Lap-Band Failure and Removal

Unfortunately, lap band failure is common, and more than half of all patients eventually have their bands removed, the Cleveland Clinic reports. The problem with the band can be due to severe complications or lack of losing extra pounds. The removal procedure itself is very straightforward, and there are many options available for converting the band into another weight loss surgery.

Once the most popular weight loss procedure, gastric banding has become problematic and the dustbin of medical history!

Reasons for Lap-Band Removal

There are 10 common reasons that the band needs to be removed,

1. Patients don’t lose an adequate amount of weight (less than 25-30% of their excess weight);
2. Band slippage. This occurs when the lower portion of the stomach slips through the band, which creates a large pouch above the band. Fluid can be extracted from the band itself, or repositioning is required to repair it. If this isn’t effective, it should be taken out.
3. Difficulty swallowing. Dysphagia occurs from eating too quickly, not chewing food well, or eating too much. This can be avoided with proper eating patterns.
4. Band infection. If an infection cannot be healed with antibiotics, lap band elimination is necessary.
5. Band intolerance symptoms such as discomfort, pain, nausea, and/or vomiting.
6. GERD. This chronic condition can lead to reflux, damage to the esophagus, and heartburn.
7. Esophageal Dilatation or Dysmotility. This is when the esophagus can no longer move food from the mouth to the stomach effectively. Regurgitation of the food, pain, and difficulty swallowing may all occur due to this condition.
8. Pouch dilation. This involves the enlarging of the pouch that forms above the band. This can be fixed by extracting fluid from the band.
9. Port infection. This can occur in the abdomen at the port site. Lap band removal can be required if the problem becomes chronic or will not heal with antibiotics.
10. Band erosion. This can lead to a hole being worn away into the stomach, making the Lap-Band entirely ineffective.

About the Lap Band Removal Procedure

Generally, if the original surgery was performed laparoscopically, then the removal procedure will be performed the same way. In these instances, the removal can be quick and easy, depending on the patient’s complications. Usually, the surgery will take less than one hour (10 minutes to take out the band itself). The surgeon will eliminate all sutures and adhesions used during the initial surgery to help the stomach go back to its original state. The capsule the body has formed around the band will also be cut away. The band itself will be cut and pulled out from around the stomach and removed with the tube. The port will be removed through the incision in the same place it was inserted originally.

Weight gain is common after surgery as the stomach returns to a normal state. The loss of stomach restriction leads to increased feelings of hunger. This makes replacement surgery into another weight loss surgery popular for many patients.

Types of Revisional Surgeries Available

It is recommended that patients with a failed gastric band revise their initial procedure to a more effective weight loss surgery options, such as sleeve gastrectomy. The surgeon continues with the change over to a different bariatric procedure following the removal of the band.

There are occasions when the conversion cannot be performed in the same operation and the patient needs to wait three months before the revision.

Here are the gastric band corrective choices,

1. Rebanding – Some patients decide to replace their old band with a new one.
2. Conversion to gastric sleeve – Many patients switch their band with sleeve gastrectomy.
3. Conversion to Roux-en-y Gastric Bypass or Mini Gastric Bypass – Band to RNY gastric bypass or mini-bypass is a viable option after the gastric banding if you have GERD problems.
4. Conversion to Duodenal Switch – Duodenal switch (DS/BDP or SADI-S) is also available to patients who opt for this extensive surgical weight loss procedure.

A bariatric surgeon can help you decide if revisional surgery is for you. Certain factors come into play when deciding, including when and where the operation was performed, the patient’s weight loss history, any complications experienced after the first surgery, and the patient’s overall weight loss goals.

Lap Band Removal Surgery Complications

Reoperations are more technically challenging and they run a higher risk of complications post-surgery. Some lap band removal surgeries can lead to complications. For instance, intense inflammatory reactions around the stomach can occur, which can lead to major scarring. This can lead to difficulty removing the band and much more challenging recovery. Bleeding is also a major risk when this occurs (and with any surgery), and some patients may require a blood transfusion. A hole or perforation in the stomach can also occur. If this occurs, a drain tube will be placed adjacent to the perforation and kept in for an undisclosed period of time until the surgeon deems it safe to suture the area.

Some more common surgical complications include bleeding, infection, anesthesia complications, deep vein thrombosis, nausea, and vomiting. If a patient has worsening pain, persistent nausea or vomiting, a fever over 101, or redness around the incisions, consult the surgeon or a medical professional immediately.

Lap Band Removal Surgery Recovery

Patients generally wake up in a half-hour after surgery without pain. Narcotics from surgery should keep the patient comfortable and in and out of sleep. There may be some pain at the incision sites during the first night. The throat itself may be painful, sore, or dry. These are all common signs after general anesthesia. A few hours after surgery, you will be asked to walk a bit. This will help you get rid of the CO2 in the abdomen from surgery, leading to painful gas. It would help if you also urinated before leaving the hospital. Your IV will be discontinued, and you will go home. Most patients do not feel hungry on the day of surgery; however, if a patient is, they will only be allowed small sips of clear liquids.

Cost of Lap-Band Removal

Ordinarily, if a patient’s insurance paid for the lap band surgery, they will also pay for the removal surgery to rescue the initial procedure. If you do not have insurance, many surgeons offer an affordable rate for removal because of how often they occur and how quick the procedure is. The out-of-pocket average price for the band removal in the United States is $14,500. The cash price of band removal in Mexico is as low as $4,195.

Related: Discover the Costs of Various Weight Loss Procedures.

Resources: 

• A 10-year experience with laparoscopic gastric banding for morbid obesity: high long-term complication and failure rates. Obesity Surgery. “The failure rate increased from 13.2% after 18 months to 23.8% at 3, 31.5% at 5, and 36.9% at 7 years.”
• Lap-Band Surgery Failure (Study Article). ABC News. “Among 82 patients followed for at least 12 years after lap-band surgery at a single institution, 49 had at least one reoperation for complications or device failure, according to Dr. Jacques Himpens, of Saint Pierre University Hospital in Brussels, and colleagues.”