Unfortunately lap band removal is common and as many as half of all patients eventually have their bands removed, whether for serious complications or for problems losing weight, the Cleveland Clinic reports. The surgical procedure itself is very straightforward and there are many options available for converting the band into another weight loss surgery.
Reasons for Lap Band Removal Surgery
- Patients don’t lose an adequate amount of weight (less than 25-30% of their excess weight);
- 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 removed from the band itself or repositioning is required in order to repair it. If this isn’t effectively, removal is necessary.
- Difficulty swallowing. Dysphagia occurs from eating too quickly, not chewing food well or by eating too much. This can be avoided with proper eating patterns.
- Band infection. If an infection cannot be healed with antibiotics, lap band removal is necessary.
- Band intolerance symptoms such as discomfort, pain, nausea and/or vomiting.
- GERD. This chronic condition can lead to reflux, damage to the esophagus and heartburn.
- 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 as a result of this condition.
- Pouch dilation. This involves the enlarging of the pouch that forms above the band. This can be fixed by removing fluid from the band.
- 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.
- 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 Surgery Procedure
Generally if the initial 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. Generally surgery will take less than one hour (10 minutes to remove the band itself). The surgeon will remove 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 back to a normal state. The loss of the stomach restriction leads to increased feelings of hunger. This makes revisional surgery into another weight loss surgery popular for many patients.
Types of Revisional Surgeries Available
- Rebanding. Many patients decide to remove their old band and replace it with a new one.
- Conversion to gastric sleeve.
- Conversion to Roux-en-y Gastric Bypass.
- Conversion to Duodenal Switch
A surgeon can help you decide if revisional surgery is for you. Certain factors come into play when making this decision including when the operation was performed, where the surgery was performed, the weight loss history of the patient, any complications experienced after the first surgery and the patient’s overall weight loss goals.
Lap Band Removal Surgery Complications
Because revisional operations are more technically challenging, 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 a much more difficult 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 will be kept in for an undisclosed period of time until the surgeon deems it safe to suture the area.
Some more common surgery 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 to get rid of the CO2 in the abdomen from surgery, which can lead to painful gas. You also must urinate before leaving the hospital. Your IV will be removed and you will go home. Most patients do not feel hungry at all the day of surgery, however if a patient is they will be allowed small sips of clear liquids only.
Cost of Lap-Band Removal
Generally if a patient’s insurance paid for the lap band surgery, they will also pay for the removal surgery or any revisional surgery procedure. If you do not have insurance, many surgeons have become offering an affordable rate for removal because of how often they occur and how quick the procedure is.
Related: Discover the Costs of Various Weight Loss Procedures.
- 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.”