Confidential Inquiry

*First Name:

*Last Name:

*Age:

*Phone Number:
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*Street Address:

*City

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*email:

Gender:

Height:
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Weight:
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BMI:

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What is Involved in This Study?

A thorough weight-loss surgery evaluation is performed by several specialists. Laboratory ("blood") and radiographic ("X-ray") evaluations are also performed. Certain questionnaires must be completed as part of the study.

All information collected is kept confidential; it is not given away or sold. Only physicians, clinicians, administrators or agencies which oversee patient safety will have access to your information.

The surgery typically involves:

  • 'Same day surgery', meaning, you leave the hospital hours after the surgery
  • General anesthesia: you will be asleep during the surgery
  • Laparoscopic or "minimally invasive" surgery: surgery is performed using five incisions that can be covered with dressings the size of postage stamps
  • A Gastric Band will be placed
    The Band is a soft inflatable ring that is placed around the top part of your stomach to reduce the amount of food it takes for you to feel "full". Soft, small tubing connects the Band to an adjustment port located deep beneath the skin of the left upper belly wall. The fit of the Band around the stomach is adjusted as needed, usually in minutes in the doctor's office.

Usually, you may return home within an hour or two after your surgery.

You will be evaluated each month for the first year after your band is placed, then eventually every 6 months; this will include occasional blood tests, questionnaires, and yearly X-rays. Your band may or may not need adjustment during these appointments. You may be seen at any time to address concerns you may have about your Band or your participation in the study.