Patients who have the LAP-BAND system often require band adjustments especially during the first year post-operation. Typically during the first year the patient can expect an average of 3 to 4 adjustments that can be performed in our office. It is a simple and short (5 minutes) procedure that involves inserting a special small needle into the access port to fill the band system with saline. Radiology imaging is often required in order to find the access port or to optimize the adjustment. Dr Spivak is one of the few surgeons in the country who offers in-office fluoroscopy examination, a technique which uses x-rays to obtain real-time moving images to assure the correct fill of the band. Post-operative office visits, fluoroscopy examinations and band adjustments are included in the packages offered to our patients (see fee section).