No down time. I was able to travel home (3 hr car ride) same day. It's done during pouchoscopy in the endoscopy suite. Prep with Metamucil and Gatorade the night before, and clear liquids the day prior. They use propofol to put you to sleep during the procedure. Dr Shen will talk to you before and after to let you know what to expect.
He places tiny multiple bands. These are used to pinch the mucosa to form scar tissue to tighten up the problem area(s). There can be some pain and minor bleeding afterwards, and the bands will fall off themselves - you won't notice. I think of it as a facelift for the pouch.
He did explain in a later conversation that there is some risk that you lose some of the bands before they're able to be effective.
I had no pain after, no noticeable bleeding, and It definitely improved things for me. I communicated with several people on this site before I had it done and they had good results without any problems.
Banding can be repeated if the problem recurs or issue is not fully resolved after the first procedure. At least one person a I spoke with had it done twice, some years apart.
I need annual screening pouchoscopies. Dr Shen will do those for me and band at the same time should I need it.