Lap Band Removal 

Though this weight loss device rose to considerable popularity several years ago, subsequent research has concluded that it is not as effective as other bariatric options, such as the gastric sleeve (VSG) . Not only that, but some complications from the device can be severe and debilitating. Even if a patient heels well after surgery, a lap band can become faulty years after the initial procedure.   

What’s Wrong With The Lap Band?

Lap band surgery, or adjustable gastric banding, is a type of weight loss surgery that became popular in the early 2000s. Lap band procedures grew in demand rapidly after their introduction to the U.S. market in 2001, but soon enough, they would be eclipsed by more effective, safer procedures that provide long-term success for the right candidates. The growing interest in more effective alternatives such as sleeve gastrectomy has led to a sharp decline in lap band procedures as patients find weight loss treatments that better suit their needs and expectations. 

Unlike the lap band, the sleeve does not involve prosthetic devices, which greatly reduces the likelihood of complications. Instead, surgeons reform the shape of the stomach to decrease its absorption of calories. ⁽¹⁾ The gastric bypass is another procedure in which surgeons create a smaller stomach pouch and make modifications to allow food to pass through a shorter length of the small intestine, allowing for less absorption as well. Unlike the lap band, the newly formed pouch is permanent and is much less likely to pose future problems with dilation- an issue in which the tissue stretches. Losing weight with the lap band is possible, but maintaining your results can be much more challenging. Not only does the band require somewhat frequent adjustments, but many individuals experience complications related to the band itself, including band slippage, port complications, infection around the port, dislocation, and band erosion into the stomach. Aside from these, weight regain is the most common issue in patients with the gastric band. ⁽²⁾ 

When To Remove Your Lap Band 

Even if you have had a positive experience with your lap band in the past, your body changes over time. If you have noticed any gastrointestinal symptoms, it is worth investigating the cause. Oftentimes, surgeons resolve issues of acid reflux and nausea by simply extracting some of the saline from the port to relax the pressure around the stomach pouch. Though this can be effective in some cases, if problems persist, a full lap band removal may be necessary. Much of the current research suggests that since the procedure’s inception almost 25 years ago, as many as 50% to 80% of patients will need to remove their lap band. ⁽³⁾ Here are some of the most common signs and symptoms that indicate you need to remove your lap band: 

Food Intolerance 

Food intolerance may be one of the first symptoms signaling an issue with the lap band. Your stomach may have issues digesting fatty foods, and your doctor may provide you with nutritional guidance to mitigate this. Still, discomfort with eating can be extremely bothersome and even lead to nutritional deficiencies. 

Pouch Dilation 

Pouch dilation, or pouch enlargement, is also called a type III prolapse. In this situation, the pouch overlying the band stretches and accommodates more food, and it can lead to weight regain. Patients may also lack feelings of satiation and experience heartburn, nausea, and chest pain. Pouch dilation is one of the leading causes of food intolerance. 

Band Slippage and Twisting

Band slippage indicates that the band migrated downward, restricting a greater portion of the stomach. In a type I prolapse, the anterior “front” of the stomach herniates over the band. In a type II prolapse, the posterior “back” of the stomach may protrude over the band. In some cases, the herniated portion of the stomach may twist over the band, even compromising blood supply. A type IV prolapse occurs immediately after a lap band procedure, while a type V prolapse is characterized by tissue necrosis after the initial prolapse. In these types of situations, patients may experience difficulty swallowing and more symptoms of food intolerance, but there may be pain as well. Catching such a complication early is essential for avoiding serious consequences; all prolapses require a procedure to reposition the band or remove it entirely. ⁽⁴⁾

Band Erosion 

Band erosion is not a prolapse caused by slippage, but the band erodes into the stomach lining. Unfortunately, band erosion can be symptomless, but in some cases, patients may experience abdominal pain, infection, and gastrointestinal bleeding. Complete band removal is required for individuals with this serious complication. 

Broken Port and/or Port Infection 

The port is the portion of the lap band device that remains just under the skin next to the navel, giving physicians the ability to add or remove saline to inflate or deflate the band. Sometimes, the port can cause infection or even break. The tubing from the port to the band may also experience damage. In many cases, port infections do not respond to antibiotics, so the quickest way to resolve them is through permanent removal. ⁽⁴⁾ 

Candidates 

If you are concerned about any of the above lap band complications, you are not alone. Thousands of patients who underwent the lap band procedure in the 2000s have followed up with the lap band removal procedure. You may be an ideal candidate if you have symptoms related to food intolerance, such as nausea or pain. If you have experienced weight regain since your initial surgery, you may be able to undergo a gastric bypass or sleeve gastrectomy to promote more effective weight loss.  

Lap Band Removal to Sleeve Gastrectomy or Gastric Bypass 

For those who want a more comprehensive treatment that eases their weight loss efforts and promotes remission of weight-related conditions, Dr. Bonnor can perform a sleeve gastrectomy or gastric bypass concurrently at the time of lap band removal.  

 To take the next step in your weight loss journey to attain a better quality of life and overall health, call (281) 579-5638 or fill out the Texas Endosurgery Associates contact form today. 

Commonly Asked Questions (FAQ)

References

1. Seeras K, Acho RJ, Prakash S. Laparoscopic Lap Band Placement. PubMed. Published 2021. https://www.ncbi.nlm.nih.gov/books/NBK526062/ 
2. Kowalewski PK, Olszewski R, Kwiatkowski A, Gałązka-Świderek N, Cichoń K, Paśnik K. Life with a Gastric Band. Long-Term Outcomes of Laparoscopic Adjustable Gastric Banding—a Retrospective Study. Obesity Surgery. 2016;27(5):1250-1253. doi:https://doi.org/10.1007/s11695-016-2435-2 
3. Falk V, Sheppard C, Kanji A, Birch D, Karmali S, de Gara C. The fate of laparoscopic adjustable gastric band removal. Canadian Journal of Surgery. 2019;6(5):328-333. doi:https://doi.org/10.1503/cjs.001918 
4. Eid I. Complications associated with adjustable gastric banding for morbid obesity: a surgeon’s guide. Canadian Journal of Surgery. 2011;54(1):61-66. doi:10.1503/cjs.015709