Lap Band Revision

Dr. R M Bonnor is a double board-certified surgeon serving the greater Houston area, including Katy, Cypress and Sugarland.

Lap Band revision is for patients who have experienced complications such as weight gain or band slippage with a current adjustable gastric band. Gastric banding was a widely practiced procedure for portion control.  But it has marginal long term results and it requires an implantation of a device.  Studies have shown that around 20-30% of Lap Band patients need a revision or removal within the first five years.[1] Another study found that around 30% deemed their results to be less than satisfactory.[2]  

Dr. Ricardo M Bonnor is a double board-certified surgeon who helps patients seeking to revise their lap band.  If you are interested in scheduling a one-on-one to discuss your options for adjustable gastric band revision, fill out this online form. To reach our offices directly, please call us at (281) 579-5638.

Possible Complications

Many factors can cause a gastric band to fail, leading to poor weight loss results and uncomfortable complications. Though rare, some symptoms of lap band failure can pose severe health risks. A properly placed band creates a small pouch just below the entrance to the stomach. Based on the band’s tightness, this smaller pouch reduces portions of ingested food and leads to subsequent weight loss. Or, at least, this is its intended purpose. Different complications can arise that force the band out of place, enlarge the pouch, or result in the band damaging the stomach.

Pouch Enlargement

Following around 12% of Lap Band procedures,[3] the fashioned pouch enlarges past the intended size. This complication can arise when patients continue to overeat after the Lap Band has failed to control portions. Pouch enlargement can also be caused by a band that is overinflated, causing the internal pressure to swell inside the pouch.   The stomach tissue’s flexible membrane dilates to a greater size, which may jeopardize the patient’s health. Noticeable side effects of pouch enlargement include lack of satiety, heartburn, regurgitation, and chest pain.

Band Slip

The most common major complication in gastric banding is band slippage, affecting around 5% of patients.[4] A Lap Band device can migrate from its original position, making the pouch bigger where the band slips lower, or smaller when it slides closer to the esophagus. This complication arises from improper placement, premature consumption of solid food after surgery, vomiting, overeating, or incorrect band tightness.[4] Band slippage can happen right after surgery or years down the road. Surgery is typically the only way to correct band slippage. Patients with band slippage may experience dysphagia (difficulty swallowing), vomiting, food intolerance, and regurgitation.

Band Erosion

Present in around 3% of Lap Band patients,[5] band erosion occurs when the gastric band’s tightness constricts blood vessels in the stomach tissue, damaging the organ’s outer wall.  While this condition is not necessarily life-threatening it can cause abdominal pain, acid reflux, and bowel obstruction. It may be hard to tell if you have band erosion as patients occasionally are asymptomatic.[6]  If you need a Lap Band revision is to contact our office at (281) 579-5638 and schedule a consultation with Dr. Bonnor.  

Lap Band to Gastric Sleeve

During a Lap Band to gastric sleeve procedure, Dr. Bonnor uses a robot assisted technique to remove the gastric band device through small incisions around the upper abdomen. Typically, he tries to use the same incision points as your initial surgery. Next, he places trocars in these incisions to place his surgical instruments through. Unlike Lap Bands that need eventual removal, alterations made during a gastric sleeve procedure are permanent. Instead of a pouch, a gastric sleeve gives patients a clearer symmetric digestive route, without the aforementioned complications. One study found that patients who underwent a sleeve gastrectomy to correct complications from Lap Band saw a 24% reduction in excess body weight.[7] 

Lap Band to Gastric Bypass

A Lap Band to gastric bypass procedure is recommended for those who have seen little weight loss, suffer metabolic conditions such as diabetes or have even gained weight after their Lap Band was placed. Much like with a gastric sleeve, Dr. Bonnor robotically creates a small portion of the stomach just below the esophageal opening. Next, he sutures this gastric pouch directly to a portion of the small intestine. Patients who undergo a Lap Band to gastric bypass revision procedure see dramatic improvement in symptoms including acid reflux and improvement in diabetes control with an 80% remission rate.

Frequently Asked Questions (FAQ)

Who is a good candidate for weight loss  surgery?

Adult patients are eligible for gastric surgery. Typically, bariatric procedures are reserved for patients with a BMI over 30 and more than one comorbidity. These include high blood pressure, cardiovascular disease, sleep apnea, and diabetes. 

How long do Lap Bands last?

Some patients experience complications within even the first few months.  Weight regain is a common complication that can happen years after a Lap Band procedure. This occurs when the band slips or loosens its grip around the stomach. Weight gain, vomiting, and regurgitation are common side effects of lap band slippage. Due to the overall marginal outcomes, this procedure has fallen out of favor among surgeons. Dr. Bonnor does not perform placement of the adjustable Lap Band system.

References

  1. Altieri, M.S., Yang, J., Telem, D.A. et al. Lap band outcomes from 19,221 patients across centers and over a decade within the state of New York. Surg Endosc 30, 1725–1732 (2016). https://doi.org/10.1007/s00464-015-4402-8
  2. Steffen R. (2008). The history and role of gastric banding. Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery, 4(3 Suppl), S7–S13. https://doi.org/10.1016/j.soard.2008.04.002
  3. Eid, I., Birch, D. W., Sharma, A. M., Sherman, V., & Karmali, S. (2011). Complications associated with adjustable gastric banding for morbid obesity: a surgeon’s guides. Canadian journal of surgery. Journal canadien de chirurgie, 54(1), 61–66. https://doi.org/10.1503/cjs.015709
  4. Sertkaya, M., Emre, A., Yazar, F. M., & Bülbüloğlu, E. (2016). Diagnosis and management of early gastric band slip after laparoscopic adjustable gastric banding. Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques, 11(2), 121–125. https://doi.org/10.5114/wiitm.2016.60237
  5. Chisholm, Jacob, et al. “Gastric Band Erosion in 63 Cases: Endoscopic Removal and Rebanding Evaluated.” Obesity Surgery, vol. 21, no. 11, 28 June 2011, pp. 1676–1681, cbc.org.br/wp-content/uploads/2013/07/02112011OBs.pdf, 10.1007/s11695-011-0468-0.
  6. Yun, G. Y., Kim, W. S., Kim, H. J., Kang, S. H., Moon, H. S., Sung, J. K., & Jeong, H. Y. (2016). Asymptomatic Gastric Band Erosion Detected during Routine Gastroduodenoscopy. Clinical endoscopy, 49(3), 294–297. https://doi.org/10.5946/ce.2016.001
  7. Khan, O.A., et al. “Sleeve Gastrectomy for Gastric Band Failures – a Prospective Study.” International Journal of Surgery, vol. 11, no. 5, June 2013, pp. 407–409, www.sciencedirect.com/science/article/pii/S1743919113000800, 10.1016/j.ijsu.2013.03.005
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