The silicone band can be tightened or loosened over time to change the size of the passage. Realize Band is the brand name of an adjustable gastric band developed in Sweden in 1985 by Ethicon-Endo Surgery, the medical devices division of Johnson & Johnson, generally known as Swedish Adjustable Gastric band or SAG-BAND. Over 200,000 Swedish band surgeries were performed across the world since it's U.S. Food and Drug Administration approval in 2007.

Similar to the Lap-Band system, the Realize Band is a restrictive type of weight loss surgery. It comprises two devices that are implanted at the same time during surgery.

The Realize Band is made of a strong, flexible silicone. A bariatric surgeon would wrap the band completely around the upper part of your stomach. This creates a small pouch and a narrow passage to the lower stomach. This small passage delays the emptying of food from the pouch and causes a feeling of fullness.

A soft balloon inside the band comes into direct contact with the stomach. This balloon holds up to 1.8 teaspoons of saline solution.

The second implant is called the Realize Injection Port, and it is attached to the abdominal wall under the skin. It is used for fills or adjustments. During fills, your surgeon injects saline into the port to tighten or loosen the Realize Band. These adjustments are made periodically based on weight loss, food cravings and other physical reactions to the surgery. The Realize Band and port are connected by a hollow tube.

Adjustable gastric banding with the Realize Band is usually performed laparoscopically, meaning that your surgeon makes small incisions as opposed to one large incision. He or she inserts a viewing tube with a small camera (laparoscope) and other tiny instruments into these small incisions to perform gastric banding.

Gastric banding surgery with the Realize Band takes about one to one-and-a-half hours to perform. It can be done on an outpatient basis or may require a one-day hospital stay.

The adjustable gastric band is placed around the uppermost part of the stomach, dividing it into two parts: a small upper pouch and a lower stomach. The upper pouch can only hold about 4 ounces (1/2 cup) of food. This means you eat less food at one time, feel full sooner, and feel satisfied longer. That makes it easier to adopt—and stick with—healthy eating and lifestyle habits.

No part of your stomach is stapled or removed during surgery and your intestines are not rerouted, so you can continue to absorb nutrients from food.

How the band impacts weight loss
The Realize Band is made entirely of biocompatible materials and has a soft balloon that fits around the stomach. The amount of saline in the balloon controls the tightness around your stomach. (The balloon can hold up to 1.8 teaspoons of saline.)

The degree of band tightness affects how much food you're able to eat during a meal and the length of time it takes for food to leave your stomach pouch (on its way through your digestive system). As a result, you'll feel fuller sooner and stay fuller longer. As the Realize Band helps you eat less food, your body will stop storing excess calories and start using its fat energy supply.

The low-profile Realize Port
Saline, which controls the tightness of the band, is delivered into the balloon through a port connected to thin, flexible tubing. The port is made from an implant-grade medical plastic and silicone. It is usually fastened about two inches below the rib cage on the left or right side. The exact location will depend upon your body shape and your surgeon's decision. The port is attached during the gastric band procedure.

Once in place, the Realize Injection Port is completely enclosed inside the body. It has the lowest profile of any injection port,33 to minimize its appearance under the skin, even as you lose weight. But it's easy for your surgeon to locate. This helps make band adjustments fast and easy for you, too. You may be able to feel the port by gently pressing on your abdomen, but otherwise you probably won't notice it at all.

Band adjustments
Your first band adjustment will probably be scheduled 4 to 6 weeks after your surgery. As you lose weight, your band will be adjusted to your individual needs. Regular band adjustments ensure the amount of saline in your band (often called a fill level) is appropriate and comfortable for you. Adjustments are simple procedures made at your surgeon's office.

How is the band implanted?
The Realize Adjustable Gastric Band is implanted using laparoscopic surgery while you’re under anesthesia. Laparoscopic surgery involves small incisions. That means a shorter hospital stay, faster recovery, smaller scars, and less pain than open surgical procedures.

How laparoscopic surgery works
A small incision (less than 1/2 inch) is made near the belly button. Carbon dioxide (a gas that occurs naturally in the body) is introduced into the abdomen to create a work space for the surgeon. Then a small laparoscopic camera is placed through this incision into the abdomen.

The camera sends a picture of the stomach and abdominal cavity to a video monitor. This gives the surgeons a good view and access to key structures in the abdominal cavity. A few additional small incisions are made in the abdomen. The surgeon watches the video monitor and works through these small incisions using instruments with long handles to complete the procedure. The surgeon creates a small circular tunnel behind the stomach, inserts the gastric band through the tunnel, and locks the band around the stomach.

If you’re like most people, surgery makes you anxious. Understanding what’s involved can ease your concerns. By attending an informational seminar, you'll get a better idea of the surgery experience by learning what happens on the day of surgery and what expectations you should have for recovery.

The Realize Adjustable Gastric Band is intended for long-term use
The Realize Band is intended for long-term use. At this time, no evidence suggests that it will need to be replaced, except in the event of a complication.

