Dear Doctor: I had gastric banding surgery and have just become pregnant. Do I need to have the band removed?

Answer Provided by Walter Medlin, MD, FACS

Summer 2015

No, you do not need your gastric band removed during pregnancy!

There are a couple of important points to keep in mind, though:

Make sure you have an expert surgical team available. There are plenty of other caregivers who say they are “knowledgeable” or “familiar” or “comfortable” handling band issues. Unless they have a surgeon in the office, you need to take control and get that extra appointment. Plan to meet with a bariatric program dietitian during your pregnancy, and to have monthly phone calls or telemedicine visits.

Band Adjustments

You do not automatically need to have the band adjusted, but you want to have that relationship “on your speed dial” so that urgent adjustments can happen in a day or two, and also so that you are on the lookout for more subtle changes that may help you avoid a crisis.

Some less experienced providers will jump to completely empty the band, which is not always needed, and can result in excess weight gain.

Of course, it is best if you have kept up a steady relationship with your original surgeon. He or she will know the most about your anatomy, and have records on hand. He or she may recommend a yearly barium swallow to check your band position and function. You definitely want to consider this before any pregnancy, if possible. Even though shields can be used, your healthcare provider will avoid any “elective” use of x-ray once pregnant.

Addressing Problems during Pregnancy

If you are having problems during a pregnancy, that is another matter. All of your providers need to have your important health information, so do not be afraid to remind them. Our office has a trans-nasal endoscope that allows us to inspect the inside of the stomach in the office with no sedative medications. We almost never use this during pregnancy, but it can be a valuable tool.

Your time after pregnancy is also important. Get back in with your program dietitian ASAP – and get regular with a support group and a trainer. Post pregnancy metabolism is not a trap, but there are a lot of moving targets and you need all the angles covered.

Conclusion

A happy mom means a happy family. Taking care of yourself is never harder than this, but your family will benefit from your self-care as well as from your self-sacrifice.

About the Author:
Walter Medlin, MD, FACS, is a bariatric surgeon in Utah and sleeve gastrectomy patient now five years post-op. He is a member of the OAC National Board of Directors and tweets @bonuslife.

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