Lap Band Corrective or Revision Surgery

BariBuzz

May 29, 2017

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Lap band revision surgery

It is necessary for unsuccessful weight loss or complications that require removal of the band.
Is usually performed as a single 2-stage procedure: band removal + new procedure
Includes 4 options: rebanding, convert to gastric sleeve, convert to gastric bypass, or convert to duodenal switch

When to Consider a revision

Unsuccessful Weight Loss:

“Unsuccessful” means different things to different surgeons, but in general a procedure is considered to be a failure if you lose 25% to 30% or less of your excess weight (in other words, if you’re 100 pounds overweight that would mean you lost 25 to 30 pounds or less). Complete success generally means 50% or more of excess weight lost.

Complications:

Problems that require lap band removal usually include one of the following complications, however, good bariatric doctors can often repair the problems without removing the band.

Band problems:
- Band erosion (2.1% – 9.5% of patients) – (also called “band migration”) occurs when the band actually grows into the stomach. The only treatment is permanent removal of the band. See our Lap Band Erosion page for more information.
- Band infection – (1.5% – 5.3% of patients) – if this occurs, it is usually healed with antibiotics, but removal of the band may be necessary.
- Band intolerance symptoms include excessive vomiting or a continuous feeling of discomfort. If these symptoms do not subside, removal of the band is the only option.
- Band slippage (2% – 18% of patients) – occurs when the lower part of the stomach “slips” through the band, creating a bigger pouch above the band. Either removing fluid (from the lap band) or surgical repositioning it is required to repair it, although band removal may be necessary.Symptoms include vomiting and reflux, and it’s diagnosed by drinking a dye and checking for leaks via X-Ray. The band placement technique used by the surgeon also makes a difference; between the perigastric technique (PGT) and the pars flaccida technique (PFT), the pars flaccida technique appears to have a much lower rate of slippage (up to 16% less often).

Lap Band Removal

Difficulty swallowing (also called “dysphagia”) is caused by eating too quickly, too much or not chewing food enough. While it can usually be avoided by addressing these issues, some patients’ bodies simply can’t get over this problem, in which case band removal is required.
Esophageal Dysmotility and/or Dilatation – as a result of the patient’s gastric band, the esophagus cannot move food from the mouth to the stomach as well as it should. Symptoms may include difficulty swallowing, regurgitation of food and/or pain.
Gastro-esophageal reflux disease (GERD) is a highly variable chronic condition that is characterized by periodic episodes of gastro-esophageal reflux usually accompanied by heartburn and that may result in histopathologic changes in the esophagus. It also often leads to esophagitis. GERD increases the risk of some bariatric surgery complications such as sepsis, but the condition is also improved for many patients following bariatric surgery.Several at-home treatments are effective, including avoiding certain foods and drinks (alcohol, citrus juice, tomato-based food and chocolate), waiting 3 hours before lying down after a meal, eating smaller meals and elevating your head 8 inches when you lay down. If these don’t work, your doctor may recommend/prescribe antacids to be taken after meals and before going to bed, H2 blockers or even Proton Pump Inhibitors (PPI). If the condition becomes too severe, it may require removal of the band.
Port infection (1.5% – 5.3% of patients) – can occur in your abdomen at the port site. It is usually healed with antibiotics, but removal of the band or port may be necessary.
Pouch dilation (4.4% of patients) – refers to the enlarging of the pouch created after lap band surgery. It can often be fixed by removing fluid from the band but sometimes requires re-operation.