evaluation of the band’s position or upper stomach pouch is needed. These take about 5 minutes.
The Lap-Band operation is a safe and excellent choice for young women who plan to have children in the future. The adjustability of the band allows it to be either tightened or loosened at any time. In cases of pregnancy, notify Dr. Minkin immediately and he will instruct you to keep a detailed food diary for 2 weeks. After this, you will meet with Dr. Minkin and the Bariatric Nutritionist. If you are consuming adequate calories, protein, etc. for yourself and the developing baby, the band is left alone. If need be, we can loosen the band and reevaluate. The lap-band device can always be “tightened back up” after delivery of the baby.
In nearly every case, yes you can. Dr. Minkin has safely performed many lap-band operations on patients who have had gallbladder surgery, hernia surgery, bowel resections, open heart surgery and heart valve replacement surgery. He has also performed lap-band surgery on wheelchair bound patients and is also listed with the Jehovah’s Witness Medical Registry. Dr. Minkin is one of only a few Lap-Band surgeons who will selectively perform Bariatric Revisions, and has safely placed Lap-Bands in patients who have had gastric bypass surgery and vertical banded gastroplasty stomach staplings in the past.
If you have a known hiatal hernia, or if Dr. Minkin diagnoses you with a hiatal hernia before surgery, he will repair it laparoscopically at the time of the Lap-Band operation. Similarly, if you have known gallstones or if these are diagnosed before surgery, Dr. Minkin will remove the gallbladder laparoscopically at the time of the lap-band operation as well.
Patients having the operation spend approximately 1 hour in the recovery room after surgery. You then move to a hospital room where you are encouraged to sit up, walk and use the restroom. After surgery there is no tube in the nose or catheter in the bladder. Most patients spend 24 hours or less in the hospital and are discharged home. When you get home you can go up and down stairs and walk as much as you want. Showers are allowed in 24 hours. Patients are seen in the office one week after surgery and can drive themselves to their first follow up appointment. Most patients will return to work in 7 – 10 days.
The Lap-Band operation takes approximately 45 minutes to complete. Operative times can vary depending on the size of the patient, presence of scar tissue from previous operations and whether or not a concomitant operation needs to be performed (gallbladder removal or hernia repair).
The Laparoscopic Adjustable Gastric Banding procedure is the safest, most least invasive operation we have available for weight loss today. It has rapidly gained popularity due to its excellent combination of safety, effectiveness, adjustability and reversibility. The complication rate for the operation is well below that of the other operations available for weight loss today.
For most people the procedure is covered by insurance, and the procedure is covered by Medicare. If, on your own, you would like to investigate this you should get out your insurance card and call the number on the back. Let them know you are interested in having a lap-band operation done and give them the CPT code 43770. Of course, Dr. Minkin’s office staff will verify insurance coverage for you and investigate any specific requirements your particular insurance company may have for you. The office will also apply for any precertifications, file any appeals or perform any peer-to-peer discussions if necessary to gain insurance approval for you. If you do not have insurance coverage, a cash pay option is available and these patients follow a “Fast-Track” process to surgery. Financing is available as well.
Yes. It is a permanent implantable device and similar to an artificial joint, mesh from a hernia repair, filling in your tooth, pacemaker, stent in the heart, etc., it is made to stay in forever. It is a reversible procedure. At any time any portion of the system can be revised, replaced, or the entire lap-band system removed. This can nearly always be done laparoscopically.
Absolutely! Many studies looking at long term results have found the average weight loss with the lap-band to be between 55-65% of excess body weight. Many patients do better. If the procedure is done correctly, the patient is given the proper guidance and follow up, and the patient follows the appropriate dietary and lifestyle recommendations, then it is a recipe for success!