In this article we determine the role of sonograms in the Lap-band adjustment process. The question is, do you need to have a sonogram each time your Lap-band is adjusted?

What is medical ultrasonography?

It’s pretty simple…sound in, sound out. The sound wave is produced by a piezoelectric transducer encased in a probe.  The frequencies can range anywhere between 2 and 18  megahertz, hundreds of times higher than the maximum range of human hearing at 16,384 hertz. A water-based gel is placed on the ceramic probe. The transducer wand is glided along the outside of the body over a centralized area or organ. Through it, sound waves travel into the body and come into focus at a desired depth as controlled by frequency adjustments. The sound wave is reflected from the layers between different types of tissues. The reflected sound waves return to the probe and vibrates the transducer. The transducer reads and turns the vibrations into electrical pulses that travel to the ultrasonic scanner where they are transformed into a digital image. High frequency ultrasound produces clearer images but can’t penetrate as deeply as low frequency ultrasound which sacrifices image clarity.

Sonograms are used to diagnose and monitor fatty liver disease


Most obese Americans suffer from some fatty infiltration of the liver. This is not a benign disease, and can lead to cirrhosis and the need for a liver transplant. The best thing you can do for this is to lose weight – congratulations, you have started on that journey. But often with ultrasound we can examine the liver and see how the fatty liver disease is doing.  It will also tell us how your diet has been. If you eat a lot of processed foods (white bread, white sugar, pasta, potatoes, cookies, deserts) it leads to more fat in the liver.

Using ultrasound to find the Lap-band fill port – why?

It can be difficult to locate a patient’s fill port prior to substantial weight loss. The port can be buried in body fat and until the patient loses extra flesh around their midriff the physician may be required to do a sonogram to find it.  But even with a lot of body fat, ultrasound is usually only required once or twice before the doctor learns the precise location of the port…that is if the same person does the fill every time.

Grasping the Lap-band fill port is a part of every adjustment

Every fill whether done after a sonogram or not requires the fill practitioner to grasp the fill port, steadying it between two fingers prior to the injection.  The fill port is conical, the top being much narrower than the base. Because of this, the fill practitioner can easily distinguish the top from the bottom and find the port at the center by touch. No sonogram is required when the fill port can be located this way. Again, the only time a sonogram is required is when the port is completely enveloped by flesh. This situation typically arises only for the first and possibly the second fill post-surgery or with a new patient from outside the practice. After the first one or two fills, a medical professional experienced with the patient typically will have no problem finding the fill port by touch.

You don’t have to have a sonogram every time you get a Lap-band fill…

…unless your insurance requires it, or you have fatty liver disease that we are monitoring. Why would you not want one? Time…without a sonogram, Dr. Simpson can get you in and out of the treatment room in less than fifteen minutes. Sonograms are lengthy, adding considerable time to the fill procedure. As we have explained, once the doctor knows you he doesn’t need a sonogram to find your port. In this case a sonogram does nothing to improve the quality and performance of  your fill. At the time of this writing, Dr. Simpson charges only $150 for a Lap-band Adjustment (a little more for those who did not get their surgery from our office). We strive to keep the maintenance costs of your Lap-band surgery low without compromise.