Because gastric banding surgery does not permanently change the anatomy of the stomach and intestines, the Realize Band can be removed if necessary. Please keep in mind that reversal surgery is not simple, and weight gain is usually observed in people who have their bands removed and do not continue a healthy eating regimen.

• Eating small meals each day. These meals should comprise about four ounces of food (half a cup).
• Not snacking between meals.
• Sipping eight, 8-ounce cups of low-calorie, non-carbonated beverages a day.
• Avoiding carbonated beverages, as carbonation may temporarily block the stoma (stomach outlet), causing discomfort and increased burping.
• Not drinking and eating at the same time, which may increase the chance of discomfort, regurgitation and vomiting.
• Changing your vitamins to chewable or liquid and crushing or breaking up medications so they are easier to digest.
• Chewing slowly and thoroughly and waiting a few minutes between each bite.
• Avoiding foods that may block the stoma. Some common culprits include bread, pineapple, celery, high-fiber foods and non-tender cuts of red meats.
• Heeding the warning signs. Pressure at the top of your stomach or hiccups means the upper stomach is full. Continuing to eat past these signals is not wise and may increase discomfort. Regurgitation, nausea, acid reflux, constipation and diarrhea may be signs to eat less, eat more slowly, chew thoroughly or eat different types of food. (Abdominal pain that lasts more than three hours is not normal. Contact your doctor if this occurs.)

Individual experiences with food and eating after any gastric banding surgery with the Realize Band may vary. It is important to pay attention to your body and how you feel when you eat different foods at different times. Talk to your surgeon or a registered dietician about any problems you experience, as he or she will be able to offer tips on how to tweak your diet and eating habits. Keeping a journal of what you eat and how it makes you feel can aid in this effort.

Exercise is also an important part of life after Realize Band surgery. Aim for 20 to 30 minutes of aerobic activity three to four times a week. Think walking, cycling, swimming and jogging. Weight or strength training is also important. Clear it with your health care team before you begin weight training after surgery.

Realize Band surgery includes an interactive, Web-based support program. The program has four sections, covering nutrition, fitness, progress (such as weight loss and fill schedule) and obstacles. You can develop personalized eating and fitness plans with this program.

• Migration of implant (band erosion, band slippage, port displacement)
• Tubing-related complications (port disconnection, tubing)
• Band leak
• Esophageal spasm
• Gastroesophageal reflux disease (GERD)
• Inflammation of the esophagus or stomach
• Port-site infection

Note: Complications may result in reoperations. Refer to the REALIZE™ Band Patient Guide for a full description of risks and side effects.

Side effects and discomfort

After surgery your body needs to adjust to the newly implanted Gastric Band. Your recovery experience may not be the same as other patients. Regurgitation, nausea, acid reflux, constipation, and diarrhea are typical. But abdominal pain that lasts more than three hours means that you should contact your surgeon right away or go to your local emergency room.

People who lose a lot of weight, regardless of the weight loss method, are at a high risk for developing gallstones. Surgery or other procedures may be necessary to remove the stones and/or gallbladder. There may be other side effects that are specific to you. You should report any unusual experiences to your surgeon.

• Pre-Surgery Consultation
• Doctors Fee
• Surgery fee
• Hospital room charges
• Nursing fee
• All medications required
• Post-Operative Follow Up

In addition to the cost of the surgery, you will need to be prepared for the following additional costs.

Stay
For this procedure you are required to stay in Bangkok for at least 15 days of which you will be spending the first 4 - 5 nights at the hospital, and then you can choose whether to stay in the serviced apartment at the hospital or a hotel outside until the post surgery follow up appointment 7 days after the surgery. Surgeon will allow you to fly only after the follow up appointment, and therefore you need to plan accordingly.

Serviced apartment at the Hospital : Piyavate hospital provides a serviced apartment manned 24/7 by registered Nurses within the hospital complex, with prices ranging from US$ 45 -  US$ 195 / night depending on the type of room you choose. 

Hotel: If you wish to stay in a Hotel outside the hospital it could cost you anywhere between US$ 40 - 300 / night depending on the hotel you choose. There are many Quality / Clean entry level hotels that offer rooms for as little as US$ 40 in the near vicinity of the hospital and the Up market hotels near the Sukhumvit (10 mins in taxi) or Silom (25 mins in taxi) Shopping districts, the rate could go as high as USD 300 / night. 

BMT Concierge Service : If you wish to have us arrange you received at the airport and arrange the round trip airport transfer, and Transfer to all of your appointments and the surgery by one of our patient co-coordinators, there will be an additional Fee of US$ 169 which is to be paid after you confirm the surgery plan.  This fees only applies if you choose our Concierge service. There are no additional fee if you choose only the  Surgery planning service.

All the fees due for the surgery has to be paid directly to the surgeon or the hospital before undergoing the procedure.  There are no fees to be paid to us apart from the fee for the Concierge service if you wish to have us arrange all of your transportation.

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