An adjustable Gastric Band infamously called the Lap-Band surgery, is a silicone inflatable band placed over a patient’s stomach. The purpose is to restrict how much a patient eats. This is a minimally invasive procedure performed laparoscopically with 3 to 5 small incisions.
Initially, it was believed that Lap-Band surgery is a popular reversible procedure that can help people with morbid obesity. However, new research pointed out the lap-band surgery was not effective because it is neither permanent nor a long-term solution like other bariatric procedures. Moreover, the technique led to many other complications like band slippage, erosion, discomfort, and inadequate weight loss.
ABC News revealed that 50 percent of all patients who underwent a lap-band surgery had to remove the gastric band because of complications.
Some common problems that patients experience after a lap-band surgery are:
Patients regret undergoing a lap-band surgery without knowing about its inadvertent complications and risks. Lap-band revision is more popular compared to other revision surgeries. However, there is a high chance of a revision or removal surgery in another 10 years.
Any revision surgery is risky because scar tissues build up. Tissues grow into the crevice of the gastric band, thus making removal even more difficult. Generally, the lap band can be revised into any other bariatric procedure in one operation. However, in case of the revision cannot be done in a single operation, the patient has to wait for at least 6 months after the band removal before going for another procedure.
Luckily, there are other options for revising the lap band, such as gastric sleeve and gastric bypass surgery.
When patients do not want to convert to an entirely new bariatric procedure. They want to stick to the lap band because of the weight loss they achieved. In that case, rebanding, or gastric band replacement, is the option. Here, the old gastric band is replaced with a new one.
Rebanding is an option when the existing band has either malfunctioned or some complications are involved. This was a regular procedure, but surgeons now recommend converting to the gastric sleeve to manage weight in the long run.
Gastric bands can be converted into the gastric sleeve. It is one of the most common revision surgeries performed in the world today. In this surgery, the silicone lap band is removed from the patient’s stomach completely and then 80 percent of the patient’s stomach is removed. The surgery is performed in one step. However, in some cases, a second surgery may be required.
The gastric band procedure has always been controversial because it causes extensive damage over time. The lap band that is installed inside the stomach is a silicone implant, which is difficult to remove completely. If the bariatric surgeon is inexperienced or unskilled, patients may have to go through a two-step revision. It takes six months to heal completely before converting to sleeve gastrectomy.
In case is individuals seek permanent gastric sleeve, it becomes burdensome. However, if you go to an experienced surgeon, the procedure would be easier and safer.
Gastric band to Roux-en-Y or Gastric Bypass surgery is performed as revision surgery for a failed gastric banding. As a first choice, patients can opt for gastric bypass as a solo procedure. If so, the surgeon would remove the gastric band with laparoscopic surgery before revising it to gastric bypass.
The second choice is to consider gastric bypass surgery combined with the existing gastric band to increase your chances of long-term weight loss. But there’s always greater risk involved in successful surgery. With this combination, there are some immediate complications, side effects, and risks involved.
Within one year, patients may lose up to 75% of excess weight with only gastric bypass surgery. This procedure is more complicated than gastric sleeve surgery that involves redirecting the patient’s small intestine after creating a smaller new pouch. This helps in achieving weight loss by using both restrictions as well as malabsorption. Even though this revision surgery is a popular option, it cannot be the first choice.
Patients can convert from lap-band to duodenal switch for greater weight loss. This is a more aggressive option compared to gastric bypass and gastric sleeve.
Even though this revision surgery is the best option, most bariatric surgeons don’t recommend the same.
An intraGastric Balloon is an ultimate option to revise a failed lap-band surgery. The balloon is endoscopically performed. So, it cannot be termed as surgery. It has to be performed separately after moving the band.
Gastric balloon, however, is a temporary procedure, not a long-term solution for weight loss. If you are just a little overweight or you are preparing the body for an effective procedure like gastric bypass or gastric sleeve, a gastric balloon may help.
The gastric balloon is more of a procedure for weight management. Patients should follow a strict diet with a regular exercise schedule to lose weight.
Final Word Regardless of the revision procedure you choose, give your body the time to prepare for another surgery. While revision is a requirement after 10 years of any bariatric procedure, discuss your options with the surgeon. It is very important to tailor a procedure for you, which may not be suitable for others.
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